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1

Long-Term Follow-up Results of Laparoscopic Pyeloplasty  

PubMed Central

Purpose To assess the long-term follow-up results of laparoscopic pyeloplasty for ureteropelvic junction obstruction. Materials and Methods Sixty-five patients (mean age, 43.8 years) who underwent standard laparoscopic pyeloplasty by transperitoneal approaches were enrolled in this study. The chief complaint was flank pain (n=57 patients); the remaining cases were detected incidentally. Twenty-three patients had undergone previous abdominal surgeries, including open pyeloplasty and endopyelotomy. Mean stricture length was 1.06 cm. Grade 3/4 and 4/4 hydronephrosis was detected in 36 and 14 patients, respectively. An obstructive pattern was present on the renal scan in 53 patients (81.5%). Results Fifty-seven patients were treated with dismembered Anderson-Hynes pyeloplasty and eight patients with Fenger pyeloplasty. During the operation, crossing vessels were found in 27 patients (41.5%). Mean operating time was 159.42 minutes. Although there were no cases of open conversion, two patients with colon and spleen injuries were detected postoperatively. The mean starting time of postoperative ambulation and diet was 1.54 days and 1.86 days, respectively. Mean hospital stay was 8.09 days. Mean follow-up period was 36.5 months. Follow-up intravenous pyelography and renal scan showed improvements in 59 patients, and the radiologic success rate was 90.8%. Eight patients showed failure on radiologic or symptomatic evaluation, and the overall success rate was 87.7%. In the comparative analysis between the success and failure groups, drained amount was the only risk factor related to failure (554.41 mL. vs. 947.70 mL, p=0.024). Conclusions Long-term follow-up results support laparoscopic pyeloplasty as the standard treatment for ureteropelvic junction obstruction. Drained amount is a risk factor for failure of the operation. PMID:25324948

Oh, Tae Hoon; Lee, Jae Whan

2014-01-01

2

Childhood sarcoidosis: long-term follow-up.  

PubMed

The aim of the present study was to describe clinical features and long-term survival in childhood sarcoidosis. In total, 46 ethnic Caucasian Danish children (aged <16 yrs, 24 males) with sarcoidosis were identified in 1979-1994. In 33 (72%) children, diagnosis was verified by histology and, in the remaining 13, by clinical and radiological findings. In total, 37 subjects had a follow-up examination. Median (range) age at onset of disease was 14 (0.7-15.8) yrs and median (range) clinical follow-up was 15 (3-23) yrs after onset of disease. The median (range) age at clinical follow-up was 28 (17-30) yrs. At follow-up: 36 (78%) children recovered completely; 30 (65%) showed complete clinical regression at a median (range) 0.7 (0.6-5.9) yrs after onset of disease; two (4%) recovered with organ damage (unilateral loss of vision, abnormal chest radiograph); five (11%) still had chronic active disease with multiorgan involvement and impaired lung function; and three (7%) were deceased, due to central nervous system sarcoidosis and acute myeloid leukaemia probably caused by cytostatics. In Danish children, sarcoidosis had a favourable prognosis; the majority recovered <6 yrs after onset of disease. Some developed chronic active disease and impairment of pulmonary function, demanding continuous medical treatment. Prognosis was not related to the age at onset of disease. Erythema nodosum was associated with a good prognosis, and central nervous system involvement with a poor prognosis. PMID:18057063

Milman, N; Hoffmann, A L

2008-03-01

3

Cherubism--a case report with long term follow up.  

PubMed

Cherubism is a rare non-neoplastic disease of the bone characterized by bilateral painless enlargement of the jaws giving a cherubic appearance to the patient. It is an autosomal dominant disorder but may occur sporadically. In this paper, we have tried to explain about the clinical, radiological and histopathologic features of cherubism by presenting a case study. A case study of a 7 year old male patient, who first presented with mandibular bilateral swellings to our department in 1998, has been presented. In-depth clinical, radiological and histopathologic examination was done. An extensive long-term follow-up till 11 years was maintained. When presented for the first time, radiological investigation showed characteristic multilocular lytic lesions of the mandible bilaterally. Histopathological examination of the biopsy specimen showed proliferating fibrous connective tissue interspersed by multinucleated giant cells. It was diagnosed as a case nonfamilial cherubism. Follow-up after 5 years showed involvement of the maxilla as well, which was then corrected by surgical methods. Upon follow up 11 years after the first presentation, it was seen that the lesion was regressing by itself and there was improvement in facial contour. The natural course of Cherubism through its progression, stabilization and involution of the disease after puberty, has been highlighted in this case. More, in-depth studies to understand the nature and the pathogenesis of this condition better are required. PMID:22234113

Chavali, Lakshmi V; Bhimalingam, R M Rao; Sudhakar, P V

2011-01-01

4

Long-Term Follow-Up of Iliac Wallstents  

SciTech Connect

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.

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

5

Multilevel radiofrequency for OSAS: Long-term follow-up  

Microsoft Academic Search

Objectives: To determine long-term effectiveness of multilevel (tongue and palate) temperature controlled radiofrequency tissue ablation (TCRFTA) for patients with obstructive sleep apnea syndrome (OSAS)Methods: Prospective series of 20 subjects with mild to moderate OSAS (AHI 10 to 30) and at least 1 year from completion of multilevel TCRFTA were included, representing a subset of 90 subjects enrolled in a previously

David L. Steward; Edward M. Weaver; B. Tucker Woodson

2004-01-01

6

Childhood sarcoidosis: long-term follow-up  

Microsoft Academic Search

The aim of the present study was to describe clinical features and long-term survival in childhood sarcoidosis. In total, 46 ethnic Caucasian Danish children (aged ,16 yrs, 24 males) with sarcoidosis were identified in 1979-1994. In 33 (72%) children, diagnosis was verified by histology and, in the remaining 13, by clinical and radiological findings. In total, 37 subjects had a

N. Milman; A. L. Hoffmann

2008-01-01

7

Lymphangioma. A long-term follow-up study.  

PubMed

At the Hospital for Sick Children 177 patients with lymphangioma, exclusive of those who had intra-abdominal lesions, were seen between 1927 and 1964. Forty-nine of these (aged 8 to 41 years) were available for follow-up examination. The results of treatment by surgical excision, aspiration, incision and drainage, and radiation are reported. No cases confirmed histologically as lymphangioma underwent spontaneous regression. Two histologically unconfirmed cases underwent partial regression. Four of the 11 who were left with lymphangioma tissue at operation never had significant recurrences. Therefore, this clinical study does not clarify the possible role of spontaneous regression in lymphangioma. Extensive surgery is the treatment of choice whenever feasible, but in unilocular or bilocular cystic lymphagnioma subsequent regression can be expected after palliative treatment (aspiration, or incision and drainage). Clinical and pathological criteria should be established for differentiation between lymphangioma and primary lymphedema. Lesions involving subepithelial, subdermal, and subcutaneous or internodal networks of lymphatics will produce lymphagioma; lesions of the collecting lymphatic trunks will result in lymphedema. PMID:1197438

Saijo, M; Munro, I R; Mancer, K

1975-12-01

8

Long-term follow-up of functioning after spinal surgery in patients with Rett syndrome  

Microsoft Academic Search

In a prospective study, 23 consecutive girls with Rett syndrome and neuromuscular scoliosis were evaluated for functioning\\u000a at a long-term follow-up. The patients had mostly improved, which was confirmed by their parents. Rett syndrome is associated\\u000a with neuromuscular scoliosis and has a typically long C-shaped thoracolumbar kyphoscoliosis. Prospective long-term follow-up\\u000a studies related to these patients’ total situation are sparse. Most

Eva-Lena Larsson; Stig Aaro; Peter Ahlinder; Helena Normelli; Hans Tropp; Birgitta Öberg

2009-01-01

9

Cochlear implantation and quality of life in postlingually deaf adults: Long-term follow-up  

Microsoft Academic Search

OBJECTIVE: To investigate long-term quality of life (QoL) in postlingually deaf adults after entering the cochlear implantation (CI) program. STUDY DESIGN AND SETTING: Follow-up study from 1998 onwards in tertiary university medical center. Long-term CI users, patients who have not received a CI, and relatively short-term CI users were re-evaluated six years after initial data collection in 1998 by using

Godelieve W. J. A. Damen; Andy J. Beynon; Paul F. M. Krabbe; Jef J. S. Mulder; Emmanuel A. M. Mylanus

2007-01-01

10

Long-term follow-up of informal caregivers after allo-SCT: a systematic review.  

PubMed

Currently, more than 40000 patients undergo allogeneic hematopoietic SCT (HSCT) annually throughout the world, and the numbers are increasing rapidly. Long-term survival after allogeneic-HSCT (allo-HSCT) has also improved significantly since its inception over 40 years ago due to improved supportive care and early recognition of long-term complications. In long-term follow-up after transplantation, the focus of care moves beyond cure of the original disease to late effects and quality of life. Nearly one-fourth of the long-term survivors are likely to have chronic consequences of HSCT, which require frequent help by caregivers, particularly informal caregivers such as spouses, partners or children. The physical and psychosocial consequences for patients undergoing HSCT have been extensively reported. There has, however, been far less investigation into the long-term follow-up of caregivers of HSCT recipients. This article provides an overview on addressing caregiver issues after HSCT. The rapidly growing population of long-term HSCT survivors creates an obligation not only to educate patients and physicians about the late complications observed in patients but also to follow up caregivers for their psychosocial support needs. PMID:22732697

Wulff-Burchfield, E M; Jagasia, M; Savani, B N

2013-04-01

11

Long-term follow-up of three individuals with Kabuki syndrome.  

PubMed

Long-term follow-up of three individuals with Kabuki syndrome indicates their phenotype becomes less striking as adults. It is characterized by short stature, obesity, and relatively large head. Long palpebral fissures persist, as does mild to moderate mental retardation. Independent daily living skills are achieved but a sheltered living environment is needed. PMID:14981723

Shalev, Stavit A; Clarke, Lorne A; Koehn, David; Langlois, Sylvie; Zackai, Elaine H; Hall, Judith G; McDonald McGinn, Donna M

2004-03-01

12

Career Program Completers, 1993-94: A Long-Term Follow-up Study.  

ERIC Educational Resources Information Center

This long-term follow-up study, conducted in the summer of 1998 by Johnson County Community College (JCCC, Kansas) focused on graduates, certificate recipients, and students identified by career program administrators as leaving with marketable skills in 1993-94. Since first administering this type of survey in 1989, JCCC has gained a broader…

Conklin, Karen A.

13

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

Microsoft Academic Search

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

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

1998-01-01

14

Long-term follow-up of aviators after functional endoscopic sinus surgery for sinus barotrauma.  

PubMed

Prior to endonasal endoscopic advances for the treatment of sinus disease, surgical results for aviators with recurrent sinus barotrauma (RSB) were inconsistent. Between 1988 and 1992, 54 aviators, who were permanently or temporarily grounded, underwent functional endoscopic sinus (FES) surgery in an attempt to return them to active flying status. Follow-up in the immediate postoperative period revealed that 98% of these aviators returned to active flight duty. A questionnaire was mailed to each of these aviators to compare their preoperative and long-term postoperative symptoms and determine their current flying status. Long-term follow-up time ranged from 20 to 72 mo with average of 48 mo. Of the aviators who responded to the survey, 92% have continued their flying duties and do not report difficulties with RSB. We conclude that FES surgery is effective in the short- and long-term management RSB in aviators. PMID:9383504

Parsons, D S; Chambers, D W; Boyd, E M

1997-11-01

15

Papillary Thyroid Carcinoma: Four Cases Required Caution during Long-Term Follow-Up  

PubMed Central

Due to the increased prevalence of papillary thyroid carcinoma (PTC), difficult cases and unexpected events have become more common during long-term follow-up. Herein we reported four cases that exhibited poor progress during long-term follow-up. All the cases were diagnosed with PTC and treated with total thyroidectomy before several years, and the patients had been newly diagnosed with recurrent and metastatic PTC. These four cases included recurred PTC with invasion of large blood vessels, a concomitant second malignancy, malignant transformation, and refractoriness to treatment. Physicians should closely monitor patients to promptly address unforeseen circumstances during PTC follow-up, including PTC recurrence and metastasis. Furthermore, we suggest that the development of a management protocol for refractory or terminal PTC is also warranted. PMID:24396700

Yu, Hea Min; Lee, Jae Min; Park, Kang Seo; Park, Tae Sun

2013-01-01

16

Long-term follow-up after callosotomy--A prospective, population based, observational study  

PubMed Central

Objective Analyze the long-term outcome of callosotomies with regard to seizure types and frequencies and antiepileptic drug treatment. Methods This longitudinal observational study is based on data from the prospective Swedish National Epilepsy Surgery Register. Thirty-one patients had undergone callosotomy in Sweden 1995–2007 and had been followed for 2 and 5 or 10 years after surgery. Data on their seizure types and frequencies, associated impairments, and use of antiepileptic drugs have been analyzed. Results The median total number of seizures per patient and month was reduced from 195 before surgery to 110 two years after surgery and 90 at the long-term follow-up (5 or 10 years). The corresponding figures for drop attacks (tonic or atonic) were 190 before surgery, 100 2 years after surgery, and 20 at the long-term follow-up. Ten (56%) of the 18 patients with drop attacks were free from drop attacks at long-term follow-up. Three of the remaining eight patients had a reduction of >75%. At long-term follow-up, four were off medication. Only one of the 31 patients had no neurologic impairment. Significance The present population-based, prospective observational study shows that the corpus callosotomy reduces seizure frequency effectively and sustainably over the years. Most improvement was seen in drop attacks. The improvement in seizure frequency over time shown in this study suggests that callosotomy should be considered at an early age in children with intractable epilepsy and traumatizing drop attacks. PMID:24372273

Stigsdotter-Broman, Lina; Olsson, Ingrid; Flink, Roland; Rydenhag, Bertil; Malmgren, Kristina

2014-01-01

17

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

Microsoft Academic Search

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

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

2008-01-01

18

Cognitive behaviour therapy for fatigued cancer survivors: long-term follow-up  

Microsoft Academic Search

An earlier randomised-controlled trial demonstrated the positive effects of cognitive behaviour therapy (CBT), especially designed for fatigued cancer survivors in reducing fatigue, functional impairments and psychological distress. In the current prospective study, we were able to examine the long-term effect of CBT in patients who completed the therapy. Predictors of fatigue severity at follow-up were exploratory investigated. Sixty-eight patients who

M. F. M. Gielissen; C. A. H. H. V. Verhagen; G. Bleijenberg

2007-01-01

19

Long-term follow-up of patients with chronic hepatitis B treated with interferon alfa  

Microsoft Academic Search

BACKGROUND & AIMS: Therapy with interferon alfa (IFN-alpha) leads to remission of disease in one third of patients with chronic hepatitis B. The aim of this study was to better define the long-term prognosis of this outcome.METHODS: One hundred three patients with chronic hepatitis B who underwent IFN-alpha therapy in three clinical trials between 1984 and 1991 were followed up

DT Lau; J Everhart; DE Kleiner; J Vergalla; P Schmid; JH Hoofnagle

1997-01-01

20

Congenital bilateral perisylvian syndrome with partial epilepsy. Case report with long-term follow-up  

Microsoft Academic Search

Congenital bilateral perisylvian syndrome (CBPS) is a rare neurological disorder characterised by pseudobulbar palsy, cognitive deficits and epilepsy associated with bilateral perisylvian cortical dysplasia on neuroimaging studies. We report a long-term follow-up of a 18-years girl diagnosed with CBPS according to the typical clinical and magnetic resonance imaging (MRI) features. The patient showed faciopharyngoglossomasticatory diplegia, severe dysarthria, ataxia, spastic quadriparesis

Margari Lucia; Presicci Anna; Ventura Patrizia; Buttiglione Maura; Andreula Cosma; Perniola Tommaso

2005-01-01

21

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

E-print Network

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...

Turnbull, Amy; Bronicki, G. J. Buzz

1987-01-01

22

Long-Term Follow-up of Uterine Artery Embolization for Symptomatic Adenomyosis  

SciTech Connect

Introduction: Long-term results of uterine artery embolization (UAE) for adenomyosis are largely unknown. We assess long-term outcome of UAE in 40 women with adenomyosis. Materials and methods: Between March 1999 and October 2006, 40 consecutive women with adenomyosis (22 in combination with fibroids) were treated with UAE. Changes in junction zone thickness were assessed with magnetic resonance imaging (MRI) at baseline and again at 3 months. After a mean clinical follow-up of 65 months (median 58 [range 38-129]), women filled out the uterine fibroid symptom and quality of life (UFS-QoL) questionnaire, which had additional questions on the long-term evolution of baseline symptoms and adverse events. Results: During follow-up, 7 of 40 women (18%) underwent hysterectomy. Among these 7 women, the junction zones were significantly thicker, both at baseline (mean 23 vs. 16 mm, P = 0.028) and at 3-month follow-up (mean 15 vs. 9 mm, P = 0.034). Of 33 women with preserved uterus, 29 were asymptomatic. Four patients had symptom severity scores of 50 to 85 and overall QoL scores of 60 to 66, indicating substantial clinical symptoms. There was no relation between clinical outcome and the initial presence of fibroids in addition to adenomyosis. Conclusion: In women with therapy-resistant adenomyosis, UAE resulted in long-term preservation of the uterus in the majority. Most patients with preserved uterus were asymptomatic. The only predictor for hysterectomy during follow-up was initial thickness of the junction zone. The presence or absence of fibroids in addition to adenomyosis had no relation with the need for hysterectomy or clinical outcome.

Smeets, A. J., E-mail: radiol@eztilburg.nl; Nijenhuis, R. J. [St. Elisabeth Ziekenhuis, Department of Radiology (Netherlands); Boekkooi, P. F.; Vervest, H. A. M. [St. Elisabeth Ziekenhuis, Department of Obstetrics and Gynecology (Netherlands); Rooij, W. J. van; Lohle, P. N. M. [St. Elisabeth Ziekenhuis, Department of Radiology (Netherlands)

2012-08-15

23

Yield of Screening for Long-Term Complications Using the Children's Oncology Group Long-Term Follow-Up Guidelines  

PubMed Central

Purpose The Children's Oncology Group Long-Term Follow-Up (COG-LTFU) Guidelines use consensus-based recommendations for exposure-driven, risk-based screening for early detection of long-term complications in childhood cancer survivors. However, the yield from these recommendations is not known. Methods Survivors underwent COG-LTFU Guideline–directed screening. Yield was classified as negligible/negative (< 1%), intermediate (? 1% to < 10%), or high (? 10%). For long-term complications with high yield, logistic regression was used to identify subgroups more likely to screen positive. Results Over the course of 1,188 clinic visits, 370 childhood cancer survivors (53% male; 47% Hispanic; 69% leukemia/lymphoma survivors; median age at diagnosis, 11.1 years [range, 0.3 to 21.9 years]; time from diagnosis, 10.5 years [range, 5 to 55.8 years]) underwent 4,992 screening tests. High-yield tests included thyroid function (hypothyroidism, 10.1%), audiometry (hearing loss, 22.6%), dual-energy x-ray absorptiometry scans (low bone mineral density [BMD], 23.2%), serum ferritin (iron overload, 24.0%), and pulmonary function testing/chest x-ray (pulmonary dysfunction, 84.1%). Regression analysis failed to identify subgroups more likely to result in high screening yield, with the exception of low BMD (2.5-fold increased risk for males [P = .04]; 3.3-fold increased risk for nonobese survivors [P = .01]). Screening tests with negligible/negative (< 1%) yield included complete blood counts (therapy-related leukemia), dipstick urinalysis for proteinuria and serum blood urea nitrogen/creatinine (glomerular defects), microscopic urinalysis for hematuria (hemorrhagic cystitis, bladder cancer), ECG (anthracycline-related conduction disorder), and hepatitis B and HIV serology. Conclusion Screening tests with a high yield are appropriate for risk groups targeted for screening by the COG-LTFU Guidelines. Elimination of screening tests with negligible/negative yield should be given consideration. PMID:23091100

Landier, Wendy; Armenian, Saro H.; Lee, Jin; Thomas, Ola; Wong, F. Lennie; Francisco, Liton; Herrera, Claudia; Kasper, Clare; Wilson, Karla D.; Zomorodi, Meghan; Bhatia, Smita

2012-01-01

24

Congenital bilateral perisylvian syndrome with partial epilepsy. Case report with long-term follow-up.  

PubMed

Congenital bilateral perisylvian syndrome (CBPS) is a rare neurological disorder characterised by pseudobulbar palsy, cognitive deficits and epilepsy associated with bilateral perisylvian cortical dysplasia on neuroimaging studies. We report a long-term follow-up of a 18-years girl diagnosed with CBPS according to the typical clinical and magnetic resonance imaging (MRI) features. The patient showed faciopharyngoglossomasticatory diplegia, severe dysarthria, ataxia, spastic quadriparesis and severe mental retardation. Brain MRI evidenced bilateral perisylvian cortical dysplasia. Since early life she suffered from complex febrile seizures and epilepsy consisting of complex partial attacks with affective manifestations associated with centro-temporal EEG abnormalities. During 18 years of follow-up she was treated with phenobarbital, carbamazepine, lamotrigine, gabapentin but did not show any significant clinical improvement. Subsequently, monotherapy with phenytoin (PHT) was followed by a significant clinical improvement. At age 17, because of adverse effects, PHT was gradually substituted by topiramate (TPM). Full control of seizures was obtained at the age of 17 years with TPM. EEG abnormalities throughout the years have been reduced according to the clinical course. These findings emphasised the importance of long-term follow-up, suggesting that the prognosis for epilepsy may not be predicted based on the early response to treatment or on the presence of structural encephalic abnormalities, as reported in the literature. PMID:15626542

Margari, Lucia; Lucia, Margari; Presicci, Anna; Anna, Presicci; Ventura, Patrizia; Patrizia, Ventura; Buttiglione, Maura; Maura, Buttiglione; Andreula, Cosma; Cosma, Andreula; Perniola, Tommaso; Tommaso, Perniola

2005-01-01

25

Multimorbidity and long-term care dependency--a five-year follow-up  

PubMed Central

Background Not only single, but also multiple, chronic conditions are becoming the normal situation rather than the exception in the older generation. While many studies show a correlation between multimorbidity and various health outcomes, the long-term effect on care dependency remains unclear. The objective of this study is to follow up a cohort of older adults for 5 years to estimate the impact of multimorbidity on long-term care dependency. Methods This study is based on claims data from a German health insurance company. We included 115,203 people (mean age: 71.5 years, 41.4% females). To identify chronic diseases and multimorbidity, we used a defined list of 46 chronic conditions based on ICD-10 codes. Multimorbidity was defined as three or more chronic conditions from this list. The main outcome was “time until long-term care dependency”. The follow-up started on January 1st, 2005 and lasted for 5 years until December 31st, 2009. To evaluate differences between those with multimorbidity and those without, we calculated Kaplan–Meier curves and then modeled four distinct Cox proportional hazard regressions including multimorbidity, age and sex, the single chronic conditions, and disease clusters. Results Mean follow-up was 4.5 years. People with multimorbidity had a higher risk of becoming care dependent (HR: 1.85, CI 1.78–1.92). The conditions with the highest risks for long-term care dependency are Parkinson’s disease (HR: 6.40 vs. 2.68) and dementia (HR: 5.70 vs. 2.27). Patients with the multimorbidity pattern “Neuropsychiatric disorders” have a 79% higher risk of care dependency. Conclusions The results should form the basis for future health policy decisions on the treatment of patients with multiple chronic diseases and also show the need to introduce new ways of providing long-term care to this population. A health policy focus on chronic care management as well as the development of guidelines for multimorbidity is crucial to secure health services delivery for the older population. PMID:24884813

2014-01-01

26

Long-Term Follow-Up of GH-Treated Girls with Turner Syndrome: Metabolic Consequences  

Microsoft Academic Search

Aims: To investigate the metabolic consequences of long-term GH treatment in young women with Turner syndrome (TS), several years after GH discontinuation. Methods: Follow-up study of a randomized GH dose-response trial, with 3 GH dosages (1.3, 2.0, and 2.7 mg\\/m2\\/day). Thirty-nine TS patients (20.0 ± 2.1 years) participated 4.8 ± 1.9 years after GH discontinuation. Mean GH treatment duration was

Ellen M. N. Bannink; Roel L. F. van der Palen; Paul G. H. Mulder; Sabine M. P. F. de Muinck Keizer-Schrama

2009-01-01

27

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

PubMed

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

Spreyermann, Regula; Michel, Franz

2014-01-15

28

Long-term follow-up of patients with adult-onset subacute sclerosing panencephalitis.  

PubMed

Subacute sclerosing panencephalitis (SSPE) is a rare infectious central nervous system disease with a poor prognosis. Nineteen patients, 18 males and one female, ranging in age from 18 to 22, mean 19.6+/-1.5 years with SSPE were evaluated. We treated 9 patients with oral isoprinosine and 10 patients with alpha-interferon plus oral isoprinosine and followed up for 16 to 160 months. Of the 9 patients treated with oral isoprinosine, 7 (77.7%) died, one stabilized, and one showed progression. Seven (70%) of 10 patients treated with alpha-interferon plus oral isoprinosine died, one showed progression, and stabilization was observed in two patients. Thus, we suggest that isoprinosine alone or in combination with intraventricular interferon did not change the prognosis in long-term follow-up periods. PMID:18783800

Eroglu, Erdal; Gokcil, Zeki; Bek, Semai; Ulas, Umit H; Ozdag, Mehmet F; Odabasi, Zeki

2008-12-15

29

Long-term follow-up of neurological manifestations in a boy with incontinentia pigmenti.  

PubMed

Incontinentia pigmenti (IP) is an X-linked dominant genodermatosis confined to females. It is usually lethal in males. However, the survival of some males has been reported in literature. We describe a long follow-up case of a 12-year-old male with IP and a normal karyotype but a genomic deletion of the NEMO gene in the Xq28 position in the form of somatic mosaicism. The patient showed severe ophthalmic abnormalities and neurological manifestations characterised by very mild cerebellar ataxia and a history of epilepsy that was severe at the beginning with West syndrome, become moderate overtime and is now resolved. Despite these neurological manifestations, probably related to the presence of at least some mutated cells in his brain, the long-term follow-up in this patient demonstrated good neurological and cognitive outcome. PMID:23652938

Margari, Lucia; Lamanna, Anna Linda; Buttiglione, Maura; Craig, Francesco; Petruzzelli, Maria G; Terenzio, Vanessa

2013-09-01

30

Predictors of Response Rates to a Long Term Follow-Up Mail out Survey  

PubMed Central

Objective Very little is known about predictors of response rates to long-term follow-up mail-out surveys, including whether the timing of an incentive affects response rates. We aimed to determine whether the timing of the incentive affects response rates and what baseline demographic and psychological factors predict response rates to a 12 year follow-up survey. Study design and setting: Participants were 450 randomly selected people from the Penrith population, Australia who had previously participated in a mail-out survey 12 years earlier. By random allocation, 150 people received no incentive, 150 received a lottery ticket inducement with the follow-up survey and 150 received a lottery ticket inducement on the return of a completed survey. Results The overall response rate for the study was 63%. There were no significant differences in terms of response rates between the no incentive (58.8%;95%CI 49.8%,67.3%), incentive with survey (65.1%;95%CI 56.2%,73.3%) and promised incentive (65.3%;95%CI 56.1%,73.7%) groups. Independent predictors of responding to the 12 year survey were being older (OR=1.02, 95%CI 1.01,1.05,P=0.001) and being less neurotic as reported on the first survey 12 years earlier (OR=0.92, 95%CI 0.86,0.98, P=0.010). Conclusions Psychological factors may play a role in determining who responds to long-term follow-up surveys although timing of incentives does not. PMID:24223902

Koloski, Natasha A.; Jones, Michael; Eslick, Guy; Talley, Nicholas J.

2013-01-01

31

Long-term Ultrasonographic Follow-up Study of Gastric Motility in Patients with Functional Dyspepsia  

PubMed Central

Although patients with functional dyspepsia complain of epigastric symptoms, the relation between these symptoms and gastric motility remains controversial. There are few reports on the clinical course of functional dyspepsia, including changes in gastric motility, observed over a considerably long period. We conducted a study to examine association between changes in symptoms and changes in ultrasonographically evaluated gastric motility over a long-term follow-up period in patients with functional dyspepsia. Forty patients (18 men, 22 women; mean age, 53.7 years) with functional dyspepsia were followed up by medical interview, physical examination, endoscopy, and ultrasonography for gastric motility. Follow-up ranged from 1.0 to 7.8 years (mean, 3.0 years). Ultrasonographic evaluation of gastric motility included gastric emptying rate and antral contractions. During the follow-up period, patients were treated with proton pump inhibitors, H2-blockers, or prokinetics. Symptoms improved in 21 patients (group A), but symptoms persisted or worsened in 19 patients (group B). There were no significant differences in clinical characteristics between the two groups. Gastric motility improved in group A but not in group B. In conclusion, improved gastric motility appears to correspond to and may explain improved symptoms in some patients with functional dyspepsia. PMID:18385832

Kamino, Daisuke; Manabe, Noriaki; Hata, Jiro; Haruma, Ken; Tanaka, Shinji; Chayama, Kazuaki

2008-01-01

32

Long-term health impacts of hematopoietic stem cell transplantation inform recommendations for follow-up  

PubMed Central

Advances in transplantation techniques and supportive care strategies have resulted in a significant improvement in survival of those who have undergone treatment. However, hematopoietic stem cell transplantation (HSCT) survivors are at risk of developing long-term complications, such as endocrinopathies, musculoskeletal disorders, cardiopulmonary compromise and subsequent malignancies. These complications have a direct impact on the morbidity and mortality experienced by HSCT survivors. Two-thirds of HSCT survivors develop at least one chronic health condition; while a fifth develop severe or life-threatening conditions. HSCT patients who have survived for at least 5 years post-transplantation are at a fourfold to ninefold increased risk of late mortality for as long as 30 years from HSCT, producing an estimated 30% lower life expectancy compared with the general population. The high burden of morbidity experienced by HSCT survivors makes it critically important that there is standardized follow-up of HSCT survivors at high risk for post-HSCT complications. The Center for International Blood and Marrow Transplant Research/European Group for Blood and Marrow Transplantation/American Society for Blood and Marrow Transplantation and the Children’s Oncology Group long-term follow-up guidelines offer such standardized care. Future steps include wider dissemination and refinement of these guidelines. PMID:21801135

Bhatia, Smita

2011-01-01

33

Long-term Follow-up of Patients After Antegrade Continence Enema Procedure  

PubMed Central

Background Antegrade continence enema (ACE) has become an important therapeutic modality in the treatment of intractable constipation and fecal incontinence. There are little data available on the long-term performance of the ACE procedure in children. Methods A retrospective review of patients who underwent the ACE procedure was conducted. Irrigation characteristics and complications were noted. Outcome was assessed for individual encounters based on frequency of bowel movements, incontinence, pain, and predictability. Results One hundred seventeen patients underwent an ACE. One hundred five patients had at least 6 months of follow-up, and were included in the analysis. Diagnoses included myelodysplasia (39%), functional intractable constipation (26%), anorectal malformations (21%), nonrelaxing internal anal sphincter (7%), cerebral palsy (3%), and other diagnoses (4%). The average follow-up was 68 months (range 7–178 months). At the last follow-up, 69% of patients had successful bowel management. Of the 31% of patients who did not have successful bowel management, 20% were using the ACE despite suboptimal results, 10% required surgical removal, and 2% were not using the ACE because of behavioral opposition to it. Patients were started on normal saline, but were switched to GoLYTELY (PEG-3350 and electrolyte solution) if there was an inadequate response (61% at final encounter). Additives were needed in 34% of patients. The average irrigation dose was 23 ± 0.7mL/kg. The average toilet sitting time was 51.7 ± 3.5minutes, with infusions running for 12.1 ± 1.2minutes. Stomal complications occurred in 63% (infection, leakage, and stenosis) of patients, 33% required surgical revision and 6% eventually required diverting ostomies. Conclusions Long-term use of the ACE gives successful results in 69% of patients, whereas 63% had a stoma-related complication and 33% required surgical revision of the stoma. PMID:21502828

Siddiqui, Anees A.; Fishman, Steven J.; Bauer, Stuart B.; Nurko, Samuel

2013-01-01

34

Long-Term follow up after intra-Uterine transfusionS; the LOTUS study  

PubMed Central

Background The Leiden University Medical Center (LUMC) is the Dutch national referral centre for pregnancies complicated by haemolytic disease of the fetus and newborn (HDFN) caused by maternal alloimmunization. Yearly, 20-25 affected fetuses with severe anaemia are transfused with intra-uterine blood transfusions (IUT). Mothers of whom their fetus has undergone IUT for HDFN are considered high responders with regard to red blood cell (RBC) antibody formation. Most study groups report high perinatal survival, resulting in a shift in attention towards short- and long-term outcome in surviving children. Methods/Design We set up a large long-term observational follow-up study (LOTUS study), in cooperation with the Sanquin Blood Supply Foundation and the LUMC departments of Obstetrics, Neonatology and ImmunoHematology & Bloodtransfusion. The first part of this study addresses several putative mechanisms associated with blood group alloimmunization in these mothers. The second part of this study determines the incidence of long-term neurodevelopment impairment (NDI) and associated risk factors in children treated with IUT. All women and their life offspring who have been treated with IUT for HDFN in the LUMC from 1987-2008 are invited to participate and after consent, blood or saliva samples are taken. RBC and HLA antigen profile and antibodies are determined by serologic or molecular techniques. Microchimerism populations are tested by real time polymerase chain reaction (RT PCR). All children are tested for their neurological, cognitive and psychosocial development using standardised tests and questionnaires. The primary outcome is neurodevelopmental impairment (NDI), a composite outcome defined as any of the following: cerebral palsy, cognitive or psychomotor development < 2 standard deviation, bilateral blindness and/or bilateral deafness. Discussion The LOTUS study includes the largest cohort of IUT patients ever studied and is the first to investigate post-IUT long-term effects in both mother and child. The results may lead to a change in transfusion policy, in particular future avoidance of certain incompatibilities. Additionally the LOTUS study will provide clinicians and parents better insights in the long-term neurodevelopmental outcome in children with HDFN treated with IUTs, and may improve the quality of antenatal counselling and long-term guidance. PMID:21122095

2010-01-01

35

The natural history of the rheumatoid shoulder: a prospective long-term follow-up study.  

PubMed

The purpose of this study was to evaluate the natural history of rheumatoid disease of the shoulder over an eight-year period. Our hypothesis was that progression of the disease is associated with a decrease in function with time. A total of 22 patients (44 shoulders; 17 women, 5 men, (mean age 63)) with rheumatoid arthritis were followed for eight years. All shoulders were assessed using the Constant score, anteroposterior radiographs (Larsen score, Upward-Migration-Index (UMI)) and ultrasound (US). At final follow-up, the Short Form-36, disabilities of the arm, shoulder and hand (DASH) Score, erythrocyte sedimentation rate and use of anti-rheumatic medication were determined. The mean Constant score was 72 points (50 to 88) at baseline and 69 points (25 to 100) at final follow-up. Radiological evaluation showed progressive destruction of the peri-articular structures with time. This progression of joint and rotator cuff destruction was significantly associated with the Constant score. However, at baseline only the extent of rotator cuff disease and the UMI could predict the Constant score at final follow-up. A plain anteroposterior radiograph of the shoulder is sufficient to assess any progression of rheumatoid disease and to predict functional outcome in the long term by using the UMI as an indicator of rotator cuff degeneration. Cite this article: Bone Joint J 2014;96-B:1520-4. PMID:25371467

van der Zwaal, P; Pijls, B G; Thomassen, B J W; Lindenburg, R; Nelissen, R G H H; van de Sande, M A J

2014-11-01

36

Intraventricular craniopharyngioma: a long-term follow-up of six cases.  

PubMed

Intraventricular craniopharyngiomas are rare tumours. They are wholly within the third ventricle and can be distinguished from suprasellar lesions which extend into the third ventricle by the presence of an intact floor of the third ventricle. They are attached to the wall of the third ventricle to a variable extent, most commonly in the region of the tuber cinereum. The long-term follow-up on six cases treated by one of the authors is presented. Headache and visual disturbance were the most common presenting features but, unlike the more common suprasellar lesions, symptomatic endocrine disturbances were not a common presenting feature. Total surgical removal can cause hypothalamic damage and the resulting morbidity can be serious and sometimes life-threatening. Subtotal removal followed by radiotherapy is probably the treatment of choice for these lesions. PMID:11013625

Davies, M J; King, T T; Metcalfe, K A; Monson, J P

1997-12-01

37

Short- and long-term surgical follow-up of the postbariatric surgery patient.  

PubMed

Follow-up of the large numbers of patients undergoing bariatric surgery poses problems for surgical programs and for internists who care for morbidly obese patients. Early surgical follow up is concentrated on the perioperative period to ensure healing and care for any surgical complications. It is especially important to treat persistent vomiting to avoid thiamine deficiency. Subsequently, monitoring weight loss and resolution of comorbidities assumes more importance. Identification and management of nutritional deficiencies and other unwanted consequences of surgery may become the responsibility of internists if the patient no longer attends the office of the operating surgeon. The long-term goal is to avoid weight regain and deficiencies, especially of protein, iron and vitamin B12, and calcium and vitamin D. Abdominal pain and gastrointestinal dysfunction should be investigated promptly to exclude or confirm such conditions as small bowel obstruction or gallstones. Good communication between bariatric surgeons and internal medicine specialists is essential for early and accurate identification of problems arising from bariatric surgery. PMID:20202586

Frank, Paul; Crookes, Peter F

2010-03-01

38

Heart-shaped anastomosis for Hirschsprung's disease: Operative technique and long-term follow-up  

PubMed Central

AIM: To study the long-term therapeutic effect of “heart-shaped” anastomosis for Hirschsprung’s disease. METHODS: From January 1986 to October 1997, we performed one-stage “heart-shaped” anastomosis for 193 patients with Hirschsprung’s disease (HD). One hundred and fifty-two patients were followed up patients (follow-up rate 79%).The operative outcome and postoperative complications were retrospectively analyzed. RESULTS: Early complications included urine retention in 2 patients, enteritis in 10, anastomotic stricture in 1, and intestinal obstruction in 2. No infection of abdominal cavity or wound and anastomotic leakage or death occurred in any patients. Late complications were present in 22 cases, including adhesive intestinal obstruction in 2, longer anal in 5, incision hernia in 2, enteritis in 6, occasional stool stains in 7 and 6 related with improper diet. No constipation or incontinence occurred in any patient. CONCLUSION: The early and late postoperative complication rates were 7.8% and 11.4% respectively in our “heart-shaped anastomosis” procedure. “Heart-shaped” anastomosis procedure for Hirschsprung’s disease provides a better therapeutic effect compared to classic procedures. PMID:15633236

Wang, Guo; Sun, Xiao-Yi; Wei, Ming-Fa; Weng, Yi-Zhen

2005-01-01

39

Long-term follow-up of inversion trauma of the ankle.  

PubMed

In our institution lateral ankle ligament injuries are classified into three grades according to the extent of instability found on physical examination and/or stress X-rays. Grade I and II lesions are taped, while treatment of grade III lesions consists of operative reconstruction of the ruptured ligaments. In 1989 we published the results of 1012 patients after 9 months' follow-up. About 30% had residual complaints. The nature and frequency of the complaints were equally divided among the three groups. To examine the long-term follow-up results, we conducted a retrospective study with the same group of patients after 6.5 years. Although ankle ligament injuries are still considered rather innocent lesions, we conclude that even after 6.5 years patients can still have residual complaints (pain, fear of giving-way, actual instability, swelling), which interfere with daily living and/or sport activities. The result deteriorated with time. This was especially prominent in the grade II group, where the percentage of poor and fair results doubled. The overall percentage of residual complaints was 39%. We conclude that there is no such thing as "a simple sprain". PMID:7734241

Verhagen, R A; de Keizer, G; van Dijk, C N

1995-01-01

40

Long term follow-up of four patients with Keutel syndrome.  

PubMed

Keutel syndrome (KS) [OMIM 245150] is an autosomal recessive hereditary syndrome characterized by multiple peripheral pulmonary stenoses (PPS), brachytelephalangia, inner ear deafness, and abnormal cartilage ossification or calcification. Mutations in the matrix Gla protein (MGP) gene have been reported in different unrelated families with KS previously. MGP is an extracellular matrix protein and calcification inhibitor; mutations in its encoding gene result in cartilage ossification or calcification, the main presenting feature of KS. This report describes the findings of four sisters with KS born to consanguineous parents were followed for 26 years in an irregular fashion. During follow-up of the patients over the years the complications appear to be mostly involving the respiratory system. Permanent skin rashes, papillary microcarcinoma of the thyroid, asthma, massive bullous pulmonary emphysema, severe systemic arterial hypertension, and short term memory loss were observed during long term follow-up. The fertility status of the patients were also observed and infertility was observed in one of three married patients. © 2014 Wiley Periodicals, Inc. PMID:25123378

Khosroshahi, H E; Sahin, S C; Akyuz, Y; Ede, H

2014-11-01

41

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

PubMed Central

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

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

2014-01-01

42

Long-term trajectories of back pain: cohort study with 7-year follow-up  

PubMed Central

Objective To describe long-term trajectories of back pain. Design Monthly data collection for 6?months at 7-year follow-up of participants in a prospective cohort study. Setting Primary care practices in Staffordshire, UK. Participants 228 people consulting their general practitioners with back pain, on whom information on 6-month back pain trajectories had been collected during 2001–2003, and who had valid consent and contact details in 2009–2010, were contacted. 155 participants (68% of those contacted) responded and provided sufficient data for primary analyses. Outcome measures Trajectories based on patients’ self-reports of back pain were identified using longitudinal latent class analysis. Trajectories were characterised using information on disability, psychological status and presence of other symptoms. Results Four clusters with different back pain trajectories at follow-up were identified: (1) no or occasional pain, (2) persistent mild pain, (3) fluctuating pain and (4) persistent severe pain. Trajectory clusters differed significantly from each other in terms of disability, psychological status and other symptoms. Most participants remained in a similar trajectory as 7?years previously (weighted ? 0.54; 95% CI 0.42 to 0.65). Conclusions Most people with back pain appear to follow a particular pain trajectory over long time periods, and do not have frequently recurring or widely fluctuating patterns. The results are limited by lack of information about the time between data collection periods and by loss to follow-up. However, findings do raise questions about standard divisions into acute and chronic back pain. A new framework for understanding the course of back pain is proposed. PMID:24334157

Dunn, Kate M; Campbell, Paul; Jordan, Kelvin P

2013-01-01

43

Long-term follow-up on Cushing disease patient after transsphenoidal surgery  

PubMed Central

Cushing disease is caused by excessive adrenocorticotropic hormone (ACTH) production by the pituitary adenoma. Transsphenoidal surgery is its first-line treatment. The incidence of Cushing disease in children and adolescents is so rare that long-term prognoses have yet to be made in most cases. We followed-up on a 16-year-old male Cushing disease patient who presented with rapid weight gain and growth retardation. The laboratory findings showed increased 24-hour urine free cortisol and lack of overnight cortisol suppression by low-dose dexamethasone test. The serum cortisol and 24-hour urine free cortisol, by high-dose dexamethasone test, also showed a lack of suppression, and a bilateral inferior petrosal sinus sampling suggested lateralization of ACTH secretion from the right-side pituitary gland. However, after a right hemihypophysectomy by the transsphenoidal approach, the 24-hour urine free cortisol levels were persistently high. Thus the patient underwent a total hypophysectomy, since which time he has been treated with hydrocortisone, levothyroxine, recombinant human growth hormone, and testosterone enanthate. Intravenous bisphosphonate for osteoporosis had been administered for three years. At his current age of 26 years, his final height had attained the target level range; his bone mineral density was normal, and his pubic hair was Tanner stage 4. This report describes the long-term treatment course of a Cushing disease patient according to growth profile, pubertal status, and responses to hormone replacement therapy. The clinical results serve to emphasize the importance of growth optimization, puberty, and bone health in the treatment management of Cushing disease patients who have undergone transsphenoidal surgery.

Jeong, Insook; Oh, Moonyeon; Kim, Ja Hye; Cho, Ja Hyang; Choi, Jin-Ho

2014-01-01

44

Long-term follow-up on Cushing disease patient after transsphenoidal surgery.  

PubMed

Cushing disease is caused by excessive adrenocorticotropic hormone (ACTH) production by the pituitary adenoma. Transsphenoidal surgery is its first-line treatment. The incidence of Cushing disease in children and adolescents is so rare that long-term prognoses have yet to be made in most cases. We followed-up on a 16-year-old male Cushing disease patient who presented with rapid weight gain and growth retardation. The laboratory findings showed increased 24-hour urine free cortisol and lack of overnight cortisol suppression by low-dose dexamethasone test. The serum cortisol and 24-hour urine free cortisol, by high-dose dexamethasone test, also showed a lack of suppression, and a bilateral inferior petrosal sinus sampling suggested lateralization of ACTH secretion from the right-side pituitary gland. However, after a right hemihypophysectomy by the transsphenoidal approach, the 24-hour urine free cortisol levels were persistently high. Thus the patient underwent a total hypophysectomy, since which time he has been treated with hydrocortisone, levothyroxine, recombinant human growth hormone, and testosterone enanthate. Intravenous bisphosphonate for osteoporosis had been administered for three years. At his current age of 26 years, his final height had attained the target level range; his bone mineral density was normal, and his pubic hair was Tanner stage 4. This report describes the long-term treatment course of a Cushing disease patient according to growth profile, pubertal status, and responses to hormone replacement therapy. The clinical results serve to emphasize the importance of growth optimization, puberty, and bone health in the treatment management of Cushing disease patients who have undergone transsphenoidal surgery. PMID:25346922

Jeong, Insook; Oh, Moonyeon; Kim, Ja Hye; Cho, Ja Hyang; Choi, Jin-Ho; Yoo, Han-Wook

2014-09-01

45

Outcomes and long term follow-up after emergent cricothyroidotomy: is routine conversion to tracheostomy necessary?  

PubMed

The purpose of this study is to identify factors associated with survival after cricothyroidotomy (CRIC), and to ascertain long-term outcomes in patients simply decannulated after CRIC versus those revised to tracheostomy. All CRICs between October 1, 1995 and June 20, 2010 were reviewed. Patients were contacted by phone, visited at their last known address, or queried in the Center for Disease Control's National Death Index. DECAN were those CRICs decannulated without revision. TRACH were those revised to a tracheostomy at any point. Ninety-five CRIC patients were identified. In 94 per cent of survivors of initial admission, a Glasgow Coma Score (GCS) of 15 was noted at disposition. Cardiopulmonary resuscitation before or during CRIC performance was strongly associated with all-cause death during index admission, and increasing head Abbreviated Injury Score was associated with lower odds of a neurologically intact survival. Of survivors, 82 per cent of DECAN and 57 per cent of TRACH patients were followed-up with at medians of 48 (interquartile range 19-57) and 53 (20-119) months, respectively. DECAN occurred at a median of 4 days (2-7) whereas TRACH revision occurred at a median of 2 days (1-7). Endoscopy was performed on 36 per cent of DECAN patients and 22 per cent of TRACH patients. Two DECAN patients with acute subglottic edema/stenosis decannulated successfully on days 9 and 15 postinjury and had no problems at 54 and 91 months postinjury. At follow-up, no patient in either group had suffered a clinically evident airway complication. The need for cardiopulmonary resuscitation before or during CRIC portends poorly for neurologically intact survival. Simple decannulation is appropriate for CRIC patients when their need for airway protection has resolved. PMID:22273235

Graham, David B; Eastman, Alexander L; Aldy, Kim N; Carroll, Elizabeth A; Minei, Joseph P; Brakenridge, Scott C; Phelan, Herb A

2011-12-01

46

High-dose cyclophosphamide for severe aplastic anemia: long-term follow-up  

PubMed Central

Severe aplastic anemia (SAA) is a life-threatening bone marrow failure disorder that can be treated with bone marrow transplantation, immunosuppressive therapy, and high-dose cyclophosphamide. Here, we report long-term follow-up on 67 SAA patients (44 treatment-naive and 23 refractory) treated with high-dose cyclophosphamide. At 10 years, the overall actuarial survival was 88%, the response rate was 71% with the majority being complete, and the actuarial event-free survival was 58% in 44 treatment-naive SAA patients. Patients with refractory SAA fared less well after high-dose cyclophosphamide therapy; at 10 years, overall actuarial survival, response, and actuarial event-free survival rates were 62%, 48%, and 27%, respectively. High-dose cyclophosphamide is highly effective therapy for severe aplastic anemia. Large randomized controlled trials will be necessary to establish how results of high-dose cyclophosphamide compare with either bone marrow transplantation or standard immunosuppressive regimens, such as antithymocyte globulin and cyclosporine. PMID:20018919

Chen, Allen R.; Dorr, Donna; Fuchs, Ephraim J.; Huff, Carol Ann; Luznik, Leo; Smith, B. Douglas; Matsui, William H.; Goodman, Steven N.; Ambinder, Richard F.; Jones, Richard J.

2010-01-01

47

Management of nucleus loss into the vitreous: long term follow up in 63 patients  

PubMed Central

Background: The aim of present study is to determine the long-term results of patients who undergo pars plana vitrectomy after retained nucleus into the vitreous. Setting: Service of Ophthalmology, Hospital Universitari St Joan, Reus (Barcelona), Spain. Methods: Retrospective, noncomparative, consecutive case series. Medical records were reviewed of all patients who underwent pars plana vitrectomy for retained nucleus into the vitreous after complicated cataract surgery, over a 9-year period between August 1, 1997 and July 31, 2005. Result: The incidence of retained lens fragments was 0.57% (63 patients), the postoperative visual acuity was higher than 20/40 in 59.60% and fell to 48.93% by the end of the study, and was related to the presence of CME and retinal detachment. The CME appeared in 31.91% of the patients and was related to preoperative uveitis an corneal edema. In the group of patients on whom the vitrectomy was performed at the time of cataract complication, visual acuity was higher than 20/40 in 77.77%, and no one developed secondary glaucoma or uveitis. Conclusion: Being retrospective, our study was not result conclusive. Despite the initial good results of these patients after PPV surgery, follow-up should be accurate and over a long period of time in order to minimize postoperative complications such as retinal detachment, retinal breaks, secondary glaucoma and CME. PMID:19668529

Romero-Aroca, Pedro; Fernandez-Ballart, Juan; Mendez-Marin, Isabel; Salvat-Serra, Merce; Baget-Bernaldiz, Marc; Buil-Calvo, Jose A

2007-01-01

48

[Long-term follow-up of wound healing following epikeratophakia in rabbits].  

PubMed

Epikeratophakia was performed on rabbit corneas using cryolathed keratolens and histological examinations were performed after long-term follow-up. On days 254 and 360 after the operation, pachymetry was performed, and corneas were excised, labeled with 3H-proline (10 muCi/ml) in DME for 4 hours, fixed by 2% glutaraldehyde and analyzed histologically using light and electron microscopy and by autoradiography. The results of pachometry revealed that postoperative increases of the corneal thickness on days 254 and 360 were both smaller than the expected value, 350 microns. However, on days 254 and 360, collagen fibril density (CFD) in the keratolens stroma to 95% and 99% of that of the control cornea (264 +/- 16/microns2). On day 254, activated keratocytes with well developed rough endoplasmic reticulum which were suggestive of active collagen production and keratocytes with extended pseudopoidia that suggested phagocytic activity were observed in the keratolens stroma. On day 360, most keratocytes in the keratolens stroma revealed a normal shape. In the epithelium over the keratolens, poor differentiation of basal cells and irregularity or lack of basement membrane were still observed. At both postoperative periods, the endothelium showed no remarkable morphologic abnormality on histological analysis under light and electron microscopy. These findings and the results of our previous study indicated that the reconstruction of the keratolens stroma continued for about one year postoperatively and complete healing after epikeratophakia including epithelial repair needs more than one year. PMID:2403042

Sahori, A

1990-06-01

49

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

SciTech Connect

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.

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

1994-11-15

50

Long-Term Follow-Up After Endovascular Treatment of Acute Aortic Emergencies  

SciTech Connect

Purpose. To investigate the long-term outcome and efficacy of emergency treatment of acute aortic diseases with endovascular stent-grafts. Methods. From September 1995 to April 2007, 37 patients (21 men, 16 women; age 53.9 {+-} 19.2 years, range 18-85 years) with acute complications of diseases of the descending thoracic aorta were treated by endovascular stent-grafts: traumatic aortic ruptures (n = 9), aortobronchial fistulas due to penetrating ulcer or hematothorax (n = 6), acute type B dissections with aortic wall hematoma, penetration, or ischemia (n = 13), and symptomatic aneurysm of the thoracic aorta (n = 9) with pain, penetration, or rupture. Diagnosis was confirmed by contrast-enhanced CT. Multiplanar reformations were used for measurement of the landing zones of the stent-grafts. Stent-grafts were inserted via femoral or iliac cut-down. Two procedures required aortofemoral bypass grafting prior to stent-grafting due to extensive arteriosclerotic stenosis of the iliac arteries. In this case the bypass graft was used for introduction of the stent-graft. Results. A total of 46 stent-grafts were implanted: Vanguard/Stentor (n = 4), Talent (n = 31), and Valiant (n = 11). Stent-graft extension was necessary in 7 cases. In 3 cases primary graft extension was done during the initial procedure (in 1 case due to distal migration of the graft during stent release, in 2 cases due to the total length of the aortic aneurysm). In 4 cases secondary graft extensions were performed-for new aortic ulcers at the proximal stent struts (after 5 days) and distal to the graft (after 8 months) and recurrent aortobronchial fistulas 5 months and 9 years after the initial procedure-resulting in a total of 41 endovascular procedures. The 30-day mortality rate was 8% (3 of 37) and the overall follow-up was 29.9 {+-} 36.6 months (range 0-139 months). All patients with traumatic ruptures demonstrated an immediate sealing of bleeding. Patients with aortobronchial fistulas also demonstrated a satisfactory follow-up despite the necessity for reintervention and graft extension in 3 of 6 cases (50%). Two patients with type B dissection died due to mesenteric ischemia despite sufficient mesenteric blood flow being restored (but too late). Two suffered from neurologic complications, 1 from paraplegia and 1 from cerebral ischemia (probably embolic), 1 from penetrating ulcer, and 1 from persistent ischemia of the kidney. Five of 9 (56%) patients with symptomatic thoracic aneurysm demonstrated endoleaks during follow-up and there was an increase in the aneurysm in 1. Conclusion. Endovascular treatment is safe and effective for emergency treatment of life-threatening acute thoracic aortic syndromes. Results are encouraging, particularly for traumatic aortic ruptures. However, regular follow-up is mandatory, particularly in the other pathologies, to identify late complications of the stent-graft and to perform appropriate additional corrections as required.

Pitton, M. B., E-mail: pitton@radiologie.klinik.uni-mainz.de; Herber, S. [University Hospital of Mainz, Johannes Gutenberg University of Mainz, Department of Diagnostic and Interventional Radiology (Germany); Schmiedt, W.; Neufang, A.; Dorweiler, B. [University Hospital of Mainz, Johannes Gutenberg University of Mainz, Department of Cardiovascular Surgery (Germany); Dueber, C. [University Hospital of Mainz, Johannes Gutenberg University of Mainz, Department of Diagnostic and Interventional Radiology (Germany)

2008-01-15

51

Anemia after gastrectomy for early gastric cancer: Long-term follow-up observational study  

PubMed Central

AIM: To identify the incidence and etiology of anemia after gastrectomy in patients with long-term follow-up after gastrectomy for early gastric cancer. METHODS: The medical records of those patients with early gastric adenocarcinoma who underwent curative gastrectomy between January 2006 and October 2007 were reviewed. Patients with anemia in the preoperative workup, cancer recurrence, undergoing systemic chemotherapy, with other medical conditions that can cause anemia, or treated during follow up with red cell transfusions or supplements for anemia were excluded. Anemia was defined by World Health Organization criteria (Hb < 12 g/dL in women and < 13 g/dL in men). Iron deficiency was defined as serum ferritin < 20 ?g/dL. Vitamin B12 deficiency was defined as serum vitamin B12 < 200 pg/mL. Iron deficiency anemia was defined as anemia with concomitant iron deficiency. Anemia from vitamin B12 deficiency was defined as megaloblastic anemia (mean cell volume > 100 fL) with vitamin B12 deficiency. The profile of anemia over 48 mo of follow-up was analyzed. RESULTS: One hundred sixty-one patients with gastrectomy for early gastric cancer were analyzed. The incidence of anemia was 24.5% at 3 mo after surgery and increased up to 37.1% at 48 mo after surgery. The incidence of iron deficiency anemia increased during the follow up and became the major cause of anemia at 48 mo after surgery. Anemia of chronic disease and megaloblastic anemia were uncommon. The incidence of anemia in female patients was significantly higher than in male patients at 12 (40.0% vs 22.0%, P = 0.033), 24 (45.0% vs 25.0%, P = 0.023), 36 (55.0% vs 28.0%, P = 0.004), and 48 mo (52.0% vs 31.0%, P = 0.022) after surgery. Patients with total gastrectomy showed significantly higher incidence of anemia than patients with subtotal gastrectomy at 48 mo after surgery (60.7% vs 31.3%, P = 0.008). The incidence of iron deficiency was significantly higher in female patients than in male patients at 6 (35.4% vs 13.3%, P = 0.002), 12 (45.8% vs 16.8%, P < 0.001), 18 (52.1% vs 22.3%, P < 0.001), 24 (60.4% vs 20.9%, P < 0.001), 36 (62.5% vs 29.2%, P < 0.001), and 48 mo (66.7% vs 34.7%, P = 0.001) after surgery. CONCLUSION: Anemia was frequent after gastrectomy for early gastric cancer, with iron deficiency being the major cause. Evaluation for anemia including iron status should be performed after gastrectomy and appropriate iron replacement should be considered. PMID:23155340

Lim, Chul-Hyun; Kim, Sang Woo; Kim, Won Chul; Kim, Jin Soo; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Choi, Myung-Gyu; Song, Kyo-Young; Jeon, Hae Myung; Park, Cho-Hyun

2012-01-01

52

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

PubMed

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

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

2012-01-01

53

Long-term follow-up of a novel anastomotic device in a canine model.  

PubMed

Construction of intestinal anastomosis is a fundamental general surgery skill. New constraints in creating safe, effective anastomoses are faced, however, even as minimally invasive surgery techniques continue to gain popular and scientific support. We present our experience in developing and testing a novel anastomotic device (AD) constructed of a shape memory metal, with long-term follow-up in a canine model. This device has the potential for both laparoscopic and endoscopic delivery because of its unique design and adaptable deployment system. Eight canines had gastroduodenal and jejunojejunal anastomoses formed with the AD: the gastroduodenal anastomosis by transecting the stomach immediately distal to the pylorus and forming a side-to-side functional end-to-end anastomosis and the jejunojejunal anastomosis similarly following transection in the mid-jejunum. Four animals were survived for 6 months, and 4 for 12 months. At the study's end, the animals were euthanized and the anastomotic sites harvested for both gross and microscopic pathology. Two animals developed postoperative complications: one a mechanical bowel obstruction from bedding ingestion that required laparotomy, and one an ileus that conservative management resolved. All animals survived to their endpoints, displaying normal growth and development. All jejunojejunal anastomoses had AD passage and microscopic evidence of complete healing. Meanwhile, none of the gastroduodenal devices passed, with microscopy demonstrating incomplete mucosalization. This AD is highly effective in forming jejunojejunal anastomoses. Gastroduodenal anastomoses, while highly functional, retained the device without complete healing. Future studies using a more human-like animal model and an anastomotic technique avoiding the thick pylorus muscle should yield better results. PMID:24752074

Park, Adrian; Lee, Tommy H; Kavic, Stephen M

2014-04-01

54

Long term follow up of patients with endomyocardial fibrosis: effects of surgery  

PubMed Central

Aims—To determine the long term outcome of patients with endomyocardial fibrosis and to compare echocardiographic and haemodynamic data before and after ventricular endocardial resection.?Patients—Seventeen patients (11 women and six men; mean age 35.5 years) diagnosed with endomyocardial fibrosis at the University Hospital in Zurich, Switzerland from 1971 to 1995. Twelve patients (70%) had partial obliteration of both ventricles and in five patients (30%) the fibrotic lesions were limited to the left ventricle. ?Methods—Fourteen of the 17 patients had surgical resection: fibrosis was resected from both ventricles in five patients and from the left ventricle only in nine patients. Ten patients had mitral valve replacement and two had tricuspid valve replacement. Left ventricle endocardial resection was done without reconstruction or replacement of the atrioventricular valve in three patients. Preoperative and postoperatve echocardiographic data were available for 11 patients and haemodynamic data for six patients. Patients were followed up for 0.4-19 years (mean 8.6).?Results—Preoperatively four patients were NYHA functional class IV and 10 were class III; postoperatively one patient was class III, seven class II, and six class I. Preoperatively, echocardiography showed obliteration of the left ventricular apex and inflow tract in all patients, which decreased or disappeared after surgery. Left ventricular end diastolic pressure decreased from 25 mm Hg before surgery to 14 mm Hg after successful resection of the fibrosis. Left ventricular end diastolic volume (normal 93 (17) ml/m2) increased from 65 ml/m2 to 97 ml/m2 (p < 0.05) after surgery. Ejection fraction was normal preoperatively (57%) and decreased slightly (52%) after surgery. One patient died five months after surgery from heart failure. Four surgically treated patients died during the follow up period: one each from systolic dysfunction, recurrence of endomyocardial fibrosis, pneumonia, and food poisoning. Overall survival was 65% at five years and 59% at 10 years; the survival rates of the operated patients was 72% and 68%, respectively. Only one of the medically treated patients survived longer than three years from diagnosis.?Conclusions— Endomyocardial fibrosis is a rare disease in European countries and is found mainly in women. The clinical picture is characterised by severe congestive heart failure but heart size is only moderately increased. Systolic performance is normal or only slightly depressed despite severe restriction to filling, atrioventricular valve regurgitation or both. Partial obliteration of the right and/or left ventricle may be detected by echocardiography. Endocardial resection with atrioventricular valve replacement is the treatment of choice with appreciable postoperative improvement and 10 year survival of approximately 70%.?? Keywords: endomyocardial fibrosis;  atrioventricular valve regurgitation;  endocardial resection;  hypereosinophilic syndrome PMID:9616343

Schneider, U; Jenni, R; Turina, J; Turina, M; Hess, O

1998-01-01

55

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

Microsoft Academic Search

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

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

2004-01-01

56

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

Microsoft Academic Search

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

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

2007-01-01

57

Paranoid (Delusional) Disorders in the Light of a Long-Term Follow-Up Study  

Microsoft Academic Search

A large sample of first-admitted hospitalized patients with delusional psychoses were personally followed up after a mean of 10 and 30 years. At last follow-up 42% showed good overall functioning and 44% were in ordinary work. Patients with affective disorder according to DSM-III had most homogeneous and favorable outcome, while a striking heterogeneity of outcome was noticed in schizophrenia, schizophreniform

Stein Opjordsmoen

1991-01-01

58

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

PubMed

SUMMARY 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

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

2014-10-01

59

Long-Term Follow-Up After First Acute Episode of Sigmoid Diverticulitis: Is Surgery Mandatory?  

Microsoft Academic Search

PURPOSE: This study was designed to evaluate the long-term natural history of sigmoid diverticulitis in patients treated nonoperatively after a first acute episode and to assess the role of elective colectomy. METHODS: Between 1986 and 1991, 144 patients were admitted for acute diverticulitis diagnosed by abdominal computed tomography and had a successful nonoperative treatment. Remote complications (persisting or recurring diverticulitis)

R. C. Chautems; P. Ambrosetti; A. Ludwig; B. Mermillod; Ph. Morel; C. Soravia

2002-01-01

60

Early infantile epileptic encephalopathy: a long-term follow-up study  

Microsoft Academic Search

The authors describe the eletroclinical aspects and long-term evolution of five (in one male and four female patients) cases of early infantile epileptic encephalopathy. In the neonatal period, the most common seizures were tonic spasms (either generalized or lateralized) that, very often, occurred in series. All newborns showed the typical suppression-burst pattern. The neurological status (initially normal) progressively deteriorated in

A. Verrotti; S. Domizio; G. Sabatino; G. Morgere

1996-01-01

61

Long-term histological follow-up of genetically modified myoblasts grafted into the brain  

Microsoft Academic Search

Although primary muscle cells have been used as intracerebral vehicles for transgene expression in the past, data concerning their long-term survival after grafting into the brain, and the reaction of the host tissue to their implantation are lacking. In order to study these aspects, we have implanted, into the brain, primary muscle cells infected ex vivo with recombinant retroviruses carrying

F Lisovoski; J. P Wahrmann; J. C Pages; J Cadusseau; M Rieu; A Weber; A Kahn; M Peschanski

1997-01-01

62

Flexible bronchoscopic management of benign tracheal stenosis: long term follow-up of 115 patients  

Microsoft Academic Search

BACKGROUND: Management of benign tracheal stenosis (BTS) varies with the type and extent of the disease and influenced by the patient's age and general health status, hence we sought to investigate the long-term outcome of patients with BTS that underwent minimally invasive bronchoscopic treatment. METHODS: Patients with symptomatic BTS were treated with flexible bronchoscopy therapeutic modalities that included the following:

Nader Abdel Rahman; Oren Fruchter; David Shitrit; Benjamin D Fox; Mordechai R Kramer

2010-01-01

63

Long-term follow-ups of revascularized immature necrotic teeth: three case reports  

PubMed Central

Revascularization of immature necrotic teeth is a reliable treatment alternative to conventional apexogenesis or apexification. In case 1, a 12-year-old boy had his necrotic, immature mandibular left second premolar treated with a revascularization technique. At a 24-month follow-up, periapical radiolucency had disappeared and thickening of the root wall was observed. In cases 2 and 3, a 10-year-old boy had his necrotic, immature, bilateral mandibular second premolars treated with the same modality. At 48-month (in case 2) and 42-month (in case 3) follow-ups, loss of periapical radiolucencies and increases in the root wall thickness were also observed. PMID:22627612

Kim, Duck-Su; Park, Hae-Jin; Yeom, Je-Ha; Seo, Ji-Sung; Ryu, Gil-Joo; Park, Ki-Ho; Shin, Seung-Il; Kim, Sun-Young

2012-01-01

64

Long-term follow-up of extremely low birth weight infants with neonatal renal failure  

Microsoft Academic Search

The long-term outcome of 20 preterm infants with extremely low birth weight and acute renal failure in the neonatal period was studied retrospectively over an 18-year period. Those with progressive renal disease are compared with those with normal renal function. Current mean age is 7.5±4.6 years (range 3.2–18.5 years). Nine patients showed deterioration in renal function (low GFR group). Increasing proteinuria, as

Carolyn L. Abitbol; Charles R. Bauer; Brenda Montané; Jayanthi Chandar; Shahnaz Duara; Gastón Zilleruelo

2003-01-01

65

Tick-borne encephalitis—pathogenesis, clinical course and long-term follow-up  

Microsoft Academic Search

The prospective studies available today confirm the experience gained from several retrospective studies that TBE is a disease with a severe acute clinical course and considerable long-term morbidity. A defined post-encephalitic TBE syndrome exists, causing long-lasting morbidity that often affects the quality of life and sometimes also forces the individual to a change in life-style. The sequelae render high costs

Mats Haglund; Göran Günther

2003-01-01

66

Long-term follow-up and patient satisfaction after surgery for thoracic outlet syndrome  

Microsoft Academic Search

The purpose of this study was to review the long-term outcomes, particularly patient satisfaction, of patients surgically\\u000a treated for thoracic outlet syndrome (TOS). All patients who had undergone surgery for TOS at the University of Iowa Hospitals\\u000a and Clinics between 1988 and 1999 were reviewed. A retrospective chart review of 29 patients (36 operations) was performed.\\u000a In addition, 20 (69%)

W. John Sharp; Lisa R. Nowak; Tanveer Zamani; Timothy F. Kresowik; Jamal J. Hoballah; Beth A. Ballinger; John D. Corson

2001-01-01

67

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

ERIC Educational Resources Information Center

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,…

Fujinaga, Tamotsu; And Others

68

Long-term follow-up of autologous stem cell transplantation for refractory juvenile idiopathic arthritis  

Microsoft Academic Search

Since 1997, autologous stem cell transplantation (ASCT) had been applied to more than 40 children with polyarticular or systemic juvenile idiopathic arthritis (JIA). For this review, results of the follow-up are available from 25 children with systemic JIA and six with polyarticular JIA that were reported in detail from eight different pediatric European transplant centers. Before ASCT all children had

N M Wulffraat; D Brinkman; A Ferster; J Opperman; R ten Cate; L Wedderburn; H Foster; M Abinun; A M Prieur; G Horneff; F Zintl; I de Kleer; W Kuis

2003-01-01

69

Long term follow-up of diffuse idiopathic skeletal hyperostosis in the cervical spine  

Microsoft Academic Search

In eleven patients with diffuse idiopathic skeletal hyperostosis who presented with extensive ossification in the cervical spine, progression or regression of ossification during the follow-up period were measured in extent and thickness radiographically. Intervertebral range of motion was also measured and the relation between changes of ossification and intervertebral mobility was analyzed. The range of motion at the segments at

K. Suzuki; Y. Ishida; K. Ohmori

1991-01-01

70

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

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

Berglund, David; Yamamoto, Shinji; Wadstrom, Jonas

2014-01-01

71

Reconstruction of the thoracic wall—long-term follow-up including pulmonary function tests  

Microsoft Academic Search

Purpose  Thoracic wall reconstructions have become a standard procedure for the reconstructive plastic surgeon in the larger hospital\\u000a setting, but detailed reports about long-term results including pulmonary function and physical examination are rare.\\u000a \\u000a \\u000a \\u000a Materials and methods  The data of 92 consecutive patients with full thickness chest wall resections were acquired from patient’s charts and contact\\u000a to patients, their relatives or general practitioners,

Adrien Daigeler; Daniel Druecke; Mitra Hakimi; Hans-Werner Duchna; Ole Goertz; Heinz-Herbert Homann; Marcus Lehnhardt; Hans-Ulrich Steinau

2009-01-01

72

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

PubMed

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

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

2013-05-01

73

Long term follow up of multifocal motor neuropathy with conduction block under treatment  

Microsoft Academic Search

Eighteen patients (15 men, three women; age range 30 to 71 years, mean 45.8 years) with multifocal motor neuropathy treated with high dose intravenous immunoglobulin (IVIg) were evaluated for nine to 48 months (mean follow up 25.3 months). The median time between onset of multifocal motor neuropathy and treatment was 5.8 years. The dose of IVIg was 0.4 g\\/day for

J P Azulay; P Rihet; J Pouget; F Cador; O Blin; J Boucraut; G Serratrice

1997-01-01

74

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

Microsoft Academic Search

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

Ann-Marie Lundblad; Kjell Hansson

2006-01-01

75

Endoscopic ultrasonography in gastric lymphomas: appraisal on reliability in long-term follow-up.  

PubMed

The reliability of endoscopic ultrasonography (EUS) in follow-up management of gastric lymphomas has not been clearly validated. We conducted a retrospective analysis on 23 patients, 12 affected by mucosa-associated lymphoid tissue (MALT) lymphoma, eight by diffuse large B-cell lymphoma, and three by high-grade lymphoma with low-grade component, all treated with a stomach-conservative approach. One hundred and twenty matched evaluations with both EUS and endoscopy with biopsy (E-Bx) were performed, according to validated guidelines and clinical judgment. At a median follow-up of 87?months ranged between 9.5 and 166?months, the analysis of progression-free survival and disease-free survival showed a strict relationship between the persistence of EUS abnormalities and the clinical outcome in patients with MALT lymphoma (p?=?0.0079; p?=?0.02) but not in patients with high-grade lymphoma. In conclusion, EUS evaluation does not seem reliable in follow-up management of high-grade lymphomas, although it could have a great clinical impact in the management of MALT lymphoma. PMID:22189677

Vetro, Calogero; Romano, Alessandra; Chiarenza, Annalisa; Conticello, Concetta; Donnarumma, Daniela; Gorgone, Ausilia; Coppolino, Francesco; Palumbo, Giuseppe Alberto; Bonanno, Giacomo; Di Raimondo, Francesco

2012-12-01

76

Long-term follow-up after weight management in obese dogs: the role of diet in preventing regain.  

PubMed

Regain after weight loss is widely reported in humans, but there is little information on this phenomenon in dogs. The current study aim was to determine long-term success of a weight loss regime and those factors linked with regain. Thirty-three obese dogs, that had successfully lost weight, were included, all enrolled between December 2004 and May 2009. After weight loss, dogs were switched to a maintenance regime and follow-up weight checks were performed periodically. A review of cases that had completed their weight programme was held during the summer of 2010 and a follow-up check was subsequently conducted, where dogs were reweighed and information was collected on current feeding practices. Median duration of follow-up was 640 days (119-1828 days). Fourteen dogs (42%) maintained weight, 3 (9%) lost >5% additional weight, and 16 (48%) gained >5% weight. Dogs fed a purpose-formulated weight loss diet regained less weight than those switched onto a standard maintenance diet (P=0.0016). Energy intake at the time of follow-up was significantly higher in those dogs fed a standard maintenance diet, compared with those that had remained on a purpose-formulated weight loss diet (P=0.017). These results suggest that weight regain occurs in about half of dogs after successful weight loss. Long-term use of a purpose-formulated weight management diet can significantly limit regain in the follow-up period, likely by limiting food intake. PMID:21570327

German, A J; Holden, S L; Morris, P J; Biourge, V

2012-04-01

77

Arthrogryposis multiplex congenita. Long-term follow-up from birth until skeletal maturity  

PubMed Central

Purpose The aim of this retrospective long-term study was to review and present the effects of treatment for 11 children with arthrogryposis multiplex congenital, or amyoplasia, followed from birth until skeletal maturity. Methods We evaluated walking ability, age of beginning to walk, required ambulatory devices, age of independent walking and muscle strength. Results Our series showed babies with severe limb involvements without spine abnormalities. Despite the initial severity of involvement, nine patients finally became ambulators with flexion contracture of less than 20° on hips and 15° on knees, and six were independent walkers before the age of 2.5 years. The two non-ambulators presented severe scoliosis at skeletal maturity, which needed spinal fusion. Conclusion We conclude that long-term ambulatory status at skeletal maturity is not correlated with the severity of condition at birth. A prognosis for ambulation at skeletal maturity will be done before 2.5 years of age. We believe that early aggressive management of children with severe arthrogryposis is warranted and justified. PMID:19669823

Wicart, Philippe; Dubousset, Jean; Seringe, Raphael

2009-01-01

78

Health-Related Quality of Life Among Young Adults With Ischemic Stroke on Long-Term Follow-Up  

Microsoft Academic Search

Background and Purpose—We sought to compare health-related quality of life (HRQoL) in young adults with ischemic stroke on long-term follow-up with controls and to evaluate HRQoL in clinically relevant patient subgroups. Methods—HRQoL was determined with the use of the 8 subscales of the Short-Form General Health Survey (SF-36). Subgroups of patients were defined by sex, age, functional status (modified Rankin

Halvor Naess; Ulrike Waje-Andreassen; Lars Thomassen; Harald Nyland; Kjell-Morten Myhr

79

Long-term outcome of head injuries: a 23 year follow up study of children with head injuries  

Microsoft Academic Search

The purpose of the 23 year follow up study was to determine the relationship between trauma variables including measures of head injury and very long-term sequelae. The study included 159 individuals with a mean age 31.40 years, of whom approximately 90% were admitted to hospital with a mild head injury during childhood (mean age 7.96). Extent of head injury was

H Klonoff; C Clark; P S Klonoff

1993-01-01

80

Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups.  

PubMed

Superficial irregularities and certain intrinsic stains on the dental enamel surfaces can be resolved by enamel microabrasion, however, treatment for such defects need to be confined to the outermost regions of the enamel surface. Dental bleaching and resin-based composite repair are also often useful for certain situations for tooth color corrections. This article presented and discussed the indications and limitations of enamel microabrasion treatment. Three case reports treated by enamel microabrasion were also presented after 11, 20 and 23 years of follow-ups. PMID:25141208

Sundfeld, Renato Herman; Sundfeld-Neto, Daniel; Machado, Lucas Silveira; Franco, Laura Molinar; Fagundes, Ticiane Cestari; Briso, André Luiz Fraga

2014-01-01

81

Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups  

PubMed Central

Superficial irregularities and certain intrinsic stains on the dental enamel surfaces can be resolved by enamel microabrasion, however, treatment for such defects need to be confined to the outermost regions of the enamel surface. Dental bleaching and resin-based composite repair are also often useful for certain situations for tooth color corrections. This article presented and discussed the indications and limitations of enamel microabrasion treatment. Three case reports treated by enamel microabrasion were also presented after 11, 20 and 23 years of follow-ups. PMID:25141208

SUNDFELD, Renato Herman; SUNDFELD-NETO, Daniel; MACHADO, Lucas Silveira; FRANCO, Laura Molinar; FAGUNDES, Ticiane Cestari; BRISO, Andre Luiz Fraga

2014-01-01

82

Urinary calculi and jejunoileal bypass operation. A long-term follow-up.  

PubMed

Medical records of 56 patients who had undergone jejunoileal bypass (JIB) surgery because of morbid obesity were reviewed. The follow-up time varied from 3 to 25 years (average 16 years). Twenty-two of the 56 patients (39.3%) were found to have renal calculi. The interval between the operation and the occurrence or knowledge of the first stone formation ranged from some months to 19 years. The mean weight loss at 5 years was 36.5 kg. Renal function investigations showed no evidence that the jejunoileal bypass operation alters the renal function. The urinary excretion of oxalate was high: 1.112 mumol/24 h (normal range: 55-400 mumol/24 h), and citrate excretion was low: 1.48 mmol/24 h (normal range: 2-5 mmol/24 h). There was no difference in these respects between stone formers and non-stone formers. PMID:9689695

Annuk, M; Backman, U; Holmgren, K; Vessby, B

1998-05-01

83

Long-Term Follow-Up of Cushing's Disease: A Case Report  

PubMed Central

Cushing’s disease is a condition in which hypercortisolism develops due to excessive hypophyseal adrenocorticotropic hormone production. It is rare in childhood. In this paper, we report the case of a 10-year-old male patient with hypophyseal microadenoma-related Cushing’s disease who presented with obesity and was found to show poor height growth at follow-up. The diagnosis was confirmed with inferior petrosal sinus sampling, and the adenoma was successfully removed by transsphenoidal surgery. While adrenal axis suppression continued for approximately 1 year, clinical improvement was clearly observed after the third month following surgery. The findings in this patient demonstrate that decreased growth rate despite rapid weight gain in children can be early sign of Cushing’s disease and emphasize the importance of monitoring of growth in obese children. Conflict of interest:None declared. PMID:24072091

Bas, Veysel Nijat; Y?lmaz Aglad?oglu, Sebahat; Onder, Asan; Oz?s?k, P?nar; Peltek Kendirci, Havva Nur; Cetinkaya, Semra; Aycan, Zehra

2013-01-01

84

A case report of acute severe paraquat poisoning and long-term follow-up  

PubMed Central

In the present study, the successful management of severe paraquat (PQ) poisoning with multiple organ dysfunction syndrome is described. A 42-year-old female ingested >100 ml PQ (20% weight/volume) in an attempted suicide. After 22 h the patient was admitted to hospital with serious liver, kidney and lung damage. Comprehensive therapy that maximized poison elimination was administered, along with appropriate glucocorticoids and medication for anticoagulation and protection of the liver and kidney. The patient was successfully treated and recovered after 40 days. However, pulmonary damage was aggravated when the glucocorticoid treatment was stopped after 2 months; the lungs recovered again following systematic therapy. Subsequent to a 8-month follow-up, the patient was able to look after herself in her daily life. To the best of our knowledge, successful treatment following severe PQ poisoning is rare. PMID:24944627

YU, GUANGCAI; KAN, BAOTIAN; JIAN, XIANGDONG; WANG, JIERU; SUN, JING; SONG, CHENGZHEN

2014-01-01

85

Long-term follow-up and treatment of congenital alveolar proteinosis  

PubMed Central

Background Clinical presentation, diagnosis, management and outcome of molecularly defined congenital pulmonary alveolar proteinosis (PAP) due to mutations in the GM-CSF receptor are not well known. Case presentation A 2 1/2 years old girl was diagnosed as having alveolar proteinosis. Whole lung lavages were performed with a new catheter balloon technique, feasible in small sized airways. Because of some interstitial inflammation in the lung biopsy and to further improve the condition, empirical therapy with systemic steroids and azathioprin, and inhaled and subcutaneous GMCSF, were used. Based on clinical measures, total protein and lipid recovered by whole lung lavages, all these treatments were without benefit. Conversely, severe respiratory viral infections and an invasive aspergillosis with aspergilloma formation occurred. Recently the novel homozygous stop mutation p.Ser25X of the GMCSF receptor alpha chain was identified in the patient. This mutation leads to a lack of functional GMCSF receptor and a reduced response to GMCSF stimulation of CD11b expression of mononuclear cells of the patient. Subsequently a very intense treatment with monthly lavages was initiated, resulting for the first time in complete resolution of partial respiratory insufficiency and a significant improvement of the overall somato-psychosocial condition of the child. Conclusions The long term management from early childhood into young adolescence of severe alveolar proteinosis due to GMCSF receptor deficiency requires a dedicated specialized team to perform technically demanding whole lung lavages and cope with complications. PMID:21849033

2011-01-01

86

[Follow-up studies of gerontopsychiatric long-term patients following a change in residential status].  

PubMed

Changes in living conditions of the elderly are considered as critical life events. The degree of stress produced by such critical life events is seen largely dependent on controllability and predictability of the situation. Our study focuses on changes in behavior and well-being at four times during ten weeks while 34 long-term gerontopsychiatric patients moved into reconstructed wards, which were mainly improved under ecological aspects. Investigations were performed with the "Beobachtungsskala für alternde Patienten (BAP)" and by free observation. In summary, the results show reduced well-being and behavioral problems at all four times of measurement for female patients compared to the male group. In contrary, for male patients there is a significant reduction in need of help, physical disability, aggression and depression one week after the move. But these improvements are not stable. Partly, they are followed by decreases even beyond the baseline six weeks after the move. Therefore, unlike the male patients it seems that the older and more impaired women in our sample can not at all profit from the positive changes in the new living conditions on the ward at any time during our study. Their well-being remains obviously unsatisfactory and becomes even worse and threatening for single cases after the move. Results are discussed with respect to psychiatric impairments like dementia, paranoia, with regard to stress and coping as well as with respect to some contradictory findings in this field of research. PMID:2496413

Büssing, A; Knauer, E

1989-01-01

87

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

PubMed

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

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

88

Long-term follow-up of nephrotoxicity in rats administered both melamine and cyanuric acid  

PubMed Central

Background Melamine was recently identified as a risk factor for renal calculi following the milk powder contamination in China. However, the long-term natural history of melamine exposure and its renal effects remain unknown. We evaluated renal function and other adverse health effects using a rat model administered melamine and cyanuric aid, considering age and sex. Methods Twelve male F334/N rats each of ages 6, 10, and 26 weeks (N?=?36) were equally assigned to Group M + C or controls. Group M + C rats were administered 12 mg?·?kg-1?·?day-1 of melamine and cyanuric acid for 28 days. Serum and urine samples and kidney sections were evaluated on day 28. Six-week-old male and female F344/N rats were administered 12 mg of melamine and cyanuric acid for 28 days. Body weights were measured weekly; on days 0, 28, 90, and 180 after the 28-day period of melamine and cyanuric acid administration, serum samples and kidney sections were obtained. Results Although the control group had no crystals, 6-week-old Group M + C rats had more crystals compared to the 10- and 26-week old Group M + C rats. Male rats also had significantly more crystals than females of the same age. Male rats were affected to a greater extent than females. Conclusion Younger rats experienced more severe renal failure and greater renal crystal deposition following melamine and cyanuric acid administration. However, after melamine and cyanuric acid administration cessation, crystal deposition and renal failure improved and did not cause growth arrest. Therefore, early diagnosis of melamine-associated calculi is critical. PMID:24507656

2014-01-01

89

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

PubMed Central

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.

Steppacher, Inga; Kaps, Michael; Kissler, Johanna

2014-01-01

90

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

PubMed Central

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

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

1993-01-01

91

Cryptogenic organizing pneumonia due to amiodarone: long-term follow-up after corticosteroid treatment.  

PubMed

Cryptogenic organizing pneumonia (formerly known as bronchiolitis obliterans organizing pneumonia) is a clinicopathological entity with characteristical radiographic findings such as bilateral, asymmetrical, sometimes migrating, patchy infiltrates in chest radiograph and ground-glass opacities in computed tomography. The disease has been observed in the context of gastrointestinal disorders, certain lung infections, autoimmune-mediated diseases (such as Wegener granulomatosis), inhalation of toxic fumes, bone marrow transplantation and administration of drugs. The benzofuran amiodarone, a commonly used antiarrythmic drug for atrial fibrillation, can exhibit several pulmonary adverse effects, amongst them cryptogenic organizing pneumonia as a rarely diagnosed and published one. We report a case of cryptogenic organizing pneumonia secondary to amiodarone treatment, its clinical course with significant improvement of clinical symptoms within a few days after discontinuation of amiodarone treatment and administration of corticosteroids. Also the infiltrations found in chest X-ray and computed tomography responded well and showed remarkable resolution tendency quickly. During 5 months of corticoid therapy pulmonary abnormalities gradually resolved almost completely and remained equal during the 8 months follow-up after corticoid termination. PMID:20668958

Schindler, Katja; Schima, Wolfgang; Kaliman, Josef F

2010-08-01

92

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

SciTech Connect

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.

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

1987-09-01

93

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

SciTech Connect

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.

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

94

A long-term follow up of premarital counseling in the Israeli Arab population.  

PubMed

A follow up study of 168 Arab counselees that received premarital genetic counseling between 2001 and 2009, mostly since they planned to marry with a relative, was performed in 2013. Among the 156 cases in which the counselee married, 30 changed their marital plans (19.2 %). Those who changed their marital plans were more often Muslim Arabs that came for counseling since they were related in particular first cousins. Among the 126 counselee that married as planned, 66 were interviewed. From these interviews, it appears that many of the counselees that were related as first cousins or closer came to premarital genetic counseling in order to decide whether to marry. Most of the couples interviewed followed the recommendations concerning the use of folic acid and genetic tests. Among the 53 consanguineous couples interviewed, 49 women had 118 children. Among these 118 children, 8 (6.8 %) were born with a severe disease in 8 different families. This rate of malformations/genetic diseases is similar to the one observed for consanguineous couples from the general Arab population in the region, suggesting therefore that the premarital counseling and the adherence to the recommendations did not change the final risk to the counselees. PMID:24974306

Zlotogora, Joël; Shalev, Stavit A

2014-10-01

95

Ankle arthrodesis. Long-term follow-up with gait analysis.  

PubMed

A functional assessment of twelve patients after ankle arthrodesis for post-traumatic arthritis was carried out by means of an extensive clinical evaluation and gait analysis after an average follow-up of eight years. A weighted point system was developed to grade ankle function clinically. The data on gait analysis were examined to determine the effect of arthrodesis of the ankle on the over-all pattern of walking. Under conditions of normal daily living while wearing shoes, all patients functioned well after arthrodesis. The gait-analysis data obtained with the patients wearing shoes showed excellent gait characteristics, and the ankle motion that had been lost was compensated for by: (1) motion of the small joints of the ipsilateral foot; (2) altered motion of the ankle in the contralateral limb; and (3) appropriate footwear. While the patients were walking barefooted, some adverse effects of fusion of the ankle were evident. Velocity of gait was slowed and the length of stride was shortened in all twelve patients. One patient whose ankle had been fused in an equinus position had a back-knee deformity during stance phase, and another walked only on his toes when he was without shoes. The gait patterns of all patients were markedly improved when they were wearing shoes with appropriate heel heights. PMID:489661

Mazur, J M; Schwartz, E; Simon, S R

1979-10-01

96

Long-term follow-up of patients with silent ischemia during exercise radionuclide angiography  

SciTech Connect

A retrospective 5 year follow-up study was performed in 140 patients with unequivocal ischemia during exercise radionuclide angiography (greater than or equal to 10% decrease in left ventricular ejection fraction or greater than or equal to 5% decrease in ejection fraction together with a distinct regional wall motion abnormality). In 84 patients (60%), ischemia during radionuclide angiography was silent (silent ischemia group), whereas 56 patients experienced angina during the test (symptomatic group). Work load and antianginal medication were similar in both groups. Critical cardiac events (unstable angina, myocardial infarction, cardiac death) occurred in 27% of patients in the silent ischemia group and 16% of those in the symptomatic group (p = NS); however, myocardial infarction or death was more frequent in patients with silent ischemia (22% versus 9%; p less than 0.05). If there was additional exercise-induced ST segment depression, the rate of critical events was further increased (p less than 0.05). The difference in critical cardiac events seemed to be influenced by the higher incidence of revascularization procedures in symptomatic patients, whereas medical therapy had no similar effect. Thus, these findings suggest that patients with documented severe ischemia should undergo left heart catheterization and revascularization irrespective of symptoms to improve their prognosis.

Breitenbuecher, A.P.; Pfisterer, M.; Hoffmann, A.; Burckhardt, D. (University Hospital, Basel (Switzerland))

1990-04-01

97

Long-Term Follow-Up of Patients Who Have Participated in Children's Oncology Group Studies  

ClinicalTrials.gov

Accelerated Phase Chronic Myelogenous Leukemia; Acute Myeloid Leukemia/Transient Myeloproliferative Disorder; Acute Undifferentiated Leukemia; Angioimmunoblastic T-cell Lymphoma; Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative; Blastic Phase Chronic Myelogenous Leukemia; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Grade III Lymphomatoid Granulomatosis; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Eosinophilic Leukemia; Chronic Myelomonocytic Leukemia; Chronic Neutrophilic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; Essential Thrombocythemia; Extramedullary Plasmacytoma; Intraocular Lymphoma; Isolated Plasmacytoma of Bone; Juvenile Myelomonocytic Leukemia; Long-term Effects Secondary to Cancer Therapy in Children; Mast Cell Leukemia; Meningeal Chronic Myelogenous Leukemia; Monoclonal Gammopathy of Undetermined Significance; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Polycythemia Vera; Post-transplant Lymphoproliferative Disorder; Primary Central Nervous System Hodgkin Lymphoma; Primary Central Nervous System Non-Hodgkin Lymphoma; Primary Myelofibrosis; Primary Systemic Amyloidosis; Progressive Hairy Cell Leukemia, Initial Treatment; Prolymphocytic Leukemia; Secondary Acute Myeloid Leukemia; Secondary Myelodysplastic Syndromes; Stage 0 Chronic Lymphocytic Leukemia; Stage I Childhood Anaplastic Large Cell Lymphoma; Stage I Childhood Hodgkin Lymphoma; Stage I Childhood Large Cell Lymphoma; Stage I Childhood Lymphoblastic Lymphoma; Stage I Childhood Small Noncleaved Cell Lymphoma; Stage I Chronic Lymphocytic Leukemia; Stage I Cutaneous T-cell Non-Hodgkin Lymphoma; Stage I Multiple Myeloma; Stage I Mycosis Fungoides/Sezary Syndrome; Stage II Childhood Anaplastic Large Cell Lymphoma; Stage II Childhood Hodgkin Lymphoma; Stage II Childhood Large Cell Lymphoma; Stage II Childhood Lymphoblastic Lymphoma; Stage II Childhood Small Noncleaved Cell Lymphoma; Stage II Chronic Lymphocytic Leukemia; Stage II Cutaneous T-cell Non-Hodgkin Lymphoma; Stage II Multiple Myeloma; Stage II Mycosis Fungoides/Sezary Syndrome; Stage III Childhood Anaplastic Large Cell Lymphoma; Stage III Childhood Hodgkin Lymphoma; Stage III Childhood Large Cell Lymphoma; Stage III Childhood Lymphoblastic Lymphoma; Stage III Childhood Small Noncleaved Cell Lymphoma; Stage III Chronic Lymphocytic Leukemia; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Multiple Myeloma; Stage III Mycosis Fungoides/Sezary Syndrome; Stage IV Childhood Anaplastic Large Cell Lymphoma; Stage IV Childhood Hodgkin Lymphoma; Stage IV Childhood Large Cell Lymphoma; Stage IV Childhood Lymphoblastic Lymphoma; Stage IV Childhood Small Noncleaved Cell Lymphoma; Stage IV Chronic Lymphocytic Leukemia; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome; T-cell Large Granular Lymphocyte Leukemia; Unspecified Childhood Solid Tumor, Protocol Specific; Untreated Childhood Acute Lymphoblastic Leukemia; Untreated Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies; Untreated Hairy Cell Leukemia; Waldenström Macroglobulinemia

2014-08-05

98

A long-term follow-up of workers exposed to beryllium  

PubMed Central

ABSTRACT The relationship of features of beryllium disease to the estimated exposure to beryllium has been investigated over a 30-year period at a factory manufacturing beryllium products. The factory opened in 1952. Of the 146 men who had worked there for more than six months up to 1963, 89% were seen at that time and were followed up in 1973. The nine who continued to work in the factory and those who were engaged subsequently were examined in 1977. On each occasion a clinical interview, occupational history, chest radiograph, and assessment of lung function were carried out. The findings of the main survey were related to the beryllium content of the dust measured by mass spectrometry for 1952-60 when over 3000 determinations were made. In no part of the plant did the estimated average daily exposure exceed 2 ?g m-3, and only 9% of individual determinations exceeded this level. Twenty determinations exceeded 25 ?g m-3. During the period under review, four men developed the clinical, radiographic, and physiological features of beryllium disease. Two men acquired abnormal chest radiographs consistent with beryllium disease but without other features, and one developed probable beryllium disease despite the diagnosis not being confirmed at necropsy. The affected men were all exposed to beryllium oxide or hydroxide but in a wide range of estimated doses. In six the changes developed after exposure had ceased; trigger factors including patch testing may have contributed to their illness. Seventeen men recalled episodes of brief exposure to high concentrations of dust, two developed pneumonitis from which they recovered completely, and one developed chronic beryllium disease after a further 23 years' exposure. In subjects without clinical or radiographic evidence of disease no convincing evidence was obtained for any association between the lung function and the estimated exposure to beryllium. PMID:6824594

Cotes, J E; Gilson, J C; McKerrow, C B; Oldham, P D

1983-01-01

99

Percutaneous therapy of low stage and grade urothelial neoplasia: long-term follow up.  

PubMed

Nephroureterectomy with the excision of the ipsilateral ureteral orifice and bladder cuff has been considered the standard treatment of the urinary upper transitional cell carcinoma. With the advent of sophisticated techniques for the endo-urologic management of many benign urologic diseases of the upper tract, there has been growing enthusiasm for the application of these same techniques in the management of upper tract TCC, which is also supported by recent advances in the development of small calibre telescopes with improved optics and the development of small calibre adjunctive instruments and laser fibers. A large number of cases published in the literature has confirmed the safety and efficacy of percutaneous treatment in selected patients with upper tract TCC of low grade and stage. Between 1997 and 2005 we treated 62 pts (37 pelvic transitional cell carcinoma and 25 ureteral). 4 pts (5 renal units: 4 T1G2 and 1 TaG1) underwent percutaneous resection for a tumor in a solitary kidney (2 cases), one case for bilateral neoplasm, and in the other case the lesion was unilateral with chronic renal failure. After preoperative evaluation, (excretory urography, computerized tomography and ureteroscopy with biopsy to confirm the low stage and grade of the lesion) the tumor was resected using an Amplatz sheat of 26-30 Fr and a 24 Fr resectoscope to keep a low intra-caliceal pressure. The tumor base was biopsied and fulgurated After 48 h, contrastography to assure integrity of the urinary system was performed and Mitomycin C was infused over 24 h. Second-look nephroscopy with multiple biopsies was performed in all cases 7 days later and 8 Ch nephrostomy was placed. If the biopsies resulted negative the patient was submitted to 6 weekly endocavitary instillation of BCG through the nephrostomy tube. All pts at a mean follow up of 71 months were tumor free. One patient presented a bladder relapse after 83 months. No complication of percutaneous resection was observed. The endocavitary instillations were well tolerated. In our experience the percutaneous approach is safe and useful in neoplastic lesions of low grade and stage and should be considered as first line therapy in selected patients. Adjuvant topical therapy appears efficacious and some complications may be avoided by maintaining low intracavitary pressures during administration. PMID:16444935

Montanari, Emanuele; Del Nero, Alberto; Bernardini, Paolo; Mangiarotti, Barbara; Confalonieri, Silvia; Grisotto, Massimo; Cordima, Giovanni

2005-12-01

100

Efficacy, Safety, and Long-Term Follow-Up Results of EUS-Guided Transmural Drainage for Pancreatic Pseudocyst  

PubMed Central

Background and Aim. EUS-guided transmural drainage (EUS-GTD) is now considered a minimally invasive and effective alternative to surgery for drainage of symptomatic pancreatic pseudocysts. However, the technique is rather difficult, and sometimes serious complications occur to patients undergoing this procedure. We retrospectively evaluated efficacy, safety, and long-term follow-up results of EUS-GTD for pancreatic pseudocyst. Methods. Sixty-seven patients with pancreatic pseudocyst who underwent EUS-GTD from April 2000 to March 2011 were enrolled. We retrospectively evaluated (1) technical success, (2) clinical success, (3) adverse event of procedure, and (4) long-term follow-up results. Results. Total technical success rate was 88%. Ninety-one percent of external drainage, 79% of internal drainage, and 66% of puncture and aspiration only achieved clinical success. There was only one case with an adverse event, perforation (1.5%). The case required emergency operation. Total recurrence rate was 23.9%. Median follow-up period was 33.9 months. The recurrence rates in the cases of stent remaining, spontaneously dislodged, removed on schedule, external tube removal, and aspiration only were 10.0%, 12.5%, 42.9%, 50%, and 0%, respectively. Conclusion. EUS-GTD is a relatively safe and effective therapeutic method. However, further analysis should be done by larger series to determine the method of EUS-GTD for pancreatic pseudocyst. PMID:23554548

Kato, Shin; Katanuma, Akio; Maguchi, Hiroyuki; Takahashi, Kuniyuki; Osanai, Manabu; Yane, Kei; Kim, Toshifumi; Kaneko, Maki; Takaki, Ryo; Matsumoto, Kazuyuki; Matsumori, Tomoaki; Gon, Katsushige; Tomonari, Akiko

2013-01-01

101

Efficacy, Safety, and Long-Term Follow-Up Results of EUS-Guided Transmural Drainage for Pancreatic Pseudocyst.  

PubMed

Background and Aim. EUS-guided transmural drainage (EUS-GTD) is now considered a minimally invasive and effective alternative to surgery for drainage of symptomatic pancreatic pseudocysts. However, the technique is rather difficult, and sometimes serious complications occur to patients undergoing this procedure. We retrospectively evaluated efficacy, safety, and long-term follow-up results of EUS-GTD for pancreatic pseudocyst. Methods. Sixty-seven patients with pancreatic pseudocyst who underwent EUS-GTD from April 2000 to March 2011 were enrolled. We retrospectively evaluated (1) technical success, (2) clinical success, (3) adverse event of procedure, and (4) long-term follow-up results. Results. Total technical success rate was 88%. Ninety-one percent of external drainage, 79% of internal drainage, and 66% of puncture and aspiration only achieved clinical success. There was only one case with an adverse event, perforation (1.5%). The case required emergency operation. Total recurrence rate was 23.9%. Median follow-up period was 33.9 months. The recurrence rates in the cases of stent remaining, spontaneously dislodged, removed on schedule, external tube removal, and aspiration only were 10.0%, 12.5%, 42.9%, 50%, and 0%, respectively. Conclusion. EUS-GTD is a relatively safe and effective therapeutic method. However, further analysis should be done by larger series to determine the method of EUS-GTD for pancreatic pseudocyst. PMID:23554548

Kato, Shin; Katanuma, Akio; Maguchi, Hiroyuki; Takahashi, Kuniyuki; Osanai, Manabu; Yane, Kei; Kim, Toshifumi; Kaneko, Maki; Takaki, Ryo; Matsumoto, Kazuyuki; Matsumori, Tomoaki; Gon, Katsushige; Tomonari, Akiko

2013-01-01

102

Enterovirus 71 infection-associated acute flaccid paralysis: a case series of long-term neurologic follow-up.  

PubMed

The authors undertook long-term neurologic outcomes of 27 patients aged 0 to 15 years with enterovirus 71-related acute flaccid paralysis from June 1998 to July 2012. Motor function outcome was graded from class I (complete recovery) to class V (permanent paralytic limbs). Twelve of 20 patients (60%) who received intravenous immunoglobulin for treatment of acute flaccid paralysis had motor function outcomes in classes III to V. The median duration of follow-up was 6 months, during which time 7 of 13 patients (54%) with central nervous system infection, 3 of 6 patients (50%) with autonomic nervous system dysregulation, and 3 of 8 patients (37%) with heart failure showed motor function outcomes in classes III to V. These findings suggested that the usage of intravenous immunoglobulin and the severity of disease staging at disease onset might not be able to predict long-term motor function outcomes. PMID:24453152

Lee, Hsiu-Fen; Chi, Ching-Shiang

2014-10-01

103

Long Term Streptomycin Toxicity in the Treatment of Buruli Ulcer: Follow-up of Participants in the BURULICO Drug Trial  

PubMed Central

Background Buruli Ulcer (BU) is a tropical infectious skin disease that is currently treated with 8 weeks of intramuscular streptomycin and oral rifampicin. As prolonged streptomycin administration can cause both oto- and nephrotoxicity, we evaluated its long term toxicity by following-up former BU patients that had received either 4 or 8 weeks of streptomycin in addition to other drugs between 2006 and 2008, in the context of a randomized controlled trial. Methods Former patients were retrieved in 2012, and oto- and nephrotoxicity were determined by audiometry and serum creatinine levels. Data were compared with baseline and week 8 measurements during the drug trial. Results Of the total of 151 former patients, 127 (84%) were retrieved. Ototoxicity was present in 29% of adults and 25% of children. Adults in the 8 week streptomycin group had significantly higher hearing thresholds in all frequencies at long term follow-up, and these differences were most prominent in the high frequencies. In children, no differences between the two treatment arms were found. Nephrotoxicity that had been detected in 14% of adults and in 13% of children during treatment, was present in only 2.4% of patients at long term follow-up. Conclusions Prolonged streptomycin administration in the adult study subjects caused significant persistent hearing loss, especially in the high frequency range. Nephrotoxicity was also present in both adults and children but appeared to be transient. Streptomycin should be given with caution especially in patients aged 16 or older, and in individuals with concurrent risks for renal dysfunction or hearing loss. PMID:24625583

Klis, Sandor; Stienstra, Ymkje; Phillips, Richard O.; Abass, Kabiru Mohammed; Tuah, Wilson; van der Werf, Tjip S.

2014-01-01

104

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

SciTech Connect

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%.

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

105

Long-Term Follow-up of Acoustic Schwannoma Radiosurgery With Marginal Tumor Doses of 12 to 13 Gy  

SciTech Connect

Purpose: To define long-term tumor control and clinical outcomes of radiosurgery with marginal tumor doses of 12 to 13 Gy for unilateral acoustic schwannoma. Methods and Materials: A total of 216 patients with previously untreated unilateral acoustic schwannoma underwent Gamma Knife radiosurgery between 1992 and 2000 with marginal tumor doses of 12 to 13 Gy (median, 13 Gy). Median follow-up was 5.7 years (maximum, 12 years; 41 patients with >8 years). Treatment volumes were 0.08-37.5 cm{sup 3} (median, 1.3 cm{sup 3}). Results: The 10-year actuarial resection-free control rate was 98.3% {+-} 1.0%. Three patients required tumor resection: 2 for tumor growth and 1 partial resection for an enlarging adjacent subarachnoid cyst. Among 121 hearing patients with >3 years of follow-up, crude hearing preservation rates were 71% for keeping the same Gardner-Robertson hearing level, 74% for serviceable hearing, and 95% for any testable hearing. For 25 of these patients with intracanalicular tumors, the respective rates for preserving the same Gardner-Robertson level, serviceable hearing, and testable hearing were 80%, 88%, and 96%. Ten-year actuarial rates for preserving the same Gardner-Robertson hearing levels, serviceable hearing, any testable hearing, and unchanged facial and trigeminal nerve function were 44.0% {+-} 11.7%, 44.5% {+-} 10.5%, 85.3% {+-} 6.2%, 100%, and 94.9% {+-} 1.8%, respectively. Conclusions: Acoustic schwannoma radiosurgery with 12 to 13 Gy provides high rates of long-term tumor control and cranial nerve preservation after long-term follow-up.

Chopra, Rahul [Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Kondziolka, Douglas [Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Niranjan, Ajay [Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Lunsford, L. Dade [Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Center for Image-Guided Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States); Flickinger, John C. [Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States) and Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA (United States)]. E-mail: flickingerjc@upmc.edu

2007-07-01

106

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

PubMed

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 16years. 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=14-46years). 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 12months 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

Sillanpää, Matti; Saarinen, Maiju; Schmidt, Dieter

2014-08-01

107

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

PubMed Central

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

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

108

Long-term follow-up after reimplantation of tumorous mandible bone treated with combination of decalcification and lyophilization.  

PubMed

Mandibular resection requires reconstruction, with often unsatisfactory morphofunctional results. Reimplantation of the resected mandible itself is one of ideal solutions to this problem. However, both devitalization of tumor cells involved in resected bone and preservation of osteoinductive activity are required for successful results. Lyophilization appears to enable devitalization of tumor cells, and decalcified bone implants are likely to have osteoinductive potential. Accordingly, we speculated that decalcification and lyophilization of resected bone would be an appropriate method for mandibular reconstruction. However, there is no study on the reimplantation of mandibles treated with these methods to date. The purpose of this study was to estimate the long-term follow-up of reimplanted mandibles treated with decalcification and lyophilization. Presented here are 2 patients of reimplanted mandibles treated by decalcification and lyophilization who were followed up for 8 and 9 years. We observed a good incorporation of the graft in 1 case, but severe absorption in the other. Our results suggest that treatment with decalcification and lyophilization is 1 strategy for reimplantation of the resected bone in mandibular reconstruction, but further study is needed to prevent absorption of the reimplanted bone over the long term. PMID:24621751

Uehara, Masataka; Inokuchi, Tsugio; Sano, Kazuo; Tominaga, Kazuhiro; Asahina, Izumi

2014-03-01

109

A Long-term Follow-up Study on the Engraftment of Human Hematopoietic Stem Cells in Sheep  

PubMed Central

Xenograft models of human hematopoiesis are essential to the study of the engraftment and proliferative potential of human hematopoietic stem cells (HSCs) in vivo. Immunodeficient mice and fetal sheep are often used as xenogeneic recipients because they are immunologically naive. In this study, we transplanted human HSCs into fetal sheep and assessed the long-term engraftment of transplanted human HSCs after birth. Fourteen sheep were used in this study. In 4 fetal sheep, HSCs were transduced with homeo-box B4 (HOXB4) gene before transplantation, which promoted the expansion of HSCs. Another 4 fetal sheep were subjected to non-myeloablative conditioning with busulfan. Seven of these 8 sheep showed successful engraftment of human HSCs (1–3% of colony-forming units) as assessed after the birth of fetal sheep (5 months post-transplantation), although HOXB4-transduced HSCs showed sustained engraftment for up to 40 months. Intact HSCs were transplanted into six non-conditioned fetal sheep, and human colony-forming units were not detected in the sheep after birth. These results suggest that, as compared with mouse models, where the short lifespan of mice limits long-term follow-up of HSC engraftment, the fetal sheep model provides a unique perspective for evaluating long-term engraftment and proliferation of human HSCs. PMID:25048264

Abe, Tomoyuki; Hanazono, Yutaka; Nagao, Yoshikazu

2014-01-01

110

Reasons for ICU Demand and Long-term Follow-up of a Chronic Obstructive Pulmonary Disease Cohort.  

PubMed

Abstract Acute respiratory failure (ARF) can necessitate mechanical ventilation and intensive care unit (ICU) admission in patients with COPD. We evaluated the reasons COPD patients are admitted to the ICU and assessed long-term outcomes in a retrospective cohort study in a respiratory level-III ICU of a teaching government hospital between November 2007 and April 2012. All COPD patients admitted to ICU for the first time were enrolled and followed for 12 months. Patient characteristics, body mass index (BMI), long-term oxygen therapy (LTOT), non-invasive ventilation (LT-NIV) at home, COPD co-morbidities, reasons for ICU admission, ICU data, length of stay, prescription of new LTOT and LT-NIV, and ICU mortality were recorded. Patient survival after ICU discharge was evaluated by Kaplan-Meier survival analysis. A total of 962 (710 male) patients were included. The mean age was 70 (SD 10). The major reasons for ICU admission were COPD exacerbation (66.7%) and pneumonia (19.7%). ICU and hospital mortality were 11.4%, 12.5% respectively, and 842 patients were followed-up. The new LT-NIV prescription rate was 15.8%. The 6-month 1, 2, 3, and 5-year mortality rates were 24.5%, 33.7%, 46.9%, 58.9% and 72.5%, respectively. Long-term survival was negatively affected by arrhythmia (p < 0.013) and pneumonia (p < 0.025). LT-NIV use (p < 0.016) with LTOT (p < 0.038) increase survival. Pulmonary infection can be a major reason for ICU admission and determining outcome after ICU discharge. Unlike arrhythmia and pneumonia, LT-NIV can improve long-term survival in eligible COPD patients. PMID:24915105

Takir, Huriye Berk; Karakurt, Zuhal; Salturk, Cuneyt; Kargin, Feyza; Balci, Merih; Yalcinsoy, Murat; Ozmen, Ipek; Yazicioglu, Ozlem Mocin; Gungor, Gokay; Burunsuzo?lu, Bünyamin; Adiguzel, Nalan

2014-12-01

111

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

NASA Astrophysics Data System (ADS)

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.

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

2010-04-01

112

Granulocytic sarcoma in non-leukaemic child involving maxillary sinus with long term follow up: A rare case report  

PubMed Central

Granulocytic sarcoma (GS) is a rare extramedullary malignant tumor composed of immature myeloid cells. It is strongly associated with acute myeloid leukaemia, chronic myeloproliferative diseases. Occurrence of GS in the oral cavity is extremely uncommon. Present case reported an unusual occurrence of GS without leukemia involving maxillary sinus of a child. The patient underwent chemotherapy followed by radiotherapy with complete remission. A long-term follow-up of the patient was carried without any evidence of recurrence with special focus on diagnostic difficulties. The present case highlights the perplexity in diagnosing such lesions with emphasis on the need of careful interpretation of all clinical, radiographic, histopathological and immunohistochemical details as it is one of the most frequently misdiagnosed disorder. PMID:24987607

Sharma, Aman; Singh, Harkanwal Preet; Gupta, Anish Ashok; Garg, Parveen; Moon, Ninad Joshirao; Chavan, Rahul

2014-01-01

113

Endovascular Exclusion of Visceral Artery Aneurysms with Stent-Grafts: Technique and Long-Term Follow-up  

SciTech Connect

This paper describes four cases of visceral artery aneurysms (VAAs) successfully treated with endovascular stent-grafts and discusses the endovascular approach to VAAs and the long-term results. Four balloon expandable stent-grafts were used to treat three splenic artery aneurysms and one bleeding common hepatic artery pseudoaneurysm. The percutaneous access site and the materials were chosen on the basis of CT angiography findings. In all cases the aneurysms were successfully excluded. In one case a splenic infarction occurred, with nonrelevant clinical findings. At 16- to 24-month follow-up three patients had patent stents and complete exclusion and shrinkage of the aneurysms. One patient died due to pancreatitis and sepsis, 16 days after successful stenting and exclusion of a bleeding pseudoaneurysm. We conclude that endovascular treatment using covered stent-grafts is a valid therapeutic option for VAAs. Multislice CT preoperative study helps in planning stent-graft positioning.

Rossi, Michele; Rebonato, Alberto, E-mail: albertorebonato@libero.it; Greco, Laura; Citone, Michele; David, Vincenzo [S. Andrea, University Hospital 'La Sapienza', Interventional Radiology Unit, Radiology Department (Italy)

2008-01-15

114

Long term follow-up of a child with ambiguous genitalia, mixed gonadal dysgenesis, and unusual mosaicism.  

PubMed

Mixed gonadal dysgenesis (MGD) is a condition of abnormal and asymmetrical gonadal development. This disorder is typically associated with 45,X/46,XY mosaicism; however, other karyotypes have been rarely reported. The phenotype characterizing MGD is highly variable, although in most cases ambiguous genitalia are found. In addition, many individuals with MGD exhibit stigmata of Turner's syndrome. We describe a patient with MGD, found to have a 45,X/47,XYY karyotype, with the majority of the cell lines being 47,XYY. To our knowledge, our report is the first to describe the long-term follow-up of a patient with ambiguous genitalia diagnosed at birth with 45,X/47,XYY mosaicism. PMID:19960897

Ostrow, Vlady; De Luca, Francesco

2009-09-01

115

Clinical application and long-term follow-up study of porcine acellular dermal matrix combined with autoskin grafting.  

PubMed

The purpose of this study was to investigate the clinical effects of porcine acellular dermal matrix combined with autoskin grafting on full-thickness skin defects using long-term clinical follow-up study and histologic examination. One hundred fifty-two patients with deep burn or trauma hospitalized from February 2000 to July 2003 were repaired with porcine acellular dermal matrix and split-thickness autoskin graft. Take rate of the grafts was calculated on 1 week after operation. Scar hyperplasia was examined on 1, 3, 6, and 12 months after operation. At the same time, the contracture rates of grafted areas were also calculated. Skin biopsy was performed on five patients for histologic examination, as well as transmission electron microscopy 78 months after operation. The take rate of grafts of 116 patients (76.3%) was 100%, and the take rate of the rest of the patients (36 patients, 23.7%) was more than 95%. No one needed skin transplantation for the second time. One hundred twenty-seven patients were followed up on 1 month after operation; grafts showed mild contraction. There was slight cicatricle at skin junction with tender texture. There was no obvious pruritus and blister. One hundred one patients were followed up on 3 months after operation. The graft contraction showed obvious relief with good articular function. Eighty-two patients were followed up on 6 months after operation. The color and texture of the grafts were similar to normal skin without obvious cicatricial hyperplasia. Fifty-eight patients were followed up on 12 months after operation. The grafts were similar to normal skin without obvious rejection. There were no significant differences between the contracture rates at 3, 6, and 12 months and 1 month after the second surgery. Sixteen patients were followed up on 78 months after operation. The appearance of grafts was slightly dry compared with normal skin. Tissue structure of grafts was similar to normal skin with sweat gland-like structure, and sweat gland cells were shown in the dermis. Xenogenic acellular dermal matrix combined with split-thickness autograft can repair full-thickness skin defects and inhibit scar proliferation without obvious immune rejection for long time. Newly formed sweat gland-like structure and sweat gland cells in the dermis may be a new research point for reconstruction of skin function. PMID:20182383

Jiong, Chen; Jiake, Chai; Chunmao, Han; Yingen, Pan; Qiuhe, Wu; Zhouxi, Fang; Xiangsheng, Feng

2010-01-01

116

Uterine Artery Embolization in Patients with a Large Fibroid Burden: Long-Term Clinical and MR Follow-up  

SciTech Connect

Uterine artery embolization (UAE) in patients with a large fibroid burden is controversial. Anecdotal reports describe serious complications and limited clinical results. We report the long-term clinical and magnetic resonance (MR) results in a large series of women with a dominant fibroid of >10 cm and/or an uterine volume of >700 cm{sup 3}. Seventy-one consecutive patients (mean age, 42.5 years; median, 40 years; range, 25-52 years) with a large fibroid burden were treated by UAE between August 2000 and April 2005. Volume reduction and infarction rate of dominant fibroid and uterus were assessed by comparing the baseline and latest follow-up MRIs. Patients were clinically followed at various time intervals after UAE with standardized questionnaires. There were no serious complications of UAE. During a mean follow-up of 48 months (median, 59 months; range, 6-106 months), 10 of 71 patients (14%) had a hysterectomy. Mean volume reduction of the fibroid and uterus was 44 and 43%. Mean infarction rate of the fibroid and overall fibroid infarction rate was 86 and 87%. In the vast majority of patients there was a substantial improvement of symptoms. Clinical results were similar in patients with a dominant fibroid >10 cm and in patients with large uterine volumes by diffuse fibroid disease. In conclusion, our results indicate that the risk of serious complications after UAE in patients with a large fibroid burden is not increased. Moreover, clinical long-term results are as good as in other patients who are treated with UAE. Therefore, a large fibroid burden should not be considered a contraindication for UAE.

Smeets, Albert J., E-mail: radiol@eztilburg.nl; Nijenhuis, Robbert J.; Rooij, Willem Jan van; Weimar, Emilie A. M. [St. Elisabeth Ziekenhuis, Department of Radiology (Netherlands); Boekkooi, Peter F. [St. Elisabeth Ziekenhuis, Department of Gynaecology (Netherlands); Lampmann, Leo E. H. [St. Elisabeth Ziekenhuis, Department of Radiology (Netherlands); Vervest, Harry A. M. [St. Elisabeth Ziekenhuis, Department of Gynaecology (Netherlands); Lohle, Paul N. M. [St. Elisabeth Ziekenhuis, Department of Radiology (Netherlands)

2010-10-15

117

Temporary self-expanding metallic stents for achalasia: A prospective study with a long-term follow-up  

PubMed Central

AIM: To compare the efficacy of self-expanding metallic stents (SEMSs) for the long-term clinical treatment of achalasia. METHODS: Ninety achalasic patients were treated with a temporary SEMS with a diameter of 20 mm (n = 30, group A), 25 mm (n = 30, group B) or 30 mm (n = 30, group C). Data on clinical symptoms, complications and treatment outcomes were collected, and follow-up was made at 6 mo and at 1, 3-5, 5-8, 8-10 and > 10 years, postoperatively. RESULTS: Stent placement was successful in all patients. Although chest pain occurrence was high, stent migration was less in group C than in groups A and B. The clinical remission rate at 5-8, 8-10 and > 10 years in group C was higher than that in the other two groups. The treatment failure rate was lower in group C (13%) than in groups A (53%) and B (27%). SEMSs in group C resulted in reduced dysphagia scores and lowered esophageal sphincter pressures, as well as normal levels of barium height and width during all the follow-up time periods. Conversely, these parameters increased over time in groups A and B. The primary patency in group C was longer than in groups A and B. CONCLUSION: A temporary SEMS with a diameter of 30 mm is associated with a superior long-term clinical efficacy in the treatment of achalasia compared with a SEMS with a diameter of 20 mm or 25 mm. PMID:20976849

Cheng, Ying-Sheng; Ma, Fang; Li, Yong-Dong; Chen, Ni-Wei; Chen, Wei-Xiong; Zhao, Jun-Gong; Wu, Chun-Gen

2010-01-01

118

Long-term follow-up outcomes of perinatally HIV-infected adolescents: infection control but school failure.  

PubMed

Perinatally human immunodeficiency virus (HIV)-infected children are fighting acquired immune deficiency syndrome (AIDS) and becoming adolescents. The objective of this study was to examine long-term outcomes among perinatally HIV-1-infected adolescents. Cross-sectional clinical and laboratory data were collected for 49 perinatally HIV-infected adolescents followed at the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP's) Hospital from 1987 to 2007. The mean age of these adolescents was 12.5 years, the majority were female (73.5%) with a mean follow-up duration of 9.0 years, 71.4% of adolescents had no signs of HIV infection, 81.6% had normal CD4(+) lymphocyte count, and 53.1% had undetectable HIV viral load. HIV disclosure to the adolescent was reported in 31 (63.3%) participants. The majority were in school (89.8%) but failure and drop-out were reported by 51% and 28.6% of the subjects, respectively. All five domains of quality of life (QOL) measured revealed high scores. The majority of long-term adolescent survivors showed HIV-infection control and high scores of QOL, but with problems in schooling functioning that need early detection and intervention. PMID:20167634

Souza, Edvaldo; Santos, Nicole; Valentini, Sophia; Silva, Gerlane; Falbo, Ana

2010-12-01

119

Improved life satisfaction and pain reduction: Follow-up of a 5-week multidisciplinary long-term pain rehabilitation programme  

PubMed Central

Background Multidisciplinary rehabilitation programmes can improve physical functioning and help patients with long-term pain back to work. Little is known, however, of the extent to which such rehabilitation also affects life satisfaction, pain severity, and disability. We wanted to evaluate if a 5-week rehabilitation programme for patients with long-term pain improves life satisfaction and decreases pain severity and disability. Methods The subjects were 164 patients aged 18–65 years from a pain rehabilitation clinic. Most of them were referred from primary care units. One group of repeated tests was used. Participants were asked to fill out the LiSat-11 checklist and parts of the Multidimensional Pain Inventory (MPI), including pain severity, at admission, at discharge, and 1 year after the rehabilitation programme. Results Satisfaction with life as a whole, and six of ten LiSat-11 domains improved during the follow-up, though none reached the levels for the general population. MPI subscales pain severity, pain interference, life control, and affective distress improved, whereas no change was observed for general activity. Patients older than 38 years decreased more in MPI affective distress than younger patients. Gender, pain severity, and work status before the programme did not significantly influence the outcome. Conclusions The results indicate that multidisciplinary rehabilitation improves life satisfaction, reduces pain severity, and reduces negative psychological, social, and behavioural effects of pain. These outcome variables relate to domains known to be of interest for patients and should therefore be considered for evaluation of rehabilitation programmes for long-term pain. PMID:24878367

Silvemark, Annika; Kallmen, Hakan

2014-01-01

120

Long-term follow-up of endoscopic therapy for stenosis of the biliobiliary anastomosis associated with orthotopic liver transplantation.  

PubMed

Endoscopic treatment for stenosis of an anastomotic biliary stricture (ABS) after orthotopic liver transplantation (OLT) has been proven to be effective and safe, but the long-term outcomes and the risk factors for recurrence are unknown. All 374 patients who underwent OLT at Frankfurt University Hospital were screened for the occurrence of ABSs. ABSs were treated via the endoscopic insertion of a plastic endoprosthesis (29.8%), balloon dilation (12.8%), or a combination of the two (57.4%). The mean follow-up time was 151 weeks, and the mean survival time was 3.4 years. ABSs were observed in 47 patients (12.6%). The mean time from OLT to an ABS was 16.25 months (median?=?3.25 months). The cumulative incidence rates for ABSs were 0.09 after 12 months, 0.10/24 m. and 0.11/36 m. In 12 cases (25.5%), ABSs were observed more than 12 months after OLT. ABSs recurred in 16 of the 47 patients (34%). The occurrence of an ABS 6 weeks or more after OLT was a significant predictor of ABS recurrence [P?=?0.04, hazard ratio (HR)?=?0.235]. There was a trend of hepatitis C virus (HCV) infections being predominant in patients experiencing ABS recurrence (30% for HCV etiology versus 4% for non-HCV etiology) in comparison with patients not experiencing recurrence (36% for HCV etiology versus 30% for non-HCV etiology, P?>?0.05). The severity of the initial stricture predicted ABS recurrence (P?=?0.046, HR?=?2.78), but it did not influence overall survival. The long-term resolution of ABSs was observed in 45 of the 47 patients (95.7%), and ABS recurrence was treated with another attempt (n?=?16 or 34%) or 2 more attempts (n?=?1) at endoscopic treatment. In conclusion, the long-term success of the endoscopic treatment of ABSs is highly probable if recurrent strictures are again treated endoscopically. ABSs might occur late (>36 months) after OLT, and lifelong follow-up is essential for identifying OLT patients with ABSs. PMID:23585381

Albert, Jörg G; Filmann, Natalie; Elsner, Julia; Moench, Christian; Trojan, Jörg; Bojunga, Jörg; Sarrazin, Christoph; Friedrich-Rust, Mireen; Herrmann, Eva; Bechstein, Wolf Otto; Zeuzem, Stefan; Hofmann, Wolf Peter

2013-06-01

121

Acute gastroesophageal intussusception in a juvenile Australian shepherd dog: endoscopic treatment and long-term follow-up  

PubMed Central

Background Canine gastroesophageal intussusception (GEI) is a rare and potentially fatal disease usually affecting puppies or young dogs?follow- up period of eight months, thoracic radiographs were obtained showing persistent esophageal dilatation in the absence of compatible clinical signs. Conclusion Endoscopic intervention is an effective, alternative in selected canine GEI- cases, allowing for rapid, minimally invasive confirmation of diagnosis and therapy. After initial treatment, radiographic long-term follow-up seems prudent even in asymptomatic patients. PMID:24885648

2014-01-01

122

Mid- to long-term results of irradiated allograft in acetabular reconstruction: a follow-up report.  

PubMed

Between 1990 and 2000, 123 hips in 110 patients were reconstructed for aseptic loosening using impaction bone grafting with frozen, irradiated, morsellised femoral heads and cemented acetabular components. This series was reported previously at a mean follow-up of five years. We have extended this follow-up and now describe the outcome of 86 hips in 74 patients at a mean of ten years. There have been 19 revisions, comprising nine for infection, seven for aseptic loosening and three for dislocation. In surviving acetabular reconstructions, union of the graft had occurred in 64 of 67 hips (95.5%). Survival analysis for all indications at ten years was 83.3% (95% confidence interval (CI) 68 to 89) and 71.3% (95% CI 58 to 84) at 15 years. Acetabular reconstruction using irradiated allograft and a cemented acetabular component is an effective method of reconstruction, providing results in the medium- to long-term comparable with those of reported series where non-irradiated freshly-frozen bone was used. PMID:19880883

Emms, N W; Buckley, S C; Stockley, I; Hamer, A J; Kerry, R M

2009-11-01

123

Disc degeneration in young patients with isthmic spondylolisthesis treated operatively or conservatively: a long-term follow-up.  

PubMed

The purpose of this long-term follow-up was (1) to investigate disc changes in the olisthetic segment in patients treated conservatively, (2) to compare disc changes above the slipped vertebra in conservatively treated patients with those in operatively treated patients, and (3) to establish possible relations of disc changes to the degree of the slip and to subjective back pain symptoms of the patients. The subjects were 227 patients with isthmic L5 olisthesis diagnosed under 20 years of age (mean 13.8 years) with a mean follow-up of 15.4 (range 5-30) years. Of these, 145 patients had been treated with segmental fusion and 82 had been treated conservatively. At follow-up, standing anteroposterior and lateral radiographs as well as flexion/extension views of the lumbar spine were taken. Disc degeneration was graded semiquantitatively: 0 = normal disc height, 1 = decrease of disc height < 50%, 2 = decrease > or = 50%, and 3 = obliteration of the disc. In the conservatively treated patients degeneration of the olisthetic disc was distributed by grade as follows: O: n = 38, 1: n = 24, 2: n = 14, 3: n = 6. No motion at all was observed in the olisthetic segment in 40 patients (48%) with a mean slip of 30%, segmental motion of 4 degrees-18 degrees was found in 42 patients with a mean slip of 14%. There was a statistically significant association of the degree of slip to the severity of disc degeneration and non-mobility of the segment. Grade 1 degeneration of the L4/5 disc occurred in 25.6% of the conservatively treated patients and in 32% of 48 patients treated with L5-S1 fusion. This correlated with the severity of the slip, but not with pain symptoms or pathologic segmental mobility at the time of follow-up. Out of 84 patients with L4-S1 fusion, in 17% grade 1 degeneration of the L3/4 disc was observed, and 3 out of 13 patients (23%) with L3-S1 fusion had grade 1 degeneration of the disc above the fusion. The disc changes had no correlation with subjective pain symptoms. It is concluded that the natural course of isthmic spondylolisthesis is associated with disc degeneration and spontaneous stabilization of the olisthetic segment. Fusion operations do not significantly increase the rate of disc degeneration in the adjacent disc above the fusion after a mean postoperative follow-up of 13.8 years. No correlation between the number of degenerated discs or the degree of degeneration and subjective low back pain symptoms was found. PMID:9455667

Seitsalo, S; Schlenzka, D; Poussa, M; Osterman, K

1997-01-01

124

Long-term follow-up study of elderly patients with covered stent implantation after coronary perforation  

PubMed Central

Objective To evaluate the long-term efficacy of covered stent implantation in the treatment of elderly patients with coronary perforation while undergoing percutaneous coronary intervention (PCI). Methods From June 2004 to June 2012, our center has followed ten elderly patients (age ? 60 years) who sustained coronary perforation during PCI. The major adverse cardiac events (MACE) were observed as well. The patients were advised to take 75 mg/day Clopidogrel for two years, and indefinite use of 100 mg/day enteric-coated aspirin. Results Six out of the 10 patients aged from 60 to 76 years old (mean 68.6 ± 5.2 years) were male, four were female. The average diameter of the implanted stents was 3.3 ± 0.3 mm, and the average length was 22.1 ± 3.7 mm. All the ruptures were successfully sealed without intra-procedural death. The follow-up duration ranged from 0.6 to 67 months (mean 31.7 ± 24.5 months). One patient died of multiple organ failure due to lung infection in 19 days after PCI; one died of cardiac sudden death in 13 months after PCI; one had angina pectoris in 53 months after PCI; one underwent multi-slice CT examination in six months after PCI, and no in-stent restenosis was found. The other four patients received angiography follow-up, and the results showed that three patients had no intra-stent restenosis, while one had left anterior descending (LAD) restenosis in the covered stent in 67 months after PCI. The in-hospital mortality was 10% (1/10). The MACE rate in 12 months after PCI was 10% (1/10). During the entire followed-up period, the restenosis rate in target vessels was 20% (1/5), mortality was 20% (2/10), and the MACE rate was 40% (4/10). Conclusion Treatment of coronary perforation by using covered stents can achieve favorable long-term results; a two-year dual antiplatelet therapy (DAPT) after PCI can effectively prevent intra-stent thrombosis.

Wang, Geng; Han, Ya-Ling; Jing, Quan-Min; Wang, Xiao-Zeng; Ma, Ying-Yan; Wang, Bin

2014-01-01

125

Natural course of care dependency in residents of long-term care facilities: prospective follow-up study  

PubMed Central

Background Insight in the natural course of care dependency of vulnerable older persons in long-term care facilities (LTCF) is essential to organize and optimize individual tailored care. We examined changes in care dependency in LTCF residents over two 6-month periods, explored the possible predictive factors of change and the effect of care dependency on mortality. Methods A prospective follow-up study in 21 Dutch long-term care facilities. 890 LTCF residents, median age 84 (Interquartile range 79–88) years participated. At baseline, 6 and 12 months, care dependency was assessed by the nursing staff with the Care Dependency Scale (CDS), range 15–75 points. Since the median CDS score differed between men and women (47.5 vs. 43.0, P?=?0.013), CDS groups (low, middle and high) were based on gender-specific 33% of CDS scores at baseline and 6 months. Results At baseline, the CDS groups differed in median length of stay on the ward, urine incontinence and dementia (all P?follow-up, 10% improved to a higher CDS group, 65% were in the same, and 25% had deteriorated to a lower CDS group; a similar pattern emerged at 12-month follow-up. Gender, age, urine incontinence, dementia, cancer and baseline care dependency status, predicted an increase in care dependency over time. Conclusion The majority of residents were stable in their care dependency status over two subsequent 6-month periods. Highly care dependent residents showed an increased mortality risk. Awareness of the natural course of care dependency is essential to residents and their formal and informal caregivers when considering therapeutic and end-of-life care options. PMID:24884563

2014-01-01

126

Long-term follow-up of weight status of subjects in a behavioral weight control program.  

PubMed

Few studies have examined the long-term effectiveness of behavioral weight control programs. Interpretation of the results from these studies has been limited due to small sample size, use of only one sex, and the number of evaluation parameters. A 2-year follow-up study was designed to assess the effectiveness of a behavioral weight control program on 123 obese male and 386 obese female subjects. Body weights were measured by dietitians at baseline and after an 8-week treatment program. Two-year follow-up weights were self-reported from a mailed questionnaire. The subjects' mean weight at baseline was 185.6 +/- 43.4 lb (no. = 509). Their mean percent over ideal body weight at baseline was 29.7%. Following an 8-week treatment period, mean weight was 176.4 +/- 41.3 lb (no. = 509), yielding a mean weight loss of 9.2 +/- 6.4 lb. Weight change after the 8-week treatment period ranged from a loss of 37 lb to a gain of 5 lb. The 2-year follow-up study showed that mean weight of the 498 subjects was 179.8 +/- 42.9 lb, yielding a mean weight loss of 5.8 +/- 15.5 lb. Weight change ranged from a loss of 71 lb to a gain of 47 lb. After 2 years, 325 subjects (65.3%) were still below their baseline weights, 182 subjects (36.6% of the entire study group) had maintained or enhanced the weight loss achieved during treatment, and 80 subjects (16.1%) weighed at least 10% less than their baseline weight.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2768738

Lavery, M A; Loewy, J W; Kapadia, A S; Nichaman, M Z; Foreyt, J P; Gee, M

1989-09-01

127

Long-term efficacy, safety, and side effect profile of botulinum toxin in dystonia: A 20-year follow-up.  

PubMed

Most long-term studies of the efficacy and safety profile of botulinum toxin (BoNT) in the treatment of dystonia are limited by lack of objective assessments, relatively small sample size, or short follow-up periods. We present one of the longest follow-up studies of BoNT treatment. This is a retrospective, longitudinal study that analyzes data on 89 patients treated with BoNT for dystonia at our Movement Disorders Clinic for up to 26 years (mean follow-up period of 18.5 years). The mean ages at the time of the first and last injections were 49 and 68 years old, respectively. The most common diagnoses were cervical dystonia (N = 51), blepharospasm (N = 34), and oromandibular dystonia (N = 26). The total number of onabotulinumtoxinA units received during the first injection was 140.3 as compared to 224.5 at the last injection (p < 0.0001). The global response effect was 3.18 after the first injection session and 3.57 after the last injection (p < 0.0001). The duration of response after the initial injection session and at the last injection was 16.33 weeks versus 19.42 weeks (p 0.0037), respectively. Adverse events, typically related to injection site, were reported in 19% of the visits. This series of dystonia patients with the longest reported treatment with BoNT provide evidence that in selected patients repeated chemodenervation is associated with sustained symptomatic benefit, decreased latency effect, and prolonged duration of therapeutic response. Despite the higher requirement of mean units per visit over time, only 19% of all treatment cycles are associated with adverse, but tolerable, side effects. PMID:25130293

Ramirez-Castaneda, Juan; Jankovic, Joseph

2014-11-01

128

Long-term follow-up of prenatally treated children at risk for congenital adrenal hyperplasia: does dexamethasone cause behavioural problems?  

Microsoft Academic Search

Objectives: To investigate the long-term effects of prenatal treatment of congenital adrenal hyperplasia (CAH) with emphasis on behavioural problems and temperament. Design: A population-based long-term follow-up study of Swedish children at risk for virilising CAH, who had received treatment prenatally with dexamethasone (DEX). The questionnaire-based follow-up was performed when the children had reached school age. Methods: Standardised parent-completed questionnaires were

Tatja Hirvikoski; Anna Nordenstrom; Torun Lindholm; Frank Lindblad; E Martin Ritzen; Svetlana Lajic

2008-01-01

129

Long term follow-up of HNPCC gene mutation carriers: compliance with screening and satisfaction with counseling and screening procedures.  

PubMed

Hereditary non polyposis colorectal cancer (HNPCC) is a hereditary predisposition to colorectal and endometrial cancer, caused by mutations of the mismatch repair (MMR) genes MSH2, MLH1 and MSH6. Regular colonoscopy reduces the incidence of colorectal cancer in mutation carriers dramatically. The aim of this study was to evaluate the use of colonoscopy by proven HNPCC mutation carriers. We also evaluated the satisfaction with the counseling and screening procedures at the long term. A questionnaire survey was performed among 94 proven MMR gene mutation carriers. Data were analyzed using univariate and multivariate analysis. The average time of follow-up was 3,5 years (range 0.5-8.5 years). The response rate was 74%. The proportion of unaffected mutation carriers under colonoscopic screening increased from 31 to 88% upon genetic testing, and for gynecological screening from 17 to 69%. However, more than half of the responders experienced colonoscopy as unpleasant or painful. About 97% felt well informed during counseling, and 88% felt sufficiently supported. Ten percent of the responders reported a high cancer worry that was significantly (P = 0.007) associated with a high perceived cancer risk. Six responders (9%) regretted being tested. Remarkably, of 4 of these 6 a close relative died recently of cancer. Problems with obtaining a disability or life insurance or mortgage were experienced by 4 out 10 healthy carriers opting for these services. In conclusion, genetic testing for HNPCC considerably improves compliance for screening, which will result in a reduction of HNPCC-related cancer morbidity and mortality in mutation carriers. Most HNPCC gene mutation carriers cope well with their cancer susceptibility on the long term. PMID:16341806

Wagner, Anja; van Kessel, Ingrid; Kriege, Mieke G; Tops, Carli M J; Wijnen, Juul Th; Vasen, Hans F A; van der Meer, Conny A; van Oostrom, Iris I H; Meijers-Heijboer, Hanne

2005-01-01

130

A long-term follow-up of weight changes in subthalamic nucleus stimulated Parkinson's disease patients.  

PubMed

Deep brain stimulation of the subthalamic nucleus (STN-DBS) constitutes the mainstay treatment in advanced Parkinson's disease (PD) with motor fluctuations. Despite its efficacy on motor signs and quality of life, emergent adverse events have been recently reported. Among them, weight gain (WG) is a recognized adverse event of subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD). Also, WG is poorly known at the long-term and predisposing factors have not yet been identified. We conducted a cross-sectional study of WG in 47 STN-DBS PD patients between 1999-2006. Data on disease history, motor status and dopaminergic drug treatment were retrospectively collected at surgery and 1 year post-surgery. Weight at disease diagnosis and at surgery, as well as the current weight and height were gathered by an autoquestionnaire. Moreover, the weight before surgery was obtained and verified in medical files in more than 90% of our patients. Sixty-six patients who underwent surgery between 1999-2006 were included, but six were deceased, four refused to participate and nine were lost for follow-up. So, 47 (71%) were retained in our analysis. A total of 78.7% of patients gained weight. On average 4.7 years follow up after surgery, the mean weight gain was +7.2±8.1kg compared to the preoperative assessment (p<0.001) and the mean BMI gain was +2.7±3.0kg/m(2) compared to pre-surgery values (p<0.001). The patients gained more weight after surgery than they had lost during disease evolution before surgery. Women and patients with a more severe UPDRS-III "off" drug score before surgery significantly gained more weight. Our study provides further evidence that the WG is a problem after STN-DBS and concerns a majority of patients at the long term. It may expose them to complications that should be considered for prevention and the patient's information before surgery. PMID:22019230

Foubert-Samier, A; Maurice, S; Hivert, S; Guelh, D; Rigalleau, V; Burbaud, P; Cuny, E; Meissner, W; Tison, F

2012-02-01

131

Donor P-gp polymorphisms strongly influence renal function and graft loss in a cohort of renal transplant recipients with long term follow-up.  

E-print Network

transplant recipients with long term follow-up. J-B Woillard1,2* and J-P Rerolle1,4* , N Picard1 and graft loss 2949 words, 25 references, 1 figure and 4 tables Keywords: Kidney transplantation function and subsequent graft loss, in a long-term cohort of recipients transplanted between 1990 and 2005

Paris-Sud XI, Université de

132

Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden  

PubMed Central

Context The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment. Objective To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons. Design A population-based matched cohort study. Setting Sweden, 1973-2003. Participants All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) in Sweden, 1973–2003. Random population controls (10?1) were matched by birth year and birth sex or reassigned (final) sex, respectively. Main Outcome Measures Hazard ratios (HR) with 95% confidence intervals (CI) for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]). Results The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8–4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8–62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9–8.5) and psychiatric inpatient care (aHR 2.8; 95% CI 2.0–3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls. Conclusions Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group. PMID:21364939

Dhejne, Cecilia; Lichtenstein, Paul; Boman, Marcus; Johansson, Anna L. V.; Langstrom, Niklas; Landen, Mikael

2011-01-01

133

Total hip arthroplasty after renal transplantation. Long-term follow-up study and assessment of metabolic bone status.  

PubMed

Twenty-two patients had 36 total hip arthroplasties for painful osteonecrosis of the femoral head. At a mean of 86 months after operation, a complete follow-up evaluation, including physical examination, was obtained in 24 hips in 15 patients. An additional 12 hips in seven patients were followed by telephone interview and radiographic evaluation. Although most patients experienced improved hip function and symptomatic relief from pain as a result of the operation, 10 hips developed heterotopic bone, 5 hips dislocated after operation, 6 hips failed due to aseptic loosening, and 1 hip developed a deep infection, and one patient died due to pulmonary embolism. Neither sex, preoperative steroid dose, nor postoperative mean alternate-day steroid dose could be related to aseptic loosening. However, histologic examination of transilial bone biopsy specimens (7 patients, 13 hips) revealed steroid-induced osteoporosis, by the presence of hyperosteoidosis (increased unmineralized osteoid) and increased bone resorption. Bilateral hip involvement, osteoporosis, and high turnover skeletal remodelling at the cement-bone interface potentially contributed to a failure rate that was higher in this group than that reported for primary hip arthroplasty for other diagnoses. The existence of steroid-induced metabolic bone disease and preexisting renal osteodystrophy may pose a significant threat to the long-term survival of a total hip implant. PMID:3053996

Devlin, V J; Einhorn, T A; Gordon, S L; Alvarez, E V; Butt, K M

1988-01-01

134

Long-term effect of placental type on anthropometrical and psychological traits among monozygotic twins: a follow up study.  

PubMed

The long-term effect of differences in placentation in MZ twins is a controversial subject. An effect has been clearly established for birth weight but data on psychological traits are still under debate. We studied 20 pairs of monochorionic MZ (MC MZ) and 24 pairs of dichorionic MZ (DC MZ) twins. A chorion effect was observed for Block Design (WISC-R) confirming a previous report: MC MZ co-twins were more similar that DC MZ co-twins. For anthropometrical measures, an expected effect in the opposite direction was found. No chorion effect was significant for the other variables. A follow up was undertaken 3 years later using cognitive, national academic evaluations, and personality variables. The sample included 16 pairs of MC MZ and 22 pairs of DC MZ twins. Again a chorion effect was observed on anthropometrical variables but results on the Block Design were not replicated. However, the MC MZ co-twins were more similar than the DC MZ co-twins for two other cognitive variables: Perceptual Organization Index from the WISC-R and Global Visualisation from a Belgian reasoning test. Among the personality variables only one was sensitive to a chorion effect. The discussion focuses on the need for larger samples to achieve adequate power in statistical comparisons. PMID:10555132

Gutknecht, L; Spitz, E; Carlier, M

1999-09-01

135

Long-term follow-up studies of Gamma Knife surgery for patients with neurofibromatosis Type 2.  

PubMed

Object The aim of this study was to evaluate long-term clinical outcomes after Gamma Knife surgery (GKS) for patients with neurofibromatosis Type 2 (NF2) and the role of GKS in the management of NF2. Methods From December 1994 through December 2008, a total of 46 patients (21 male, 25 female) with NF2 underwent GKS and follow-up evaluation for at least 5 years at the Gamma Knife Center of the Beijing Neurosurgical Institute. GKS was performed using the Leksell Gamma Knife Models B and C. The mean age of the patients was 30 years (range 13-59 years). A family history of NF2 was found for 9 (20%) patients. The NF2 phenotype was thought to be Wishart for 20 (44%) and Feiling-Gardner for 26 (56%) patients. Among these 46 patients, GKS was performed to treat 195 tumors (73 vestibular schwannomas and 122 other tumors including other schwannomas and meningiomas). For vestibular schwannomas, the mean volume was 5.1 cm(3) (median 3.6 cm(3), range 0.3-27.3 cm(3)), the mean margin dose was 12.9 Gy (range 10-14 Gy), and the mean maximum dose was 27.3 Gy (range 16.2-40 Gy). For other tumors, the mean volume was 1.7 cm(3) (range 0.3-5.5 cm(3)), the mean margin dose was 13.3 Gy (range 11-14 Gy), and the mean maximum dose was 26.0 Gy (range 18.0-30.4 Gy). The median duration of follow-up was 109 months (range 8-195 months). Results For the 73 vestibular schwannomas that underwent GKS, the latest follow-up MR images demonstrated regression of 30 (41%) tumors, stable size for 31 (43%) tumors, and enlargement of 12 (16%) tumors. The total rate of tumor control for bilateral vestibular schwannomas in patients with NF2 was 84%. Of the 122 other types of tumors that underwent GKS, 103 (85%) showed no tumor enlargement. The rate of serviceable hearing preservation after GKS was 31.9% (15/47). The actuarial rates for hearing preservation at 3 years, 5 years, 10 years, and 15 years were 98%, 93%, 44%, and 17%, respectively. Of the 46 patients, 22 (48%) became completely bilaterally deaf, 17 (37%) retained unilateral serviceable hearing, and 7 (15%) retained bilateral serviceable hearing. The mean history of the disease course was 12 years (range 5-38 years). Conclusions GKS was confirmed to provide long-term local tumor control for small- to medium-sized vestibular schwannomas and other types of tumors, although vestibular schwannomas in patients with NF2 responded less well than did unilateral sporadic vestibular schwannomas. Phenotype is the most strongly predictive factor of final outcome after GKS for patients with NF2. The risk for loss of hearing is high, whereas the risk for other cranial nerve complications is low. PMID:25434947

Sun, Shibin; Liu, Ali

2014-12-01

136

Short and long term outcome of neonatal hyperglycemia in very preterm infants: a retrospective follow-up study  

PubMed Central

Background Hyperglycemia in premature infants is associated with increased morbidity and mortality, but data on long-term outcome are limited. We investigated the effects of neonatal hyperglycemia (blood glucose ? 10 mmol/l, treated with insulin for ? 12 hours) on growth and neurobehavioral outcome at 2 years of age. Methods Retrospective follow-up study at 2 years of age among 859 infants ?32 weeks of gestation admitted to a tertiary neonatal center between January 2002 and December 2006. Thirty-three survivors treated with insulin for hyperglycemia and 63 matched controls without hyperglycemia were evaluated at a corrected age of 2 years. Outcome measures consisted of growth (weight, length, and head circumference) and neurological and behavioural development. Results 66/859 (8%) infants ? 32 weeks of gestation developed hyperglycemia. Mortality during admission was 27/66 (41%) in the hyperglycemia group versus 62/793 (8%) in those without hyperglycemia (p < 0.001). Mortality was higher in infants with hyperglycemia with a birth weight ?1,000 gram (p = 0.005) and/or gestational age of 24-28 weeks (p = 0.009) than in control infants without hyperglycemia. Sepsis was more prominent in infants with hyperglycemia and a birth weight of >1,000 gram (p = 0.002) and/or gestational age of 29-32 weeks (p = 0.009) than in control infants without hyperglycemia. Growth at 2 years of age was similar, but neurological and behavioural development was more frequently abnormal among those with neonatal hyperglycemia (p = 0.036 and 0.021 respectively). Conclusions Mortality was higher in very preterm infants with hyperglycemia treated with insulin during the neonatal period. At 2 years of age survivors showed normal growth, but a higher incidence of neurological and behavioural problems. Better strategies to manage hyperglycemia may improve outcome of very preterm infants. PMID:20646308

2010-01-01

137

Mortality Risk Prediction by an Insurance Company and Long-Term Follow-Up of 62,000 Men  

PubMed Central

Background Insurance companies use medical information to classify the mortality risk of applicants. Adding genetic tests to this assessment is currently being debated. This debate would be more meaningful, if results of present-day risk prediction were known. Therefore, we compared the predicted with the observed mortality of men who applied for life insurance, and determined the prognostic value of the risk assessment. Methods Long-term follow-up was available for 62,334 male applicants whose mortality risk was predicted with medical evaluation and they were assigned to five groups with increasing risk from 1 to 5. We calculated all cause standardized mortality ratios relative to the Dutch population and compared groups with Cox's regression. We compared the discriminative ability of risk assessments as indicated by a concordance index (c). Results In 844,815 person years we observed 3,433 deaths. The standardized mortality relative to the Dutch male population was 0.76 (95 percent confidence interval, 0.73 to 0.78). The standardized mortality ratios ranged from 0.54 in risk group 1 to 2.37 in group 5. A large number of risk factors and diseases were significantly associated with increased mortality. The algorithm of prediction was significantly, but only slightly better than summation of the number of disorders and risk factors (c-index, 0.64 versus 0.60, P<0.001). Conclusions Men applying for insurance clearly had better survival relative to the general population. Readily available medical evaluation enabled accurate prediction of the mortality risk of large groups, but the deceased men could not have been identified with the applied prediction method. PMID:19421319

Sijbrands, Eric J. G.; Tornij, Erik; Homsma, Sietske J.

2009-01-01

138

Fertility potential in men with a history of congenital undescended testes: a long-term follow-up study.  

PubMed

Men with a history of congenital undescended testes (UDT) have an increased risk of fertility problems. Despite no definitive proof, current guidelines recommend early surgical intervention because this may have a positive effect on future fertility potential by preventing degenerative changes of the testes in early life. Also surgical intervention facilitates observability of the testes in view of possible malignancy. We evaluated testicular function in adult men with previous UDT treated at different ages before puberty. A long-term follow-up study of men with previous UDT was performed. Andrological evaluation included medical history taking, physical examination, scrotal ultrasound, determination of reproductive hormones, and semen analysis. Findings were compared with those of a control group of men with normal testicular descent. The influence of age at orchiopexy on future fertility parameters was evaluated in a multivariate regression analysis. 62 men were included of whom seven had had bilateral UDT. Twenty-four patients had had their orchiopexy before the age of 24 months of whom eight men had it before 12 months of age. Forty-eight men had had unsuccessful luteinizing-hormone-releasing-hormone (LHRH) nasal spray treatment during childhood, whereas 14 of 24 men operated before 24 months of age had not received LHRH treatment before orchiopexy. Fertility potential in men with a history of UDT is compromised in comparison with controls. We could not detect any influence of age at orchiopexy on fertility parameters. However, the number of patients operated before the age of 12 months is limited. This study does not support the assumption that early orchiopexy results in better fertility potential. PMID:23258637

van Brakel, J; Kranse, R; de Muinck Keizer-Schrama, S M P F; Hendriks, A E J; de Jong, F H; Bangma, C H; Hazebroek, F W J; Dohle, G R

2013-01-01

139

Dynamic endocrine testing and magnetic resonance imaging in the long-term follow-up of childhood langerhans cell histiocytosis.  

PubMed

Children treated for Langerhans cell histiocytosis (LCH) are at risk for short and long term endocrine sequelae, but biological predictors of specific deficits are not well defined. We evaluated the frequency and progression of LCH-related endocrine deficits during long term follow-up and assessed the ability of dynamic endocrine testing to identify patients at risk for late anterior or posterior pituitary hormone dysfunction. The 17 patients (5 males and 12 females) were followed a median of 10 yr after diagnosis of single system (n = 6) or multisystem (n = 11) disease. Study evaluations, performed a median of 4.1 yr after the diagnosis, comprised pituitary hormone responses to the appropriate challenge, 7-h water deprivation test, 3% hypertonic saline infusion, and magnetic resonance imaging (MRI). The six patients with GH deficiency at the time of evaluation had a significantly lower GH response to GHRH than the other patients [median peak, 7.3 vs. 21.5 micrograms/L (P = 0.03); median area under the curve, 4.7 vs. 13.5 micrograms/L (P = 0.03)]; levels in the latter group did not differ significantly from those in 20 age- and sex-matched controls with constitutional or familial short stature. Two patients who had GH responses to GHRH of 20.6 and 23 ng/mL at 2.8 and 9.5 yr of age developed GH deficiency at 6.5 and 11.2 yr of age, respectively. The TSH response to TRH was less than 10 mU/L in three patients, two of whom later developed central hypothyroidism. ACTH and cortisol responses to CRF, and PRL responses to TRH were normal in all cases, and LH and FSH responses to GnRH were compatible with pubertal stage. Abnormalities in arginine vasopressin responses to water deprivation or hypertonic saline infusion were seen only in four patients who had preexisting diabetes insipidus (DI); one patient who later developed DI had normal findings. On standard MRI, posterior pituitary hyperintensity was absent only in the patients with DI. Pituitary stalk thickening was seen in seven patients, including three who did not have DI and had normal arginine vasopressin responses. Delayed posterior and anterior enhancement on dynamic MRI was present in two patients, both of whom later developed central hypothyroidism. Patients with single system disease had a lower 5-yr probability of LCH reactivation (41% vs. 83% for those with multisystem disease; P = 0.21) and a significantly lower risk of endocrine dysfunction (P = 0.007). In this series, dynamic evaluation of pituitary function was not a useful predictor of late endocrine sequelae, with the possible exception of the progressively decreasing TSH response to TRH. Similarly, a standard MRI was not predictive, although dynamic imaging may be informative regarding evolving pituitary hormone deficiency. PMID:9745408

Maghnie, M; Bossi, G; Klersy, C; Cosi, G; Genovese, E; Aricò, M

1998-09-01

140

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

SciTech Connect

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.

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

141

Relationship between hospital infection and long-term mortality in general surgery: a prospective follow-up study  

Microsoft Academic Search

A prospective study of 1431 patients admitted to a general surgery department were followed up for a median of 6.2 years after discharge (7679 person-years of follow-up). We collected information on underlying conditions, including severity of illness, and healthcare-related variables. Relative rates of death and their 95% confidence interval (CI) were estimated using person-years as the denominator. Multiple-risk factors adjusted

A Cosano; M. Á Mart??nez-González; M Medina-Cuadros; G Mart??nez-Gallego; S Palma; M Delgado-Rodr??guez

2002-01-01

142

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

Microsoft Academic Search

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,

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

143

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

ERIC Educational Resources Information Center

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…

Schaeffer, Cindy M.; Borduin, Charles M.

2005-01-01

144

Long-Term Outcomes of Children and Youth Accessing Residential or Intensive Home-Based Treatment: Three Year Follow up  

ERIC Educational Resources Information Center

In this study the long-terms outcomes of children and youth with severe mental health problems receiving residential treatment (RT) or an intensive home-based treatment (IHT) were reported. RT is 24-hour mental health intervention in a highly supervised and structured group living setting where individualized and related therapies are provided.…

Preyde, M.; Frensch, K.; Cameron, G.; White, S.; Penny, R.; Lazure, K.

2011-01-01

145

Long-term follow-up of pallidal deep brain stimulation in two cases of Huntington's disease  

Microsoft Academic Search

BackgroundDeep brain stimulator (DBS) implantation has been shown to be effective in the treatment of various movement disorders including Parkinson's disease, essential tremor and dystonia. However, there is limited information regarding the potential use of DBS in Huntington's disease (HD). In this study, the authors present their findings on the long-term motor and neurocognitive results of two HD patients (patient

Gail A Kang; Susan Heath; Johannes Rothlind; Philip A Starr

2010-01-01

146

Hair removal with a second generation broad spectrum intense pulsed light source - a long-term follow-up  

Microsoft Academic Search

BACKGROUND: There is an increasing demand for safe and efficient hair removal. Although long-term hair removal has been demonstrated using lasers and non-coherent light sources, permanent hair removal has been diffi- cult to claim due to the long growth\\/ rest cycle of normal human hair follicles. OBJECTIVE: To evaluate bikini line hair removal with a second generation intense pulsed light

Agneta Troilius; Carl Troilius

147

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

PubMed

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

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

2012-09-01

148

Carotid-Subclavian Bypass for Subclavian Artery Revascularization: Long-term Follow-up and Effect of Antiplatelet Therapy  

Microsoft Academic Search

Subclavian artery stenosis is found in up to 25% of supraaortic lesions. Bypass grafting is the procedure of choice but controversies exist concerning the optimal technique and the effect of postoperative antithrombotic therapy on long-term patency.The authors retrospectively analyzed 40 patients with carotid-subclavian bypasses. Stenoses were documented preoperatively by arteriography. Patency was determined by clinical, ultrasound, or arteriographic examinations. Cumulative

Thorsten Wittwer; Thorsten Wahlers; Christoph Dresler; Axel Haverich

1998-01-01

149

Long-term clinical follow-up of patients treated with the coronary rotablator: A single-center experience  

Microsoft Academic Search

The acute angiographic and long-term clinical outcomes of a consecutive series of patients treated with the coronary rotablator at a single center are described. The patient population was a high-risk population, with significant instances of unstable angina or acute myocardial infarctions (MI) on presentation (75.5%), three-vessel coronary artery disease (27.5%), congestive heart failure (23.8%), and diabetes (39%). The coronary anatomy

Robert M. Bersin; John C. Cedarholm; Glen J. Kowalchuk; Peter J. Fitzgerald

1999-01-01

150

Long-term follow-up of consequences of percutaneous endoscopic gastrostomy (PEG) tubes in nursing home patients  

Microsoft Academic Search

PEG (percutaneous endoscopic gastrostomy) tubes are frequently placed in nursing home patients. The aim of this study was to assess retrospectively the long-term changes in functional and nutritional statuses, tube-related complications, and factors influencing survival in 46 nursing home residents, mean age 73.6 years (range 19–96). Functional status was evaluated by a standard rehabilitation medicine scale. Nutritional status was evaluated

Madhukar Kaw; Gail Sekas

1994-01-01

151

Long-term Outcomes of Children and Youth accessing Residential or Intensive Home-based Treatment: Three year follow up  

Microsoft Academic Search

In this study the long-terms outcomes of children and youth with severe mental health problems receiving residential treatment\\u000a (RT) or an intensive home-based treatment (IHT) were reported. RT is 24-hour mental health intervention in a highly supervised\\u000a and structured group living setting where individualized and related therapies are provided. Youths attend a day school within\\u000a the residential environment. IHT developed

M. Preyde; K. Frensch; G. Cameron; S. White; R. Penny; K. Lazure

152

Long term outcome by method of delivery of fetuses in breech presentation at term: population based follow up  

Microsoft Academic Search

AbstractObjective: To compare the long term outcome of infants delivered in breech presentation at term by intended mode of delivery.Design: A population based comparison of outcomes up to school age. Data obtained from maternity, health visitor, and school medical records and handicap register.Setting: Grampian region 1981-90.Subjects: 1645 infants delivered alive at term after breech presentation.Main outcome measures: Handicap, developmental delay,

P J Danielian; J Wang; M H Hall

1996-01-01

153

Natural history of pure ground-glass opacity after long-term follow-up of more than 2 years  

Microsoft Academic Search

Background. Pure ground-glass opacity (PGGO) is a new entity that has been clearly defined on high-resolution computed tomography (CT) during the last half decade. It is important to investigate the natural history of PGGO through long-term observation for the management of this new entity.Methods. We investigated 19 patients with PGGO(s) defined on high-resolution computed tomography and retained as PGGO for

Ken Kodama; Masahiko Higashiyama; Hideoki Yokouchi; Koji Takami; Keiko Kuriyama; Yoko Kusunoki; Tomio Nakayama; Fumio Imamura

2002-01-01

154

Two Studies of the Long-Term Follow-up of Minimal Therapist Contact Treatments of Vascular and Tension Headache.  

ERIC Educational Resources Information Center

Followed up on tension and vascular headache patients, intially treated with biofeedback and/or relaxation training in either a minimal therapist contact or an intensive individual protocol, where one-half of patients continued keeping headache diaries and were seen monthly; others had minimal contact. Demonstrated equally good maintenance from…

Blanchard, Edward B.; And Others

1988-01-01

155

Demography, Clinical Characteristics, Psychological and Abuse Profiles, Treatment, and Long-Term Follow-up of Patients with Gastroparesis  

Microsoft Academic Search

Patients with gastroparesis frequently presentchallenging clinical, diagnostic, and therapeuticproblems. Data from 146 gastroparesis patients seen oversix years were analyzed. Patients were evaluated at the time of initial diagnosis and at themost recent follow-up in terms of gastric emptying andgastrointestinal symptomatology. The psychologicalstatus and physical and sexual abuse history in female idiopathic gastroparesis patients wereascertained and an association between those factors

Irfan Soykan; Bulent Sivri; Irene Sarosiek; Brian Kiernan; Richard W. Mccallum

1998-01-01

156

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

Microsoft Academic Search

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

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

2008-01-01

157

Long-term follow-up results of the observation program for neuroblastoma detected at 6-month mass screening.  

PubMed

We conducted an observation program of neuroblastoma in infants, detected by mass screening at 6 months of age; we followed up with them for 15 years. No recurrence was observed after disappearance of tumors, and persistent tumors showed no malignant transformation or metastasis. Histology of the resected tumors showed age-related differentiation. PMID:25091258

Arakawa, Ayumu; Oguma, Eiji; Aihara, Toshinori; Kishimoto, Hiroshi; Kikuchi, Akira; Hanada, Ryoji; Koh, Katsuyoshi

2014-10-01

158

Long-Term Survival Analysis and Clinical Follow-Up in Acral Lentiginous Malignant Melanoma Undergoing Sentinel Lymph Node Biopsy in Korean Patients  

PubMed Central

Background In cutaneous malignant melanoma (MM) with clinically uninvolved regional lymph nodes, sentinel lymph node (SLN) status is the most powerful indicator of both overall survival (OS) and disease-free survival (DFS). However, no studies on the long-term survival and clinical follow-up of Korean patients with acral lentiginous MM (ALM) undergoing SLN biopsy (SLNB) have been published. Objective The purpose of this study was to investigate the clinical prognosis and long-term survival of Korean patients with ALM according to SLN status. Methods Thirty-four ALM patients undergoing SLNB were included in this study. We evaluated clinical and histopathological follow-up data such as the stage of disease, treatment, recurrence, and metastasis, and analyzed OS and DFS according to SLN status. Results The median follow-up time was 60.5 months (range 3~127 months). Positive SLNs were noted in 14 patients (41.2%). Patients with negative SLNs had better OS and DFS than those with positive SLNs (p<0.05). Increased Breslow thickness was associated with short OS and DFS (p<0.05), and female patients showed better DFS than male patients (p<0.05). Conclusion To our knowledge, this is the first study on the long-term survival and clinical follow-up of patients undergoing SLNB for ALM in Korea. Our findings show that SLN status is an important prognostic factor for predicting OS and DFS. PMID:24882971

Jeon, Su-Young; Hong, Jin-Woo; Lee, Suee; Oh, Sung Yong; Hong, Young-Seoub; Kim, Ki-Ho

2014-01-01

159

Long-term results of laparoscopic versus open colorectal resections for cancer in 235 patients with a minimum follow-up of 5 years  

Microsoft Academic Search

Background  Laparoscopic resection for cure of colorectal cancer is controversial. More investigations on long-term results are required.\\u000a This study aimed to compare the long-term outcome with a minimum follow-up of 5 years between laparoscopic or open approach\\u000a for the treatment of colo-rectal cancer.\\u000a \\u000a \\u000a \\u000a Methods  The treatment modality (laparoscopic or open) was related to the patients (pts) choice. The following parameters between the

E. Lezoche; M. Guerrieri; A. De Sanctis; R. Campagnacci; M. Baldarelli; G. Lezoche; A. M. Paganini

2006-01-01

160

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

Microsoft Academic Search

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

Eva Möller; Lars Weidenhielm; Suzanne Werner

2009-01-01

161

Long-term follow-up of OCT-guided bevacizumab treatment of macular edema due to retinal vein occlusion  

Microsoft Academic Search

Background  To evaluate the long-term outcome of an OCT-guided reinjection scheme for bevacizumab treatment of macular edema (ME) due\\u000a to retinal vein occlusion.\\u000a \\u000a \\u000a \\u000a Methods  Patients with persistent ME (>250 ?m) due to central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO)\\u000a received intravitreal bevacizumab 2.5 mg\\/0.1 ml. Visual acuity (ETDRS), ophthalmic examination and OCT were performed at baseline\\u000a and at 6- to 8-week

Alexandra E. Hoeh; Thomas Ach; Karen B. Schaal; Alexander F. Scheuerle; Stefan Dithmar

2009-01-01

162

Long term follow up of idiopathic gingival enlargement associated with chronic periodontitis: A case report and review  

PubMed Central

Background: Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis. Case Description: This case report describes an unusual clinical form of gingival enlargement associated with chronic periodontitis. Clinical examination revealed diffuse gingival enlargement. The lesion was asymptomatic, firm, and pinkish red. Generalized periodontal pockets were observed. Radiographic evaluation revealed generalized severe alveolar bone loss. Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue. Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up. Clinical Implications: Successful treatment of idiopathic gingival enlargement depends on proper identification of etiologic factors and improving esthetics and function through surgical excision of the over growth. However, there may be recurrence. PMID:23869135

Nagarale, Girish P.; Ravindra, S.; Thakur, Srinath; Setty, Swati

2013-01-01

163

Long-term follow-up of a high-intensity exercise program in patients with rheumatoid arthritis  

Microsoft Academic Search

The aims of this study were to describe rheumatoid arthritis patients’ compliance with continued exercise after participation\\u000a in a 2-year supervised high-intensity exercise program and to investigate if the initially achieved effectiveness and safety\\u000a were sustained. Data were gathered by follow-up of the participants who completed the 2-year high-intensity intervention in\\u000a a randomized controlled trial (Rheumatoid Arthritis Patient In Training

Zuzana de Jong; Marten Munneke; Herman M. Kroon; Dirkjan van Schaardenburg; Ben A. C. Dijkmans; Johanna M. W. Hazes; Theodora P. M. Vliet Vlieland

2009-01-01

164

Prognostic value of steroid receptors after long-term follow-up of 2257 operable breast cancers  

Microsoft Academic Search

The prognostic value of oestrogen receptor (ER) and progesterone receptor (PR) was estimated through a multicentric study of 2257 operable breast cancer patients followed up for a median of 8.5 years. None of the patients had received adjuvant therapy. The series included 33.3% stage I patients, 57.1% stage II, 5.7% stage IIIa and 2.4% stage IIIb. At the end point

M. F. Pichon; P. Broet; H. Magdelenat; J. C. Delarue; F. Spyratos; J. P. Basuyau; S. Saez; A. Rallet; P. Courriere; R. Millon; B. Asselain

1996-01-01

165

Risk of suicide after suicide attempt according to coexisting psychiatric disorder: Swedish cohort study with long term follow-up  

Microsoft Academic Search

Objective To investigate the impact of coexistent psychiatric morbidity on risk of suicide after a suicide attempt.Design Cohort study with follow-up for 21-31 years.Setting Swedish national register based study.Participants 39 685 people (53% women) admitted to hospital for attempted suicide during 1973-82.Main outcome measure Completed suicide during 1973-2003.Results A high proportion of suicides in all diagnostic categories took place within

Dag Tidemalm; Niklas Långström; Paul Lichtenstein; Bo Runeson

2008-01-01

166

Long-Term Follow-up of Patients With Chronic Lymphocytic Leukemia Treated With Fludarabine as a Single Agent  

Microsoft Academic Search

The clinical response and survival of 1 13 patients with at least 3-year follow-up after treatment with fludarabine as a single agent for chronic lymphocytic leukemia has been evaluated. Seventy-eight patients were previously treated and 35 were untreated. The response to therapy and sur- vival were strongly correlated with the degree of previous therapy, the stage of disease, and whether

Michael J. Keating; Susan O'Brien; Hagop Kantarjian; William Plunkett; Elihu Estey; Charles Koller; Miloslav Beran; Emit J Freireich

1993-01-01

167

Long-Term Follow-Up and Outcome of a Large Cohort of Patients with Common Variable Immunodeficiency  

Microsoft Academic Search

Common Variable Immunodeficiency belongs to the group of rare diseases encompassing antibody deficiency syndromes of highly\\u000a variable clinical presentation and outcome. The multicenter prospective study on a cohort of 224 patients with Common Variable\\u000a Immunodeficiency provides an updated view of the spectrum of illnesses which occurred at the clinical onset and over a long\\u000a period of follow-up (mean time: 11

ISABELLA QUINTI; ANNAROSA SORESINA; GIUSEPPE SPADARO; SILVANA MARTINO; SIMONA DONNANNO; CARLO AGOSTINI; PIGNATA CLAUDIO; DAMMACCO FRANCO; ANNA MARIA PESCE; FEDERICA BORGHESE; ANDREA GUERRA; ROBERTO RONDELLI; ALESSANDRO PLEBANI

2007-01-01

168

Long-Term Follow-Up of Children with Mental Retardation\\/Borderline Intellectual Functioning and ADHD  

Microsoft Academic Search

Fifty-two children (ages 7 to 14 years) with moderate mental retardation to borderline intellectual functioning were recontacted 12 to 65 months following participation in a double-blind, placebo-controlled trial of methylphenidate (MPH). Sixty-nine percent of subjects continued to be prescribed medication for behavior control at follow-up. While 72% of the sample evidenced improvement, over two-thirds continued to be rated at or

Benjamin L. Handen; Janine Janosky; Sarah McAuliffe

1997-01-01

169

Effectiveness of a Computer-Based Interactive Eating Disorders Prevention Program at Long-Term Follow-Up  

Microsoft Academic Search

Computer-based delivery of health-related psychoeducational programming is increasingly popular. In the present study, 72 non-symptomatic undergraduate women were randomized to an Internet-based prevention program for eating disorders with or without accompanying discussion groups, or a control group. Sixty-one of the women (84%) completed the Student Bodies program, and were assessed at short and eight–nine month follow-up. Participation in the program

Kathryn Graff Low; Swita Charanasomboon; Jill Lesser; Katie Reinhalter; Rachel Martin; Hannah Jones; Andy Winzelberg; Liana Abascal; C. Barr Taylor

2006-01-01

170

Long-term mortality follow-up of the ISOLDE participants: causes of death during 13 years after trial completion.  

PubMed

The Inhaled Steroids in Obstructive Lung Disease (ISOLDE) study was a trial that randomised 752 patients with moderate to severe COPD to fluticasone propionate 1000 mcg/day or placebo for three years. We aimed to examine the causes of death of the ISOLDE participants after the original three up to 13 years post-randomisation. Death certificates were obtained either from the NHS Strategic Tracing Service or from the Office of National statistics. Deaths were classified according to the trial protocol. In the subsample of 375 participants from the seven ISOLDE original centers where complete extended follow-up was conducted, the factors associated with observed higher mortality (p<0.05) were male gender, older age and more severe COPD. Causes of death were; 107 (52%) respiratory, 38 (18%) cardiac, 29 (14%) lung cancer, 16 (8%) other cancer and 16 (8%) other causes. The percentage of respiratory-related deaths increased during the follow-up period; from 46% within the three-year trial, to 48% after 3-6 years, 57% after 6-9 years, and 60% after 9-13 years of follow-up (p for trend<0.05). We conclude that participants' survival is poor (only 44% in the 13 years after the ISOLDE trial), and that respiratory-related illnesses were the most frequent causes of death in patients with moderate to severe COPD. PMID:18620853

Bale, Geraldine; Martínez-Camblor, Pablo; Burge, P Sherwood; Soriano, Joan B

2008-10-01

171

Auditory processing in remitted major depression: a long-term follow-up investigation using 3T-fMRI.  

PubMed

Major depression is accompanied by cortical dysfunction including impaired auditory processing of non-speech stimuli. In a previous study, we could show that potent antidepressant treatment with electroconvulsive therapy (ECT) did not lead to full functional normalization of altered fMRI activation patterns in response to sine tones although depressive symptoms improved and remission was achieved in the majority of patients. In a next step, a longitudinal follow-up investigation was conducted looking on neuronal activation over time along with full remission in a subgroup of patients of the previous study in order to address the question whether changes in neuronal activation patterns reflect a more state- or trait-dependent characteristic. Results showed that although clinically remitted, patients still exhibited an increased activity of the secondary auditory cortex and multimodal recruitment of the left cuneus, an area of the visual system. However, activity of recruited secondary visual network had decreased over time. A positive correlation was observed between the number of hospital admissions during the follow-up period and activity of the secondary visual area of the left cuneus at baseline prior to ECT. Thus, although the persistence of differences in activation patterns after sine tone presentation in this follow-up investigation could argue for a potential trait marker of depression characterized by alterations in auditory processing, attenuation of neuronal activation in some areas over time suggests that changes might in part also be state-dependent. PMID:22926663

Zwanzger, Peter; Zavorotnyy, M; Diemer, J; Ruland, T; Domschke, K; Christ, M; Michael, N; Pfleiderer, B

2012-12-01

172

Axis I and II disorders as long-term predictors of mental distress: a six-year prospective follow-up of substance-dependent patients  

Microsoft Academic Search

BACKGROUND: A high prevalence of lifetime psychiatric disorders among help-seeking substance abusers has been clearly established. However, the long-term course of psychiatric disorders and mental distress among help-seeking substance abusers is still unclear. The aim of this research was to examine the course of mental distress using a six-year follow-up study of treatment-seeking substance-dependent patients, and to explore whether lifetime

Kjell Bakken; Anne Signe Landheim; Per Vaglum

2007-01-01

173

Efficacy of the Incredible Years Programme as an early intervention for children with conduct problems and ADHD: long-term follow-up  

Microsoft Academic Search

Background This study examined the long-term efficacy of the Incredible Years (IY) BASIC Parenting Programme delivered as a preventive intervention with parents of pre-school children who display signs of attention deficit hyperactivity disorder (ADHD) and conduct problems.Families were followed up after the completion of a controlled trial with 11 Sure Start areas in North and Mid-Wales and North West England.

K. Jones; D. Daley; J. Hutchings; T. Bywater; C. Eames

2008-01-01

174

Microvascular decompression of cochlear nerve for tinnitus incapacity: pre-surgical data, surgical analyses and long-term follow-up of 15 patients  

Microsoft Academic Search

The level of success of neurovascular decompression in ponto-cerebellar angle for hemifacial spasm and trigeminal neuralgia\\u000a has already established the reality of the pathology to explain such symptoms. However, cochlear nerve compression syndrome\\u000a by vascular loop is still a controversial topic. We have performed a retrospective cases review with long-term follow-up (5–7 years)\\u000a concerning the results of microvascular decompression surgery of

Nicolas Guevara; Arnaud Deveze; Valeriu Buza; Benoît Laffont; Jacques Magnan

2008-01-01

175

BRIEF REPORT PREVENTING ILLICIT DRUG USE IN ADOLESCENTS: LONG-TERM FOLLOW-UP DATA FROM A RANDOMIZED CONTROL TRIAL OF A SCHOOL POPULATION  

Microsoft Academic Search

National survey data indicate that illicit drug use has steadily increased among American adolescents since 1992. This upward trend underscores the need for identifying ef- fective prevention approaches capable of reducing the use of both licit and illicit drugs. The present study examined long-term follow-up data from a large-scale randomized prevention trial to determine the extent to which participation in

GILBERT J. BOTVIN; KENNETH W. GRIFFIN; TRACY DIAZ; LAWRENCE M. SCHEIER; CHRISTOPHER WILLIAMS; JENNIFER A. EPSTEIN

176

Thiopurine Methyltransferase (TPMT) Activity and Adverse Effects of Azathioprine in Inflammatory Bowel Disease: Long-Term Follow-Up Study of 394 Patients  

Microsoft Academic Search

AIM:To prospectively evaluate whether a relationship between thiopurine methyltransferase (TPMT) activity and incidence of adverse effects (especially myelotoxicity) exists, in a long-term follow-up study of a large group of patients with inflammatory bowel disease treated with azathioprine.METHODS:TPMT activity in red blood cells (RBC) was measured by a radiochemical method in 394 consecutive patients with Crohn's disease (238) or ulcerative colitis

Javier P. Gisbert; Pilar Niño; Luis Rodrigo; Carlos Cara; Luis G. Guijarro

2006-01-01

177

Long-term follow-up of busulfan, etoposide, and nimustine hydrochloride (ACNU) or melphalan as conditioning regimens for childhood acute leukemia and lymphoma  

Microsoft Academic Search

We retrospectively evaluated early and long-term complications of an intensified conditioning regimen consisting of busulfan\\u000a and etoposide in combination with either nimustine hydrochloride (ACNU) (BVA regimen, n = 18) or melphalan (BVL regimen, n\\u000a = 34) in 52 children with acute leukemia or non-Hodgkin’s lymphoma. With a median follow-up of 13.2 years after the BVA regimen\\u000a and 8.1 years after

Sakurako Izaki; Hiroaki Goto; Kumiko Okuda; Motoi Matsuda; Yuka Watanabe; Kenichirou Fujioka; Noriyuki Hanzawa; Hiroko Sumita; Hiroyuki Takahashi; Shoko Goto; Sumio Kai; Haruyuki Sekiguchi; Tetsunori Funabiki; Hideki Sasaki; Koichiro Ikuta; Shumpei Yokota

2007-01-01

178

Long-term Follow-up of Busulfan, Etoposide, and Nimustine Hydrochloride (ACNU) or Melphalan as Conditioning Regimens for Childhood Acute Leukemia and Lymphoma  

Microsoft Academic Search

We retrospectively evaluated early and long-term complications of an intensified conditioning regimen consisting of busulfan\\u000a and etoposide in combination with either nimustine hydrochloride (ACNU) (BVA regimen, n = 18) or melphalan (BVL regimen, n\\u000a = 34) in 52 children with acute leukemia or non-Hodgkin’s lymphoma. With a median follow-up of 13.2 years after the BVA regimen\\u000a and 8.1 years after

Sakurako Izaki; Hiroaki Goto; Kumiko Okuda; Motoi Matsuda; Yuka Watanabe; Kenichirou Fujioka; Noriyuki Hanzawa; Hiroko Sumita; Hiroyuki Takahashi; Shoko Goto; Sumio Kai; Haruyuki Sekiguchi; Tetsunori Funabiki; Hideki Sasaki; Koichiro Ikuta; Shumpei Yokota

2007-01-01

179

Clinical Heterogeneity of Duchenne Muscular Dystrophy (DMD): Definition of Sub-Phenotypes and Predictive Criteria by Long-Term Follow-Up  

Microsoft Academic Search

Background: To explore clinical heterogeneity of Duchenne muscular dystrophy (DMD), viewed as a major obstacle to the interpretation of therapeutic trials Methodology\\/Principal Findings: A retrospective single institution long-term follow-up study was carried out in DMD patients with both complete lack of muscle dystrophin and genotyping. An exploratory series (series 1) was used to assess phenotypic heterogeneity and to identify early

Isabelle Desguerre; Christo Christov; Michele Mayer; Reinhard Zeller; Henri-Marc Becane; Sylvie Bastuji-Garin; Catherine Chiron; Jamel Chelly; Romain K. Gherardi

2009-01-01

180

Clinical Heterogeneity of Duchenne Muscular Dystrophy (DMD): Definition of Sub-Phenotypes and Predictive Criteria by Long-Term Follow-Up  

Microsoft Academic Search

BackgroundTo explore clinical heterogeneity of Duchenne muscular dystrophy (DMD), viewed as a major obstacle to the interpretation of therapeutic trialsMethodology\\/Principal FindingsA retrospective single institution long-term follow-up study was carried out in DMD patients with both complete lack of muscle dystrophin and genotyping. An exploratory series (series 1) was used to assess phenotypic heterogeneity and to identify early criteria predicting future

Isabelle Desguerre; Christo Christov; Michele Mayer; Reinhard Zeller; Henri-Marc Becane; Sylvie Bastuji-Garin; Catherine Chiron; Jamel Chelly; Romain K. Gherardi; Iris Schrijver

2009-01-01

181

Radiotherapy treatment planning and long-term follow-up with [ 11C]methionine PET in patients with low-grade astrocytoma  

Microsoft Academic Search

Purpose: To evaluate the feasibility of [11C]-methionine positron emission tomography (MET PET) in radiotherapy (RT) treatment planning and long-term follow-up in patients with low-grade glioma.Patients: Thirteen patients with low-grade astrocytoma and 1 with anaplastic astrocytoma underwent sequential MET PET and magnetic resonance imaging (MRI) before and 3, 6, 12, and 21–39 months after RT, respectively. Ten patients were studied after

Joanne Nuutinen; Pirkko Sonninen; Pertti Lehikoinen; Eija Sutinen; Ritva Valavaara; Esa Eronen; Stefan Norrgård; Jarmo Kulmala; Mika Teräs; Heikki Minn

2000-01-01

182

Long-term effects of a single course of nicotine treatment in acute ulcerative colitis: remission maintenance in a 12-month follow-up study  

Microsoft Academic Search

Patients with mild to moderate active colitis who are treated with mesalazine plus transdermal nicotine reportedly suffer\\u000a fewer relapses than patients treated with mesalazine plus oral prednisone. A long-term follow-up period was carried out to\\u000a confirm this. Thirty patients with remission of distal colitis after therapy with the above treatment schedules were monitored\\u000a for 12 months (Rachmilewitz’ activity index plus

M. Guslandi

1999-01-01

183

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

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.

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

184

Randomized Controlled Trial of an Interactive Internet Smoking Cessation Program with Long-Term Follow-up  

Microsoft Academic Search

Background  Internet programs for smoking cessation are widely available but few controlled studies demonstrate long-term efficacy.\\u000a \\u000a \\u000a \\u000a Purpose  To determine the 13-month effectiveness of an Internet program presenting a set sequence of interactive steps, and the role\\u000a of depressed affect.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  In a randomized controlled trial sponsored by the American Cancer Society, a treatment condition (n?=?1,106) was compared to a control site (n?=?1,047).\\u000a \\u000a \\u000a \\u000a \\u000a Results  More

Daniel F. Seidman; J. Lee Westmaas; Steve Goldband; Vance Rabius; Edward S. Katkin; K. Joanne Pike; Dawn Wiatrek; Richard P. Sloan

2010-01-01

185

Diagnosis and treatment of teeth with primary endodontic lesions mimicking periodontal disease: three cases with long-term follow ups  

PubMed Central

A tooth with primary endodontic disease that demonstrates a periodontal defect might be extracted because of misdiagnosis as severe periodontal disease or a vertical root fracture. The aim of this case report was to demonstrate the long-term survival of endodontically treated teeth, which had been initially considered unsavable. With meticulous evaluation including the patient's dental history, clinical and radiographic examinations, teeth with primary endodontic lesions could be differentiated and saved after proper root canal treatment. Pain history, vitality test, and radiographic examinations, as well as a general periodontal condition check with periodontal probing on an affected tooth, might be the key methods to differentiate endodontic pathosis from that of periodontal disease. PMID:24516831

Lim, Jae-Hyung; Lee, Ji-Hyun

2014-01-01

186

Long-term follow-up after organ-preserving pancreatic head resection in patients with chronic pancreatitis.  

PubMed

In chronic pancreatitis (CP), enlargement of the pancreatic head develops as a result of inflammatory alterations. This report relates to the results attained with an organ-preserving pancreatic head resection (OPPHR) in 135 patients in a 7-year period. The surgical procedure consists of a wide excision of the inflammatory tumor in the region of the pancreatic head, without division and cutting of the pancreas over the portal vein. Reconstruction, with drainage of the secretion from the remaining pancreas into the intestinal tract, takes place through a jejunal Roux-en-Y loop. Only one reoperation was required in consequence to anastomosis bleeding, but no mortality occurred in the postoperative period. The duration of hospitalization ranged between 7 and 12 days. The mean follow-up period was 4.1 years (range, 0.5-7.0). The late mortality rate was 3.7%. The quality of life, measured during the follow-up by using EORTC Quality-of-Life Questionnaire, improved in 89% of the patients. One hundred sixteen patients became complaint-free, while 14 patients had moderate symptoms; the weight increased by a median of 11.3 kg (range, 4-28). The 7-year experience clearly reveals that this OPPHR technique is a safe and effective procedure for definitive control of the complications of CP. PMID:17906905

Farkas, Gyula; Leindler, László; Daróczi, Mária; Farkas, Gyula

2008-02-01

187

Low-grade fibromyxoid sarcoma: a clinicopathologic study of 33 cases with long-term follow-up.  

PubMed

Cases listed in the U.T.M.D Anderson Cancer Center files as low-grade fibromyxoid sarcoma and originally diagnosed before 2004 were reviewed. They were included in the study if the diagnosis was confirmed and if there was adequate histologic material and clinical information with at least 5 years of follow-up. Thirty-three cases met the study criteria. The patients were 6 to 52 years old at the time of diagnosis (median, 29 y); 19 were male and 14 were female. The most common tumor locations were the shoulder area (5), thigh (5), and inguinal area (4). Tumor size varied from 1.5 to 16 cm (median, 9.4 cm) in those cases in which it was known. The typical histologic findings were contrasting fibrous and myxoid areas, moderate to low cellularity, bland-appearing spindle cells with no or slight nuclear pleomorphism and rare mitotic figures, and a swirling, whorled growth pattern. Prominent vascularity in myxoid areas and perivascular hypercellularity were fairly common, whereas larger hypercellular zones were sometimes seen in primary tumors but were more frequent in recurrences (local) and metastases. Hypercellular regions sometimes had round rather than spindle cells, a diffuse sheet-like cell arrangement, and/or a somewhat increased mitotic rate. Very hypocellular fibrotic areas were also observed and sometimes had thick collagen bundles. Pericollagenous rosettes were present in 6 cases but not in all specimens from these. Other growth pattern variations included storiform, fascicular-herringbone, and patternless areas; uncommonly noted were cell clusters, strands, palisades, and a retiform network. Additional unusual features were moderate nuclear pleomorphism (seen mostly in recurrent and metastatic tumors), cysts, osseous metaplasia, and a tigroid pattern with alternating fibrous and myxoid strips. One patient had a recurrence with features of sclerosing epithelioid fibrosarcoma, whereas 2 had dedifferentiated recurrences with anaplastic predominantly round cells and numerous mitotic figures. Fourteen patients died of tumor after 3 (this patient's tumor became dedifferentiated) to 42 years (median, 15 y). Nineteen patients were alive at last follow-up of 5½ to 70 years (median, 13 y), 6 with tumor and 13 without. Twenty-one patients had recurrence after intervals of up to 15 years (median, 3½ y), and 15 had metastases (mostly in the lungs and pleura) after periods of up to 45 years (median, 5 y). Except for dedifferentiation, which led to short survival after it occurred, histologic differences were not related to tumor behavior or patient survival. The 4 patients whose neoplasms measured <3.5 cm were all tumor free at last follow-up. PMID:21921785

Evans, Harry L

2011-10-01

188

Long-term follow-up of patients with subacute sclerosing panencephalitis treated with intraventricular alpha-interferon.  

PubMed

We treated 22 patients with subacute sclerosing panencephalitis (SSPE) with intraventricular alpha-interferon (alpha-IFN) and oral inosiplex between 1986 and 1991. The follow-up for 56 to 108 months demonstrates a higher survival rate in these patients compared with those who did not receive alpha-IFN. However, eight of 11 patients whose condition improved after alpha-IFN treatment and five of five patients whose condition stabilized after alpha-IFN experienced neurologic deterioration 6 to 90 months after treatment; three of 11 and four of five died. The use of inosiplex did not influence the prognosis. Re-administration of the same regimen was not effective in one patient. Treatment-induced remissions in SSPE can be temporary, analogous to spontaneous remissions. Longer treatment with higher doses, or combinations of drugs, may be required. PMID:9040751

Anlar, B; Yalaz, K; Oktem, F; Köse, G

1997-02-01

189

Long-term follow-up and molecular characterization of a patient with a RECQL4 mutation spectrum disorder.  

PubMed

The follow-up of a man from birth to adulthood, presenting with features both of RAPADILINO and Rothmund-Thomson syndrome (RTS), is described. Molecular studies confirmed the presence of two different mutations, c.2767_2768delTT and c.3061C>T, in the RECQL4 gene. This gene is known to be causative of a spectrum including Baller-Gerold syndrome, RAPADILINO syndrome and RTS. New and rare features such as oral leukoplakia and very prominent hyperkeratotic verrucous papules on both soles are shown. This patient has to date no cancer history despite bearing a truncating mutation at the age of 21 years, which is also unusual. PMID:23899764

Fradin, M; Merklen-Djafri, C; Perrigouard, C; Aral, B; Muller, J; Stoetzel, C; Frouin, E; Flori, E; Doray, B; Dollfus, H; Lipsker, D

2013-01-01

190

[Central venous stenting in patients on hemodialysis: review of our case series and long-term follow-up].  

PubMed

Aims of the study was validate the venous stenting technique as the treatment of choice in patients affected by stenosis or occlusion of the central venous area. To evaluate the long-term patency of placed stents in our series and to detect factors predisposing to restenosis. Twenty-three hemodialyzed patients were treated by PTA or placement of a metallic self-expandable stent in the central venous area because of occlusion or severe stenosis caused by repeated central venous access puncture for Port-A-Cath or pacemaker placement. All patients were examined every 3 months after treatment by clinical examination and color-Doppler ultrasound. Stents were placed with success in all cases but one, where it was impossible to get past the occlusion. Restenosis was observed in 12 cases at 4 to 12 months (average 8 months). Intrastent restenoses were treated with success by PTA alone and stent placement in 4 cases. A new restenosis was observed in 4 retreated patients in whom the stent was short or angled. In the other patients restenosis was attributable to disregard of anticoagulant therapy. In conclusions, the availability of new devices and dedicated stents is still necessary. There is a limited relationship between patency and wrong stent placement. Patients undergoing stenting should be controlled by clinical examination and color-Doppler ultrasound in hospitals where skilled interventional radiologists are available. PMID:18663694

Patanè, D; Morale, W; Malfa, P; Seminara, G; Caudullo, E; L'Anfusa, G; Spanti, D; Mandalà, M L; Di Landro, D

2008-01-01

191

Maple syrup urine disease (MSUD): a case with long-term follow-up after liver transplantation.  

PubMed

Maple syrup urine disease (MSUD) is a rare hereditary metabolic condition where the body is unable to breakdown amino acids causing toxic buildup. Acute and long-term management of MSUD involves a restricted diet and regular monitoring of amino acid levels; however, more recently liver transplants have been shown to be successful in treating this condition. Even with successful management of MSUD there is evidence from pediatric cases that shows a distinct pattern of neurocognitive deficits associated with this condition, including impaired nonverbal skills and psychomotor functioning with relatively intact verbal abilities. In the present paper, we report an adult case of MSUD with associated neurocognitive deficits and functional limitations following liver transplantation. Neuroimaging revealed no structural abnormalities, while the results from the neuropsychological evaluation showed impairment in visual-spatial processing, attention, executive functioning, and psychomotor abilities, with relative strengths in verbal skills. The patient also showed reduced adaptive functioning and mild anxiety. This case demonstrates neurocognitive deficiencies within the context of normal magnetic resonance imaging. The possible underlying mechanism of this neuropsychological profile is discussed in relation to other neurodevelopmental models. PMID:23829516

McLaughlin, Paula M; Hinshaw, Jessica; Stringer, Anthony Y

2013-01-01

192

A nationwide, population-based, long-term follow-up study of repeated self-harm in Taiwan  

PubMed Central

Background Previous follow-up studies of repeated self-harm show that the cumulative risk of repeated self-harm within one year is 5.7%–15%, with females at greatest risk. However, relatively few studies have focused on the Far East. The objective of this study was to calculate the cumulative risk of repeated self-harm over different lengths of follow-up time (3?months, 6?months, and 1–8?years), to determine factors influencing repeated self-harm and to explore the interaction between gender and self-harm methods. Methods We used self-harm patient who hospitalized due to first-time self-harm between 2000 and 2007 from 1,230 hospitals in Taiwan. Hospitalization for repeated self-harm among members of this cohort was tracked after 3?months, 6?months, and 1–8?years. Tracking continued until December 31, 2008. We analyzed the cumulative risk and risk factors of repeated self-harm by using negative binomial regression. Results Of the 39,875 individual study samples, 3,388 individuals (8.50%) were found to have repeatedly self-harmed. The cumulative risk of repeated self-harm within three months was 7.19% and within one year was 8%. Within 8?years, it was 8.70%. Females were more likely to repeatedly self-harm than males (RR?=?1.21, 95% CI?=?1.15–1.76). The main method of self-harm was solid or liquid substances (RR?=?1.88, 95% CI?=?1.23–2.04) or cutting or piercing (RR?=?1.36, 95% CI?=?1.02–1.82), and in patients with psychiatric disorders were more likely to self-harm (RR?=?1.61, 95% CI?=?1.48–1.75). Conclusions The key time for intervention for repeated self-harm is within three months. Appropriate prevention programs should be developed based on gender differences. PMID:22950416

2012-01-01

193

Percutaneous balloon mitral valvulotomy and coexisting left atrial hemangioma: case report and long-term follow-up.  

PubMed

Hemangiomas of the heart are extremely rare. The prognosis is quite variable, because this benign tumor may grow, involute, or stop growing; therefore, resection is usually the treatment of choice. In patients with tumors of the left atrium, percutaneous balloon mitral valvulotomy is generally contraindicated. Yet for patients with moderate-to-severe mitral valve stenosis, balloon valvulotomy is an established therapy. Herein, we present the case of a 73-year-old woman who was referred to our department in 1995 with severe mitral valve stenosis. Echocardiography showed a valve orifice area of 0.9 cm2, according to Gorlin's formula, and a mean pressure gradient of 11 mmHg. Surgical therapy was declined by the patient. There were no signs of coronary artery disease. The injection of contrast medium into the left coronary artery showed a hemangioma at the posterior wall of the left atrium. Magnetic resonance imaging and transesophageal echocardiography confirmed the diagnosis. Despite the increased risk posed by the hemangioma, we performed successful percutaneous balloon mitral valvulotomy with an Inoue balloon. We saw the patient in 2001, and again in 2008 when she was 86 years of age. She was in excellent condition, with no signs of relevant dyspnea. Magnetic resonance imaging showed the size of the hemangioma to be stable. By use of echocardiography, we were able to confirm a good long-term result of the balloon valvulotomy. In this patient, a nonsurgical approach was adequate because of the lack of growth of the hemangioma in the left atrium. PMID:20200640

van Buuren, Frank; Langer, Christoph; Faber, Lothar; Butz, Thomas; Schmidt, Henning Karl; Esdorn, Hermann; Bogunovic, Nikola; Mellwig, Klaus Peter; Scholtz, Werner; Horstkotte, Dieter

2010-01-01

194

Clinical Features, Prothrombotic Risk Factors, and Long-Term Follow-Up of Eight Pediatric Moyamoya Patients  

PubMed Central

Background and Purpose The aim of this study was to elucidate the clinical features, prothrombotic risk factors, and outcome of pediatric Moyamoya patients. Methods Patients diagnosed with Moyamoya disease at a tertiary center between January 2000 and December 2006 were enrolled in this study. The clinical presentations, underlying diseases, prothrombotic risk factors, family history of thrombosis, radiological findings, treatment, and outcome of the patients were reviewed retrospectively. Results Eight patients with angiographically proven Moyamoya disease were identified, one of whom had neurofibromatosis type I and one had Down syndrome. The age at diagnosis varied between 19 months and 11 years (73.4±41.8 months, mean±SD). The follow-up period after diagnosis was 52.5±14.8 months. In six patients, the initial clinical presentation was hemiparesis. None of the patients had any identifiable prothrombotic factors. Despite medical and surgical treatment, three patients had recurrences and one died. Only two patients recovered without sequelae. Conclusions The value of prothrombotic risk factor evaluation appears to be limited in Moyamoya patients; the outcome for pediatric patients remains dismal. PMID:22787492

Tatl?, Burak; Sencer, Altay; Sencer, Serra; Ayd?n, Kubilay; Ayd?nl?, Nur; Cal?skan, Mine; Ozmen, Meral; K?r?s, Talat

2012-01-01

195

Independent and social play among profoundly mentally retarded adults: training, maintenance, generalization, and long-term follow-up.  

PubMed Central

Play skills were taught to eight profoundly mentally retarded adults in two interrelated experiments. In Experiment 1, a multiple baseline across subjects design was used to assess the efficacy of verbal and physical prompts on independent play. In Experiment 2, the same subjects and experimental procedures were used to develop social play. Verbal prompting and graduated physical guidance procedures were found to be effective in substantially increasing independent play in Experiment 1 and social play in Experiment 2. Positive changes were also observed in collateral behaviors. Inappropriate play decreased slightly and stereotypy decreased to very low levels. Social interaction increased substantially in Experiment 2 when social play was targeted but little change was observed in Experiment 1 when only independent play was targeted. Treatment gains were maintained for 26 weeks in Experiment 1 and 10 weeks in Experiment 2. In addition, the treatment gains were generalized across subjects and settings in Experiment 2. Finally, regular follow-up checks showed that independent and social play remained in the repertoire of the subjects for 12 months following the termination of programmed maintenance. PMID:3583963

Singh, N N; Millichamp, C J

1987-01-01

196

A medium to long-term follow-up of ACL reconstruction using double gracilis and semitendinosus grafts.  

PubMed

This paper reports the results of our approach to ACL tears and knee laxity, based on 30 years of experience in ACL reconstruction with hamstrings and founded on the following cornerstones: the use of doubled semitendinosus and gracilis as a free graft; the use of an out-in technique for femoral drilling and of very strong and stiff fixation devices; the careful examination and repair or reconstruction of the lateral compartment in selected patients; and the use of unaggressive rehabilitation. We prospectively evaluated a series of 100 consecutive patients who underwent ACL reconstruction between 2001 and 2002. A clinical and radiological follow-up was performed at a minimum of 6 years. After 6 years, the International Knee Documentation Committee score demonstrated good-to-excellent results (A and B) in 98% of patients. However, arthrometric results using the KT-1000 demonstrated that 6/80 patients (7.5%) had >5 mm manual maximum side-to-side difference. The median Tegner activity score was 5 (range 1-9); the median Lysholm score was 96 (range 81-100); and the median subjective IKDC score was 94 (range 66-100). We reported 6/80 failures as revealed by a 2+ or 3+ pivot-shift test result and/or KT-1000 side-to-side difference of more than 5 mm. The IKDC score revealed excellent results in all women who underwent extra-articular tenodesis. Radiographic evaluation demonstrated early signs of osteoarthritis in 9% of patients. PMID:20602086

Ferretti, Andrea; Monaco, Edoardo; Giannetti, Silvio; Caperna, Ludovico; Luzon, David; Conteduca, Fabio

2011-03-01

197

TREATMENT TRIAL AND LONG-TERM FOLLOW-UP EVALUATION AMONG COMORBID YOUTH WITH MAJOR DEPRESSION AND A CANNABIS USE DISORDER  

PubMed Central

Objective This study compared the acute phase (12-week) and the long-term (1 year) efficacy of fluoxetine versus placebo for the treatment of the depressive symptoms and the cannabis use of youth with comorbid major depressive disorder (MDD) and an cannabis use disorder (CUD)(cannabis dependence or cannabis abuse). We hypothesized that fluoxetine would demonstrate efficacy in the acute phase trial and at the 1-year follow-up evaluation. Data is also provided regarding the prevalence of risky sexual behaviors in our study sample. Methods We recently completed the first double-blind placebo-controlled study of fluoxetine in adolescents and young adults with comorbid MDD/CUD. A total of 70 persons participated in the acute phase trial, and 68 of those persons (97%) also participated in the 1-year follow-up evaluation. Results of the acute phase study have already been presented (Cornelius, Bukstein, et al., 2010), but the results of the 1 year follow-up assessment have not been published previously. All participants in both treatment groups also received manual-based cognitive behavioral therapy (CBT) and motivation enhancement therapy (MET) during the 12-week course of the study. The 1-year follow-up evaluation was conducted to assess whether the clinical improvements noted during the acute phase trial persisted long term. Results During the acute phase trial, subjects in both the fluoxetine group and the placebo group showed significant within-group improvement in depressive symptoms and in cannabis-related symptoms. However, no significant difference was noted between the floxetine group and the placebo group on any treatment outcome variable during the acute phase trial. End of study levels of depressive symptoms were low in both the fluoxetine group and the placebo group. Most of the clinical improvements in depressive symptoms and for cannabis-related symptoms persisted at the 1-year follow-up evaluation. Conclusions Fluoxetine did not demonstrate greater efficacy than placebo for treating either the depressive symptoms or the cannabis-related symptoms of our study sample during the acute phase study or at the 1-year follow-up assessment. The lack of a significant treatment effect for fluoxetine may at least in part reflect efficacy of the CBT/MET psychotherapy. A persistence of the efficacy of the acute phase treatment was noted at the 1-year follow-up evaluation, suggesting long-term effectiveness for the CBT/MET psychotherapy. PMID:25328373

Cornelius, Jack R.; Salloum, Ihsan M.; Ferrell, Robert; Douaihy, Antoine B.; Hayes, Jeanie; Kirisci, Levent; Horner, Michelle; Daley, Dennis C.

2013-01-01

198

Urinary Concentration of Monocyte Chemoattractant Protein-1 in Idiopathic Glomerulonephritis: A Long-Term Follow-Up Study  

PubMed Central

Background Monocyte chemoattractant protein-1 (MCP-1), which is up regulated in kidney diseases, is considered a marker of kidney inflammation. We examined the value of urine MCP-1 in predicting the outcome in idiopathic glomerulonephritis. Methods Between 1993 and 2004, 165 patients (68 females) diagnosed with idiopathic proteinuric glomerulopathy and with serum creatinine <150 µmol/L at diagnosis were selected for the study. Urine concentrations of MCP-1 were analyzed by ELISA in early morning spot urine samples collected on the day of the diagnostic kidney biopsy. The patients were followed until 2009. The progression rate to end-stage kidney disease was calculated using Kaplan–Meier survival analysis. End-stage kidney disease (ESKD) was defined as the start of kidney replacement therapy during the study follow-up time. Results Patients with proliferative glomerulonephritis had significantly higher urinary MCP-1 excretion levels than those with non-proliferative glomerulonephritis (p<0.001). The percentage of patients whose kidney function deteriorated significantly was 39.0% in the high MCP-1 excretion group and 29.9% in the low MCP-1 excretion group. However, after adjustment for confounding variables such as glomerular filtration rate (GFR) and proteinuria, there was no significant association between urine MCP-1 concentration and progression to ESKD, (HR?=?1.75, 95% CI?=?0.64–4.75, p?=?0.27). Conclusion Our findings indicate that progression to end-stage kidney disease in patients with idiopathic glomerulopathies is not associated with urine MCP-1 concentrations at the time of diagnosis. PMID:24489972

Tofik, Rafid; Ohlsson, Sophie; Bakoush, Omran

2014-01-01

199

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

PubMed Central

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

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

2003-01-01

200

Adrenocortical carcinoma in children: First population?based clinicopathological study with long-term follow-up.  

PubMed

Adrenocortical carcinoma (ACC) is rare in both adult and pediatric populations. Literature suggests significant differences between children and adults in presentation, histological properties and outcome. The aim of this first nationwide study on pediatric ACC was to describe the incidence, presentation, pathological characteristics, treatment and survival in The Netherlands. All ACC patients aged <20 years at diagnosis and registered in the population-based Netherlands Cancer Registry between 1993 and 2010 were included. Clinical data were extracted from medical records. Archival histological slides were collected via the Dutch Pathology Registry (PALGA). We compared our findings to all clinical studies on pediatric ACC that were found on PubMed. Based on the results, 12 patients were identified: 8 females and 4 males. The median age was 4.1 years (range 1.1-18.6). The population-based age-standardized incidence rate for patients <20 years was 0.18 per million person-years. Autonomous hormonal secretion was present in 10 patients. Seven patients were aged ?4 years at diagnosis, 5 presented with localized disease and 2 with locally advanced disease. Five patients were aged ?5 years, 3 presented with distant metastases and 1 with locally advanced disease. For all patients, histological examination displayed malignant characteristics. All patients aged ?4 years at diagnosis survived; the median follow-up was 97 months (57-179 months). All patients aged ?5 years died; the median survival was 6 months (0-38 months). Pediatric ACC is extremely rare in the Western world. The clinical outcome was remarkably better in patients aged ?4 years. This is in accordance with less advanced stage of disease at presentation, yet contrasts with the presence of adverse histological characteristics. Clinical management in advanced disease is adapted from adult practice in the absence of evidence regarding pediatric ACC. PMID:25241764

Kerkhofs, T M A; Ettaieb, M H T; Verhoeven, R H A; Kaspers, G J L; Tissing, W J E; Loeffen, J; Van den Heuvel-Eibrink, M M; De Krijger, R R; Haak, H R

2014-12-01

201

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

PubMed Central

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

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

2013-01-01

202

The risks and benefits of long-term use of hydroxyurea in sickle cell anemia: A 17.5 year follow-up.  

PubMed

A randomized, controlled clinical trial established the efficacy and safety of short-term use of hydroxyurea in adult sickle cell anemia. To examine the risks and benefits of long-term hydroxyurea usage, patients in this trial were followed for 17.5 years during which they could start or stop hydroxyurea. The purpose of this follow-up was to search for adverse outcomes and estimate mortality. For each outcome and for mortality, exact 95% confidence intervals were calculated, or tests were conducted at alpha = 0.05 level (P-value <0.05 for statistical significance). Although the death rate in the overall study cohort was high (43.1%; 4.4 per 100 person-years), mortality was reduced in individuals with long-term exposure to hydroxyurea. Survival curves demonstrated a significant reduction in deaths with long-term exposure. Twenty-four percent of deaths were due to pulmonary complications; 87.1% occurred in patients who never took hydroxyurea or took it for <5 years. Stroke, organ dysfunction, infection, and malignancy were similar in all groups. Our results, while no longer the product of a randomized study because of the ethical concerns of withholding an efficacious treatment, suggest that long-term use of hydroxyurea is safe and might decrease mortality. PMID:20513116

Steinberg, Martin H; McCarthy, William F; Castro, Oswaldo; Ballas, Samir K; Armstrong, F Danny; Smith, Wally; Ataga, Kenneth; Swerdlow, Paul; Kutlar, Abdullah; DeCastro, Laura; Waclawiw, Myron A

2010-06-01

203

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

PubMed Central

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

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

2014-01-01

204

Long-term Follow-up Study of HTLV-I Infection in Bottle-fed Children Born to Seropositive Mothers  

Microsoft Academic Search

Human T-lymphotropic virus Type-I (HTLV-I) infects children via mother's milk. Infection of Human T-lymphotropic virus Type-I (HTLV-I) was investigated by long-term follow-up surveys of modified milk-fed children. Our observations of modified milk-fed infants revealed that: 1 of 154 (0.6%) at year 1, 5 of 129 (3.9%) at 1.5 years, and 5 of 108 (4.6%) at year 2 were anti-HTLV-I antibody-positive.

Y. Ando; Y. Matsumoto; S. Nakano; K. Saito; K. Kakimoto; T. Tanigawa; Y. Ekuni; M. Kawa; T. Toyama

2003-01-01

205

All-trans retinoic acid and late relapses in acute promyelocytic leukemia: Very long-term follow-up of the North American Intergroup Study I0129  

PubMed Central

We report a long-term follow-up (median 11.8 years) of the First North American Intergroup Study. 379 patients were randomized to induction with ATRA or to chemotherapy. All complete responders (CR) received consolidation chemotherapy, then randomized to 1 year ATRA or observation. 245 patients received ATRA sometime during the study: 195 (80%) achieved a CR. Nine (4.6%) relapsed late (>3 years from CR), the last occurred after 4.6 years; 7 of them were still alive after 5.5–15 years. In APL patients, late relapses are uncommon, and those who sustain CR >5 years can be considered cured. PMID:23528262

Douer, Dan; Zickl, Lynette N.; Schiffer, Charles A.; Appelbaum, Fredrick R.; Feusner, James H.; Shepherd, Lois; Willman, Cheryl L.; Bloomfield, Clara D.; Paietta, Elisabeth; Gallagher, Robert E.; Park, Jae H.; Rowe, Jacob M.; Wiernik, Peter H.; Tallman, Martin S.

2014-01-01

206

Incidence and predictors of heart failure during long-term follow-up after stress Tc99m sestamibi tomography in patients with suspected coronary artery disease  

Microsoft Academic Search

Background  Heart failure is a major cause of morbidity and death in patients with coronary artery disease (CAD). The aim of this study\\u000a was to define the incidence and predictors of heart failure during long-term follow-up in patients with suspected CAD referred\\u000a for stress myocardial perfusion imaging.\\u000a \\u000a \\u000a \\u000a Methods and Results  We studied 787 patients (mean age, 57 00B1; 12 years; 470 men)

Abdou Elhendy; Arend F. L. Schinkel; Ron T. van Domburg; Jeroen J. Bax; Don Poldermans

2004-01-01

207

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

SciTech Connect

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.

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

2003-02-24

208

Clinical and biologic features of triple-negative breast cancers in a large cohort of patients with long-term follow-up  

PubMed Central

Studies on well characterized, large populations of estrogen receptor (ER)/progesterone receptor (PgR)/HER2-negative [triple-negative (TN)] breast cancer (BC) patients with long-term follow-up are lacking. In this study, we analyze clinical outcomes of TN BC and implications of epidermal growth factor receptor (EGFR) expression. Clinical and biologic features, time to first recurrence (TTFR), and overall survival (OS) were compared in 253 TN versus 1,036 ER positive, PgR positive, HER2-negative [estrogen-driven (ED)] BC. Compared to ED, TN tumors were larger (p = 0.02), more proliferative (high S-phase 54 vs. 17 %, p < 0.0001), more aneuploid (64 vs. 43 %, p < 0.0001) and more likely EGFR positive (?10 fmol/mg by radioligand-binding assay, 49 vs. 7 %, p < 0.0001). Among TN, EGFR-positive BC were larger (p = 0.0018), more proliferative (p < 0.0001), and more aneuploid, (p < 0.0001) than EGFR-negative BC. Adjuvant-treated TN patients had shorter TTFR (p = 0.0003), and OS (p = 0.0017), than ED patients. However, in untreated patients, no differences in TTFR and OS were observed at 8 years median follow-up. Among TN patients, EGFR expression was not associated with worse outcome. TN tumors have a worse outcome in systemically treated patients but not in untreated patients. EGFR expression, does not predict for worse long-term survival. PMID:23124476

Malorni, L.; Shetty, P. B.; Hilsenbeck, S.; Rimawi, M. F.; Elledge, R.; Osborne, C. K.; De Placido, S.; Arpino, G.

2012-01-01

209

Clinical and biologic features of triple-negative breast cancers in a large cohort of patients with long-term follow-up.  

PubMed

Studies on well characterized, large populations of estrogen receptor (ER)/progesterone receptor (PgR)/HER2-negative [triple-negative (TN)] breast cancer (BC) patients with long-term follow-up are lacking. In this study, we analyze clinical outcomes of TN BC and implications of epidermal growth factor receptor (EGFR) expression. Clinical and biologic features, time to first recurrence (TTFR), and overall survival (OS) were compared in 253 TN versus 1,036 ER positive, PgR positive, HER2-negative [estrogen-driven (ED)] BC. Compared to ED, TN tumors were larger (p = 0.02), more proliferative (high S-phase 54 vs. 17 %, p < 0.0001), more aneuploid (64 vs. 43 %, p < 0.0001) and more likely EGFR positive (?10 fmol/mg by radioligand-binding assay, 49 vs. 7 %, p < 0.0001). Among TN, EGFR-positive BC were larger (p = 0.0018), more proliferative (p < 0.0001), and more aneuploid, (p < 0.0001) than EGFR-negative BC. Adjuvant-treated TN patients had shorter TTFR (p = 0.0003), and OS (p = 0.0017), than ED patients. However, in untreated patients, no differences in TTFR and OS were observed at 8 years median follow-up. Among TN patients, EGFR expression was not associated with worse outcome. TN tumors have a worse outcome in systemically treated patients but not in untreated patients. EGFR expression, does not predict for worse long-term survival. PMID:23124476

Malorni, L; Shetty, P B; De Angelis, C; Hilsenbeck, S; Rimawi, M F; Elledge, R; Osborne, C K; De Placido, S; Arpino, G

2012-12-01

210

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

PubMed Central

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

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

2014-01-01

211

Long-term follow-up results in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents: results from a single high-volume PCI centre  

PubMed Central

Objective To assess both short-term and long-term prognosis in consecutive patients with coronary heart disease treated with drug-eluting stents in a high-volume percutaneous coronary intervention (PCI) centre. Design Observational cohort study. Setting A hospital in the Henan province, China, between 2009 and 2011. Participants A total of 2533 patients were enrolled. Patients with ST-elevation myocardial infarction (STEMI) treated with urgent PCI accounted for 3.9% of cases; patients with STEMI treated with delayed PCI accounted for 20.5% of cases; patients with stable angina accounted for 16.5% of cases; and patients with non-ST elevation acute coronary syndrome (NSTE-ACS) accounted for 58.6% of cases. Primary outcomes Death, major adverse cardiac and cerebrovascular events (MACCE: death/myocardial infarction/stroke), and target vessel revascularisation. Results Follow-up after a median of 29.8?months was obtained for 2533 patients (92.6%). The mortality rate during hospitalisation was highest in the urgent PCI group (p<0.001). During follow-up, although the incidences of death and MACCE were highest in the urgent PCI group, no significant differences were observed among the different groups. The incidences of cardiac death and myocardial infarction were significantly higher in the paclitaxel-eluting stent (PES) group than in the sirolimus-eluting stent (SES) group. Independent predictors of death during follow-up were age, left ventricular ejection function <40%, diabetes mellitus, prior coronary artery bypass graft and chronic total occlusion. Conclusions PCI patients with STEMI had the worst hospital and long-term prognosis. The mortality rate after hospital increased markedly in patients with NSTE-ACS. SESs seem to be more effective than PESs. PMID:25113554

Yao, Hai-Mu; Wan, You-Dong; Zhang, Xiao-Juan; Shen, De-Liang; Zhang, Jin-Ying; Li, Ling; Zhao, Luo-Sha; Sun, Tong-Wen

2014-01-01

212

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

PubMed Central

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

Konopacki, Johanna; Porcher, Raphael; Robin, Marie; Bieri, Sabine; Cayuela, Jean-Michel; Larghero, Jerome; Xhaard, Alienor; Andreoli, Anna Lisa; Dhedin, Nathalie; Petropoulou, Anna; Rodriguez-Otero, Paula; Ribaud, Patricia; Moins-Teisserenc, Helene; Carmagnat, Maryvonnick; Toubert, Antoine; Chalandon, Yves; Socie, Gerard; Peffault de Latour, Regis

2012-01-01

213

Benign core biopsy of probably benign breast lesions 2 cm or larger: correlation with excisional biopsy and long-term follow-up  

PubMed Central

Purpose: To evaluate the accuracy of benign core biopsy of probably benign breast lesions (category 3) 2 cm or larger on the basis of excisional biopsy and long-term follow-up. Methods: We retrospectively reviewed 146 category 3 lesions in 146 patients 2 cm or larger which were diagnosed as benign by ultrasound (US)-guided core biopsy. Patients were initially diagnosed as benign at core needle biopsy and then followed up with excisional biopsy (surgical excision, n=91; US-guided vacuum assisted excision, n=35) or breast ultrasonography (n=20). Results: Of the 126 patients who underwent surgical excision or US-guided vacuum-assisted excision, 114 patients were diagnosed with benign lesions, 10 patients with borderline lesions (benign phyllodes tumor), and two patients with malignant phyllodes tumors. The probabilities of lesions being benign, borderline and malignant were 91.8% (134/146), 6.8% (10/146), and 1.4% (2/146), respectively. Of 13 patients who had growing masses on follow-up ultrasonography, three (23.1%) were non-benign (two benign phyllodes tumors and one malignant phyllodes tumor). Conclusion: US-guided core needle biopsy of probably benign breast mass 2 cm or larger was accurate (98.6%) enough to rule out malignancy. But, it was difficult to rule out borderline lesions even when they were diagnosed as benign. PMID:25038810

2014-01-01

214

Laser-assisted myringotomy versus conventional myringotomy with ventilation tube insertion in treatment of otitis media with effusion: Long-term follow-up  

PubMed Central

Background Otitis media with effusion is the most common cause of conductive hearing loss in the pediatric population. Insertion of ventilation tubes with or without adenoidectomy is the accepted and standard surgical procedure. CO2 laser myringotomy without tube placement has been advocated as an alternative treatment. Aim To compare long-term follow-up results of laser versus classical myringotomy with ventilation tube insertion over five years. Materials and Methods 86 patients with bilateral otitis media with effusion were divided into two groups: laser myringotomy group and myringotomy with ventilation tube insertion group, with follow-up in hearing results and recurrence rates over five years. Results The mean patency time of myringotomy in laser group was 23 days, while the mean patency time of the ventilation tubes ears was 4.0 months in myringotomy group. Twelve patients in laser group (13.9%) showed a recurrent otitis media with effusion compared to 9 patients in myringotomy group (10.4%). Conclusion Laser fenestration is a less effective alternative to myringotomy and tube placement. The recurrence rates after both procedures did not show statistical significance over long follow-up. It might be considered as an effective alternative to classical surgery and ideal for short-term ventilation. PMID:24265883

Youssef, Tarek Fouad

2013-01-01

215

Long-Term Survival and Dialysis Dependency Following Acute Kidney Injury in Intensive Care: Extended Follow-up of a Randomized Controlled Trial  

PubMed Central

Background The incidence of acute kidney injury (AKI) is increasing globally and it is much more common than end-stage kidney disease. AKI is associated with high mortality and cost of hospitalisation. Studies of treatments to reduce this high mortality have used differing renal replacement therapy (RRT) modalities and have not shown improvement in the short term. The reported long-term outcomes of AKI are variable and the effect of differing RRT modalities upon them is not clear. We used the prolonged follow-up of a large clinical trial to prospectively examine the long-term outcomes and effect of RRT dosing in patients with AKI. Methods and Findings We extended the follow-up of participants in the Randomised Evaluation of Normal vs. Augmented Levels of RRT (RENAL) study from 90 days to 4 years after randomization. Primary and secondary outcomes were mortality and requirement for maintenance dialysis, respectively, assessed in 1,464 (97%) patients at a median of 43.9 months (interquartile range [IQR] 30.0–48.6 months) post randomization. A total of 468/743 (63%) and 444/721 (62%) patients died in the lower and higher intensity groups, respectively (risk ratio [RR] 1.04, 95% CI 0.96–1.12, p?=?0.49). Amongst survivors to day 90, 21 of 411 (5.1%) and 23 of 399 (5.8%) in the respective groups were treated with maintenance dialysis (RR 1.12, 95% CI 0.63–2.00, p?=?0.69). The prevalence of albuminuria among survivors was 40% and 44%, respectively (p?=?0.48). Quality of life was not different between the two treatment groups. The generalizability of these findings to other populations with AKI requires further exploration. Conclusions Patients with AKI requiring RRT in intensive care have high long-term mortality but few require maintenance dialysis. Long-term survivors have a heavy burden of proteinuria. Increased intensity of RRT does not reduce mortality or subsequent treatment with dialysis. Trial registration www.ClinicalTrials.gov NCT00221013 Please see later in the article for the Editors' Summary PMID:24523666

Gallagher, Martin; Cass, Alan; Bellomo, Rinaldo; Finfer, Simon; Gattas, David; Lee, Joanne; Lo, Serigne; McGuinness, Shay; Myburgh, John; Parke, Rachael; Rajbhandari, Dorrilyn

2014-01-01

216

Long-term follow-up of endoscopic therapy in stenosis of the bilio-biliary anastomosis associated with orthotopic liver transplantation.  

PubMed

BACKGROUND: Endoscopic treatment of stenosis of the anastomotic biliary stricture (ABS) after orthotopic liver transplantation (OLT) has been proven to be effective and safe, but long term outcome and risk factors for recurrence are unknown. METHODS: All 374 patients who underwent OLT at Frankfurt University hospital were screened for occurrence of ABS. ABS was treated by endoscopic insertion of plastic endoprosthesis (29.8%), balloon dilation (12.8%), or a combination of both (57.4%). Long-term outcome and risk factors for occurrence and recurrence of ABS was determined through competing risk analysis. Mean follow-up time was 151 weeks and mean survival was 3.4 years. RESULTS: ABS was observed in 47 patients (12.6%). Mean (median) time from OLT to ABS was 16.3 months (3.3 months). Cumulative incidence rates of ABS were 0.09 after 12 months, 0.10 after 24 months and 0.11 after 36 months. In 12 cases (25.5%), ABS was observed later than 12 months after OLT. ABS recurred in 14 of 47 (29%). Ocurrence of ABS more than six weeks after OLT was a significant predictor of ABS recurrence (p=0.04, H.R. 0.235). There was a trend of HCV infection to be predominant in patients with recurrence of ABS (30% HCV vs. 4% non-HCV) in comparison to patients with non-recurrence (HCV 36%, non-HCV 30%); p > 0.05. Severity of initial stricture predicted recurrence of ABS (p = 0.046, HR=2.78), but did not influence overall survival. Long-term resolution of ABS was observed in 45 of 47 patients (95.7%), recurrence of ABS was treated with a second (n= 16, 34%), or a third endoscopic treatment attempt (1). CONCLUSION: Long-term success of endoscopic treatment of ABS is highly probable if recurrent strictures are again treated endoscopically. ABS might occur late (>36 months) after OLT and life-long follow-up is essential in OLT patients to identify patients with ABS. © 2013 American Association for the Study of Liver Diseases. PMID:23526624

Albert, Jörg G; Filmann, Natalie; Elsner, Julia; Moench, Christian; Trojan, Jörg; Bojunga, Jörg; Sarrazin, Christoph; Friedrich-Rust, Mireen; Herrmann, Eva; Bechstein, Wolf Otto; Zeuzem, Stefan; Hofmann, Wolf Peter

2013-03-22

217

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

SciTech Connect

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.

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

218

Aortic valve replacement with autologous pericardium: long-term follow-up of 15 patients and in vivo histopathological changes of autologous pericardium  

PubMed Central

OBJECTIVES The study aimed to assess the long-term follow-up of patients with an autologous pericardial aortic valve (APAV) replacement and to analyse in vivo histopathological changes in implanted APAVs. METHODS From 1996 to 1997, 15 patients (mean age, 34 years) underwent aortic valve replacement with the glutaraldehyde-treated autologous pericardium. All patients were followed up after discharge. The excised APAVs were processed for haematoxylin–eosin, Victoria blue-van Gieson and immunohistochemical staining. RESULTS The mean clinical follow-up was 11.43 ± 4.50 years. APAV-related in-hospital and late mortalities were both 0%. Five (33%) patients required reoperation because of a prolapse of the right coronary cusp (n = 1), infective endocarditis (n = 1) or fibrocalcific degeneration (n = 3). Freedom from endocarditis, fibrocalcific degeneration and reoperation at the end of follow-up was 93, 80 and 67%, respectively. The remaining 10 patients were alive and well with a mean New York Heart Association class of 1.10 ± 0.32 and normally functioning aortic valves (peak pressure gradient: 7.70 ± 3.41 mmHg; mean pressure gradient: 1.79 ± 0.64 mmHg). Histopathology revealed that (i) a thin factor VIII-positive layer (endothelialization) was found on all non-endocarditis APAVs; (ii) pericardial cells in all APAVs were positive for ?-smooth muscle actin (myofibroblast phenotype) and some cells in the fibrocalcific APAVs were positive for alkaline phosphatase (osteoblast phenotype) and (iii) an elastic band was found in 3 cases (in vivo >9 years). CONCLUSIONS APAV replacement is a procedure with a low mortality. APAVs adapt to new environmental demands by producing an elastic band and by endothelialization, whereas myofibroblast/osteoblast transdifferentiation seems to be responsible for the fibrocalcification of APAVs. PMID:23143205

Liu, Xiaohong; Han, Lin; Song, Zhigang; Tan, Mengwei; Gong, Dejun; Xu, Zhiyun

2013-01-01

219

Long-term HPV type-specific risks for ASCUS and LSIL: A 14-year follow-up of a randomized primary HPV screening trial.  

PubMed

Human papillomavirus (HPV) infections result in a significant burden of low-grade cervical lesions. Between 1997 and 2000, our randomized trial of primary HPV screening enrolled 12,527 women participating in population-based screening. Women between 32 and 38 years of age (median: 34, interquartile range: 33-37) were randomized to HPV and cytology double testing (intervention arm, n?=?6,257 enrolled, n?=?5,888 followed-up) or to cytology, with samples frozen for future HPV testing (control arm, n?=?6,270 enrolled, n?=?5,795 followed-up). We estimated the HPV type-specific, long-term absolute risks (AR), and population attributable proportions (PAR) for cytological diagnoses of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) and for histopathologically diagnosed cervical intraepithelial neoplasia grade 1 (CIN1). The women were followed using comprehensive, nationwide register-based follow-up. During a mean follow-up time of 11.07 years, 886 ASCUS and LSIL lesions were detected, 448 in the intervention arm and 438 in the control arm. Poisson regression estimated the incidence rate ratios (IRRs) of low-grade lesions by HPV type. The IRRs were strongly dependent on follow-up time. The IRRs for ASCUS/LSIL associated with high-risk HPV positivity were 18.6 (95% CI: 14.9-23.4) during the first screening round, 4.1 (95% CI: 2.8-6.2) during the second, 2.6 (95% CI: 1.7-4.1) during the third, and 1.1 (95% CI: 0.7-1.8) for >9 years of follow-up, with similar declines seen for the individual types. Type 16 contributed consistently to the greatest proportion of ASCUS, LSIL, and CIN1 risk in the population (first screening round PAR: ASCUS: 15.5% (95% CI: 9.7-21.9), LSIL: 14.7% (95% CI: 8.0-20.9), and CIN1: 13.4% (95% CI: 3.2-22.5)), followed by type 31 [8.4% (95% CI: 4.2-12.5) for ASCUS to 17.3% (95% CI: 6.8-26.6) for CIN1]. In summary, most ASCUS/LSIL lesions associated with HPV infection are caused by new HPV infections and most lesions are found during the first screening round. PMID:24842156

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

2015-01-15

220

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

PubMed

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

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

221

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

PubMed Central

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

Hegenbart, Ute; Sanchorawala, Vaishali; Merlini, Giampaolo; Palladini, Giovanni; Blade, 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

222

Long term follow up of 93 families with myeloproliferative neoplasms: life expectancy and implications of JAK2V617F in the occurrence of complications.  

PubMed

The long-term evolution of familial myeloproliferative neoplasms was studied in 93 families with 227 subjects including 97 with polycythemia vera (PV), 105 essential thrombocythemia (ET), 14 primary myelofibrosis (PMF) and 11 chronic myeloid leukemia (CML). In PV patients, with 12years of median follow-up, overall survival was 83% at 10years and 37% at 20years. A high JAK2(V617F) allele burden was correlated with the transformation to myelofibrosis (p<0.0001), but not with the transformation to acute leukemia. Among the 105 ET, with 8years of median follow-up, overall survival was 83% at 10years and 57% at 20years. Progression to acute leukemia and progression to myelofibrosis were 10% and 13%. There was a trend toward a more frequent evolution to myelofibrosis when the JAK2(V617F) mutated allele burden was >50% (p=0.09), but not to AML. Hematologic transformation of the MPN was responsible for 69% of the deaths, cerebral stroke for 7% and 4% died of myocardial infarction. Eleven JAK2(V617F) mutated patients developed 13 deep splanchnic thromboses in PV and ET. Finally whereas patients with familial PV and ET have a comparable prognosis to non-familial MPN, the JAK2(V617F) mutation was associated with a more frequent occurrence of thrombosis in the entire population. PMID:22818858

Malak, Sandra; Labopin, Myriam; Saint-Martin, Cecile; Bellanne-Chantelot, Christine; Najman, Albert

223

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

PubMed Central

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.

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

2014-01-01

224

Management of Gastric Varices Unsuccessfully Treated by Balloon-Occluded Retrograde Transvenous Obliteration: Long-Term Follow-Up and Outcomes  

PubMed Central

Our aim was to evaluate the long-term efficacy and safety of percutaneous transhepatic obliteration (PTO) alone and combined with balloon-occluded retrograde transvenous obliteration (BRTO) for gastroesophageal varices refractory to BRTO alone. Between July 1999 and December 2010, 13 patients with gastroesophageal varices refractory to BRTO were treated with PTO (n = 6) or a combination of PTO and BRTO (n = 7). We retrospectively investigated the rates of survival, recurrence, or worsening of the varices; hepatic function before and after the procedure; and complications. The procedure achieved complete obliteration or significant reduction of the varices in all 13 patients without major complications. During follow-up, the varices had recurred in 2 patients, of which one had hepatocellular carcinoma, and the other died suddenly from variceal rebleeding 7 years after PTO. The remaining 11 patients did not experience worsening of the varices and showed significant improvements in the serum ammonia levels and prothrombin time. The mean follow-up period was 90 months, and the cumulative survival rate at 1, 3, and 5 years was 92.9%, 85.7%, and 85.7%, respectively. Both PTO and combined PTO and BRTO seem as safe and effective procedures for the treatment of gastroesophageal varices refractory to BRTO alone. PMID:24453866

Nakazawa, Ken; Narahara, Yoshiyuki; Uchida, Eiji; Amano, Yasuo; Kumita, Shin-ichiro

2013-01-01

225

High-power (80-w) KTP laser vaporization of the prostate in the management of urinary retention: long-term follow up  

NASA Astrophysics Data System (ADS)

Introduction and Objectives: We have previously reported the use of high-powered photoselective vaporization of the prostate (PVP) for patients in urinary retention due to benign prostatic hyperplasia (BPH). PVP is a relatively new treatment for bladder outlet obstruction due to BPH, using laser energy to vaporize obstructing prostatic tissue. This study investigates the long-term follow up of patients treated with PVP for urinary retention. Materials and Methods: All participants signed informed consent, and were treated with high power 80 W quasi-continuous wave potassium-titanyl-phosphate (KTP) laser. Ten patients underwent the procedure from December 2001 until the present. One patient was excluded from the study for failure to return for follow-up. Mean patient follow-up was nine months, maximum of twelve months. Results: The mean pre-operative gland size by trans-rectal ultrasound was 48 grams. Mean urethral length was 3.2 cm. Mean laser time was 48.2 minutes and the mean energy usage was 82.2 kJoules. There were no peri-operative complications such as sepsis or measurable postoperative bleeding. The preoperative AUA Symptom Score (AUASS) decreased from a mean of 22.6 preoperatively to 17 at nine months postoperatively (p = 0.032). The Quality of Life Score (QOL) decreased from 4.6 preoperatively to 3.25 at 12 months postoperatively (p = 0.26). The maximum urine flow rate increased from a mean of 7.7 cc/sec preoperatively to 14.5 cc/sec at six months follow-up (p = 0.03). Conclusions: This follow-up study suggests that HP-KTP has a durable response in patients treated specifically for retention. It significantly improved urine flow rate and symptom score, and had a trend towards improvement in subjective quality of life. HP-KTP prostatectomy should be considered in treating patients in retention, especially those with significant co-morbidities or taking anticoagulation.

Kleeman, M.; Nseyo, Unyime O.

2004-07-01

226

Microsurgical excision without fusion as a safe option for resection of synovial cyst of the lumbar spine: long-term follow-up in mono-institutional experience.  

PubMed

Spinal synovial cysts are cystic dilatations of the synovial membrane that may arise at all levels of the spine. We describe our experience, paying attention to diagnosis, surgical treatment, and long-term follow-up. Between 1995 and 2007, 18 patients were surgically treated. Of these, three patients were excluded from the study because they presented spinal instability at pre-operative assessment. All patients were evaluated pre-operatively with CT, MRI, and dynamic X-rays, and underwent surgery for removal of the cyst by hemilaminectomy and partial arthrectomy. All patients were evaluated with early MRI and had a minimum 2-year follow-up by dynamic X-rays. None of the patients required instrumented fusion due to the absence of radiological signs of instability on the pre-operative dynamic tests. In all patients, there was an immediate resolution of the symptoms, with evidence of complete removal of the cysts on post-operative MRI. At 2-year follow-up, all patients underwent dynamic X-rays and responded to a questionnaire for evaluation of outcome. None of them showed signs of relapse. The gold standard for treatment is surgery, even though other conservative treatment regimens have been proposed. Correct surgical strategy relies on pre-operative assessment of biomechanical stability for deciding whether patients need instrumented fusion during cyst removal. Patients with no instability signs are suitable for hemilaminectomy with partial arthrectomy, preserving 2/3 of the medial portion of the articular facet, because this represents a valid option of treatment with a low risk of complications and a low rate of relapse. PMID:22009492

Landi, A; Marotta, N; Tarantino, R; Ruggeri, A G; Cappelletti, M; Ramieri, A; Domenicucci, M; Delfini, R

2012-04-01

227

Prevalence and management of post-transplant anemia in long-term follow-up of Chinese kidney transplant recipients: a single-center report  

PubMed Central

Background Post-transplant anemia (PTA) has long been a less-recognized complication in kidney transplant recipients, and its prevalence also tends to be underestimated. This study sought to evaluate the prevalence, management, and risk factors of PTA from a group of long-term follow-up Chinese kidney transplant recipients. Methods One hundred and fifty-four adult kidney transplant recipients were followed up at Fuzhou General Hospital, China, and retrospectively studied. Results PTA prevalence at transplant and at 5-yearly time points after transplantation were 45.5%, 10.7%, 9.6%, 14.8%, 13.5%, and 19.6%, respectively. Overall, 38.3% of patients had been anemic at least once during the follow-up period, and 42% of these patients had recurrent anemia. Correlation analysis indicated that hemoglobin levels were associated with graft function. No correlations between anemia and age, gender, immunosuppressive regimens, or antihypertensive agents were observed. Binary logistic regression analysis suggested that serum creatinine and blood urea nitrogen were associated with the diagnosis of anemia at 1 year post-transplant. At 5 years post-transplant, only serum creatinine concentrations correlated with anemia. Although iron drugs are frequently used, erythropoietin was rarely administered in those anemic patients suffering poor graft function that necessitated such therapies. Conclusions The prevalence of PTA is noticeably high, and impaired kidney graft function seemed to be the major risk factor for anemia. There is an urgent need to improve current PTA management and to establish modified guidelines for this common complication in kidney transplant recipients. PMID:24237955

2013-01-01

228

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

PubMed

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

Jasinskaja-Lahti, Inga

2008-02-01

229

Total parathyroidectomy without autotransplantation for the treatment of secondary hyperparathyroidism associated with chronic kidney disease: clinical and laboratory long-term follow-up.  

PubMed

Forty-six consecutive patients who underwent total parathyroidectomy (tPTX) for hyperparathyroidism associated with end-stage kidney disease (CKD5) in a University Hospital from 1990 to 1999 were included in a long-term observational study. Outcome parameters included symptoms (bone pain, pruritus and muscle weakness evaluated by visual analog scales [VAS]) and laboratory data (intact parathyroid hormone [iPTH], total calcium, and alkaline phosphatase) assessed before, shortly postoperatively and then at a later time point: 40 patients were on maintenance hemodialysis and six on conservative medical therapy. Forty-four patients had four glands removed, while only three glands were found in the remaining two. Perioperative complications consisted of acute symptomatic hypocalcemia in 10 (22%) patients and non-specific complaints in three (7%). No laryngeal nerve palsies occurred. After a median follow-up of eight years, 43 subjects were evaluated: 37 (86%) were cured, three (7%) had persistent and three (7%) recurrent disease. Eleven patients underwent successful renal transplantation and 23 died during the period of observation. iPTH decreased from a mean of 1084+/-505 pg/ml to 120+/-381 pg/ml (p < 0.0001). No subsequent bone fractures, persistent bone pain or disability were reported; this includes patients who later received a functioning renal graft. tPTX was able to correct hyperparathyroidism in most of the patients and was associated with a low long-term relapse rate. iPTH levels remained low in 17 cases without symptoms and no clinically significant side effects. The beneficial effects of tPTX occurred in the majority of patients while renal transplantation was performed in a minority of patients. tPTX should be considered a safe and successful procedure for the treatment of severe secondary hyperparathyroidism associated with chronic kidney disease. PMID:20435429

Puccini, M; Carpi, A; Cupisti, A; Caprioli, R; Iacconi, P; Barsotti, M; Buccianti, P; Mechanick, J; Nicolini, A; Miccoli, P

2010-05-01

230

Long-term follow up Helicobacter Pylori reinfection rate after second-line treatment: bismuth-containing quadruple therapy versus moxifloxacin-based triple therapy  

PubMed Central

Background The increasing trend of antibiotic resistance requires effective second-line Helicobacter pylori (H. pylori) treatment in high prevalence area of H. pylori. The aim of our study was to evaluate the reinfection rate of H. pylori after second-line treatment that would determine the long-term follow up effect of the rescue therapy. Methods A total of 648 patients who had failed previous H. pylori eradication on standard triple therapy were randomized into two regimens: 1, esomeprazole (20 mg b.i.d), tripotassium dicitrate bismuthate (300 mg q.i.d), metronidazole (500 mg t.i.d), and tetracycline (500 mg q.i.d) (EBMT) or 2, moxifloxacin (400 mg q.d.), esomeprazole (20 mg b.i.d), and amoxicillin (1000 mg b.i.d.) (MEA). At four weeks after completion of eradication therapy, H. pylori tests were performed with 13C urea breath test or invasive tests. In patients who maintained continuous H. pylori negativity for the first year after eradication therapy, H. pylori status was assessed every year. For the evaluation of risk factors of reinfection, gender, age, clinical diagnosis, histological atrophic gastritis or intestinal metaplasia were analyzed. Results The recrudescence rate of the EBMT was 1.7% and of the MEA group 3.3% (p?=?0.67). The annual reinfection rate of H. pylori of EBMT was found to be 4.45% and the MEA group 6.46%. Univariate analysis (Log-rank test) showed no association with any clinical risk factor for reinfection. Conclusions The long-term reinfection rate of H. pylori stayed low in both of bismuth-containing quadruple therapy and moxifloxacin-based triple therapy; thus reinfection cannot affect the choice of second-line treatment. Trial registration Clinical Trial Registration Number NCT01792700 PMID:24050512

2013-01-01

231

Sick leave patterns as predictors of disability pension or long-term sick leave: a 6.75-year follow-up study in municipal eldercare workers  

PubMed Central

Objectives The aim was to study whether a workplace-registered frequent short-term sick leave spell pattern was an early indicator of future disability pension or future long-term sick leave among municipal eldercare workers. Setting The municipal healthcare sector in the city of Aarhus, which is the second largest city in Denmark. Participants All elder care employees who worked the entire year of 2004 in the municipality of Aarhus, Denmark (N=2774). The employees’ sick leave days during 2004 were categorised into: 0–2 and 3–17 short (1–7?days) spells, 2–13 mixed short and long (8+?days) spells and long spells only. Student workers (n=180), employees who were absent due to maternal/paternal leave (n=536) and employees who did not work the entire year of 2004 (n=1218) were not included. Primary outcome Disability pension and long-term sick leave (?8?weeks) were subsequently identified in a National register. The cumulative incidence proportion as a function of follow-up weeks was estimated using the Kaplan-Meier curve. The relative cumulative incidence (RR) of experiencing events within 352?weeks was analysed in a generalised linear regression model using the pseudo values method adjusted for age, occupation, unfavourable work factors and sick leave length. Results A frequent short-term and a mixed sick leave pattern showed RRs of being granted a disability pension of 2.08 (95% CI 1.00 to 4.35) and 2.61 (95% CI 1.33 to 5.12) compared with 0–2 short spells. The risk of long-term sick leave was significantly increased for all sick leave patterns compared with 0–2 short spells. Adding sick leave length to the models attenuated all RRs and they became non-significant. Conclusions Sick leave length was a better indicator of future workability than spell frequency. Preventive actions should target employees engaged in homecare. The more sick leave days the greater the preventive potential seems, irrespective of spell frequency. PMID:24508850

Stapelfeldt, Christina Malmose; Nielsen, Claus Vinther; Andersen, Niels Trolle; Krane, Line; Borg, Vilhelm; Fleten, Nils; Jensen, Chris

2014-01-01

232

Thyroid Lobe Ablation with Radioactive Iodine as an Alternative to Completion Thyroidectomy After Hemithyroidectomy in Patients with Follicular Thyroid Carcinoma: Long-Term Follow-Up  

PubMed Central

Background Radioactive iodine lobe ablation (RAI-L-ABL) is a possible alternative to completion thyroidectomy (C-Tx) for follicular thyroid carcinoma (FTC), but no long-term outcome data are available after lobe ablation. We analyzed the long-term outcome of lobe ablation in a series of patients with FTC. Methods This was a retrospective study of patients who were treated with lobe ablation between 1983 and 2008. Of 134 patients with FTC, 37 (27.6%) had lobe ablation with 131I (30–32 mCi) (RAI-L-ABL), 68 (50.7%) had C-Tx, and 29 (21.6%) had initial total thyroidectomy (T-Tx). The main outcomes analyzed were 131I uptake after lobe ablation, C-Tx or T-Tx, serum thyroglobulin (Tg), serum thyroid-stimulating hormone (TSH), long-term disease-specific mortality, and disease-free survival. Results After lobe ablation, radioiodine uptake was significantly lower for the RAI-L-ABL group (0.6%) than for the C-Tx group (2.0%, p<0.005) or T-Tx group (1.3%, p=0.054). Subsequent remnant ablation was performed in 12 of 37 (32%) patients in the RAI-L-ABL group, in 58 of 68 (85.3%) patients in the C-Tx group, and in 25 of 29 (86.2%) patients in the T-Tx group (p<0.01). With median follow-up of 95 months for the RAI-L-ABL group, 47 months for the C-Tx group, and 53 months for the T-Tx group, there was one death in the RAI-L-ABL group and one death in the T-Tx group. No other RAI-L-ABL patients had detectable disease, whereas patients in the C-Tx group and two patients in the T-Tx group had detectable disease (p=0.18). Long-term stimulated or suppressed Tg of <1?ng/mL were found in 87.5% of the RAI-L-ABL group (n=28), 86.3% of the C-Tx group (n=57), and 77.8% of the T-Tx group (n=21). Tg was detectable in 40.6% of the RAI-L-ABL group compared to 13.8% of C-Tx and 28.6% of T-Tx groups (p<0.05, between groups). Conclusions RAI-L-ABL, C-Tx, and T-Tx are equally effective in achieving serum TSH concentrations of >25 mIU/L and preparing patients for conventional 131I treatment and whole body scanning with similar long-term outcomes. However, persistent measurable Tg (range 0.2–2.2?ng/mL) is more common after RAI-L-ABL. PMID:22385290

Goldfarb, Melanie; Parangi, Sareh; Yang, Jingyun; Ross, Douglas S.; Daniels, Gilbert H.

2012-01-01

233

A self-reported long-term follow-up of patients operated with either shortening techniques or a TachoSil grafting procedure.  

PubMed

The aim of this article is to analyse the long-term results of different surgical techniques for correction of penile deviations in Peyronie's disease. Patients who underwent surgery for a penile deviation in Peyronie's disease between 1997 and 2007 were included into this study. Cases were retrospectively analysed by chart review. The current situation was evaluated by a 16-item standardized questionnaire addressing penile straightness, sensation, length, sexual function and satisfaction. Ninety patients were contacted with a return rate of 75 (83%) evaluable questionnaires. Thirty-two patients were operated by shortening techniques (STs) with either Schroeder-Essed (n=16) or Nesbit (n=16). Forty-three were operated by a plaque in-/excision and defect covering by TachoSil method (TM). Both groups were similar regarding age (ST 56 years, TM 57 years), comorbidities, mean preoperative erection hardness score (EHS; 3.1 ST, 3.4 TM) and time of follow-up (total mean, 63 months). Preoperatively ST patients had significantly less plaques (P<0.05) and a lower deviation angle in comparison to TM patients (ST 56° versus TM 74°; P< 0.001). Still TM patients reported slightly better straightening results, but a significantly lower mean EHS (ST 3.3 versus TM 2.6; P<0.001) during the follow-up. Satisfaction rates were similar in both groups. In conclusion, both techniques revealed to be safe and sustainable successful in penile straightening with better functional outcome of patients operated by STs. PMID:21240293

Horstmann, Marcus; Kwol, Matthias; Amend, Bastian; Hennenlotter, Joerg; Stenzl, Arnulf

2011-03-01

234

A self-reported long-term follow-up of patients operated with either shortening techniques or a TachoSil grafting procedure  

PubMed Central

The aim of this article is to analyse the long-term results of different surgical techniques for correction of penile deviations in Peyronie's disease. Patients who underwent surgery for a penile deviation in Peyronie's disease between 1997 and 2007 were included into this study. Cases were retrospectively analysed by chart review. The current situation was evaluated by a 16-item standardized questionnaire addressing penile straightness, sensation, length, sexual function and satisfaction. Ninety patients were contacted with a return rate of 75 (83%) evaluable questionnaires. Thirty-two patients were operated by shortening techniques (STs) with either Schroeder–Essed (n=16) or Nesbit (n=16). Forty-three were operated by a plaque in-/excision and defect covering by TachoSil method (TM). Both groups were similar regarding age (ST 56 years, TM 57 years), comorbidities, mean preoperative erection hardness score (EHS; 3.1 ST, 3.4 TM) and time of follow-up (total mean, 63 months). Preoperatively ST patients had significantly less plaques (P<0.05) and a lower deviation angle in comparison to TM patients (ST 56° versus TM 74° P< 0.001). Still TM patients reported slightly better straightening results, but a significantly lower mean EHS (ST 3.3 versus TM 2.6; P<0.001) during the follow-up. Satisfaction rates were similar in both groups. In conclusion, both techniques revealed to be safe and sustainable successful in penile straightening with better functional outcome of patients operated by STs. PMID:21240293

Horstmann, Marcus; Kwol, Matthias; Amend, Bastian; Hennenlotter, Joerg; Stenzl, Arnulf

2011-01-01

235

Defibrillation threshold testing fails to show clinical benefit during long-term follow-up of patients undergoing cardiac resynchronization therapy defibrillator implantation  

PubMed Central

Background The utility of defibrillation threshold testing in patients undergoing implantable cardioverter–defibrillator (ICD) implantation is controversial. Higher defibrillation thresholds have been noted in patients undergoing implantation of cardiac resynchronization therapy defibrillators (CRT-D). Since the risks and potential benefits of testing may be higher in this population, we sought to assess the impact of defibrillation safety margin or vulnerability safety margin testing in CRT-D recipients. Methods and results A total of 256 consecutive subjects who underwent CRT-D implantation between January 2003 and December 2007 were retrospectively reviewed. Subjects were divided into two groups based on whether (n= 204) or not (n= 52) safety margin testing was performed. Patient characteristics, tachyarrhythmia therapies, procedural results, and clinical outcomes were recorded. Baseline characteristics, including heart failure (HF) severity, were comparable between the groups. Four cases of HF exacerbation (2%), including one leading to one death, were recorded in the tested group immediately post-implantation. No complications were observed in the untested group. After a mean follow-up of 32 ± 20 months, the proportion of appropriate shocks in the two groups was similar (31 vs. 25%, P = 0.49). There were three cases of failed appropriate shocks in the tested group, despite adequate safety margins at implantation, whereas no failed shocks were noted in the untested group. Survival was similar in the two groups. Conclusion Defibrillation efficacy testing during implant of CRT-D was associated with increased morbidity and did not predict the success of future device therapy or improve survival during long-term follow-up. PMID:21252192

Michowitz, Yoav; Lellouche, Nicolas; Contractor, Tahmeed; Bourke, Tara; Wiener, Isaac; Buch, Eric; Boyle, Noel; Bersohn, Malcolm; Shivkumar, Kalyanam

2011-01-01

236

EUCROMIC (European Collaborative Research on Mosaicism in Chorionic Villus Sampling): New initiatives concerning uniparental disomy research and long-term clinical follow-up  

SciTech Connect

Since 1986 the European collaborative study on mosaicism in chorionic villus sampling (CVS), based in Glostrup, Denmark. has been collecting cytogenetic and clinical data on pregnancies in which testing revealed mosaicism or fetal/extrafetal chromosomal discrepancies. From 1986-1992, data on 60,823 samples, including 751 mosaics and 241 nonmosaic discrepancies, was collected. This information has proven helpful in prenatal counseling, by indicating which chromosomes are most often involved in mosaicism, whether the latter is likely to be confirmed in the fetus and/or placenta, and the relationship of cytogenetic results obtained by different culture techniques to pregnancy outcome. Since December 1, 1993 the European collaborative study has been funded by the European Community and by the Swiss government as a concertation project, {open_quotes}EUCROMIC{close_quotes}, a step which has allowed enlargement of the database and broadening of the project goals. Forty-five genetics centers are currently involved in this effort to monitor not only CVS, but changing trends in prenatal diagnosis in Europe. Two ancillary projects, based in Geneva, were initiated in early 1993: long-term clinical follow-up of children born after CVS mosaicism, and a search for uniparental disomy (UPD) in these same children (as well as in abortuses). Clinical data is collected from the initial reporting centers via questionnaires; at the time of writing, clinical follow-up has been obtained for over 250 children liveborn after CVS mosaicism. UPD testing results are received from the individual centers; for those not having the possibility to do the parental origin analyses themselves, testing is offered in one of several EUCROMIC-UPD laboratories.

DeLozier-Blanchet, C.D.; Hahnemann, J.M.; Vejersley, L.O.

1994-09-01

237

Can intensity of long-term follow-up for survivors of childhood and teenage cancer be determined by therapy-based risk stratification?  

PubMed Central

Objective To determine the feasibility of therapy-based, risk-stratified follow-up guidelines for childhood and teenage cancer survivors by evaluating adverse health outcomes in a survivor cohort retrospectively assigned a risk category. Design Retrospective cohort study. Setting Tertiary level, single centre, paediatric cancer unit in South East Scotland. Participants All children and teenagers diagnosed with cancer (<19?years) between 1 January 1971 and 31 July 2004, who were alive more than 5?years from diagnosis formed the study cohort. Each survivor was retrospectively assigned a level of follow-up, based on their predicted risk of developing treatment-related late effects (LEs; levels 1, 2 and 3 for low, medium and high risk, respectively). Adverse health outcomes were determined from review of medical records and postal questionnaires. LEs were graded using the Common Terminology Criteria for Adverse Event, V.3. Results 607 5-year survivors were identified. Risk stratification identified 86 (14.2%), 271 (44.6%) and 250 (41.2%) as levels 1, 2 and 3 survivors, respectively. The prevalence of LEs for level 1 survivors was 11.6% with only one patient with grade 3 or above toxicity. 35.8% of level 2 survivors had an LE, of whom 9.3%, 58.8%, 18.5%, 10.3% and 3% had grades 1, 2, 3, 4 and 5 toxicity, respectively. 65.2% of level 3 survivors had LE, of whom 5.5% (n=9), 34.4% (n=56), 36.2% (n=59), 22.1% (n=36) and 1.8% (n=3) had grades 1, 2, 3, 4 and 5 toxicity, respectively. Conclusions Therapy-based risk stratification of survivors can predict which patients are at significant risk of developing moderate-to-severe LEs and require high-intensity long-term follow-up. Our findings will need confirmation in a prospective cohort study that has the power to adjust for all potentially confounding variables. PMID:23913770

Edgar, A B; Duffin, K; Borthwick, S; Marciniak-Stepak, P; Wallace, W H

2013-01-01

238

Efficacy of treatment and long-term follow-up of Batrachochytrium dendrobatidis PCR-positive anurans following itraconazole bath treatment.  

PubMed

All anuran specimens in the Wildlife Conservation Society's collections testing positive for Batrachochytrium dendrobatidis (Bd) were treated with itraconazole and then studied after treatment to assess the long-term effects of itraconazole and the drug's effectiveness in eliminating Bd carriers. Twenty-four individuals and eight colonies of 11 different species (75 total specimens) tested positive for Bd via polymerase chain reaction (PCR) on multicollection survey. All positive individuals and colonies were treated with a 0.01% itraconazole bath solution and retested for Bd via one of two PCR methodologies within 14 days of treatment completion, and all were negative for Bd. A total of 64 animals received secondary follow-up PCR testing at the time of death, 6-8 mo, or 12-15 mo post-treatment. Fourteen animals (14/64, 21.9%) were PCR positive for Bd on second follow-up. The highest percentage positive at second recheck were green-and-black poison dart frogs (Dendrobates auratus; 5/5 specimens, 100%), followed by red-eyed tree frogs (Agalychnis callidryas; 4/11, 36.4%), grey tree frogs (Hyla versicolor; 1/3, 33.3%), and green tree frogs (Hyla cinera; 3/11, 27.3%). Re-testing by PCR performed on 26/28 individuals that died during the study indicated 11/26 (42.3%) were positive (all via DNA extracted from formalin-fixed paraffin-embedded skin sections). However, there was no histologic evidence of chytridiomycosis in any of 27/28 individuals. The small number of deceased animals and effects of postmortem autolysis limited the ability to determine statistical trends in the pathology data, but none of the necropsied specimens showed evidence of itraconazole toxicity. Problems with itraconazole may be species dependent, and this report expands the list of species that can tolerate treatment. Although itraconazole is effective for clearance of most individuals infected with Bd, results of the study suggest that repeat itraconazole treatment and follow-up diagnostics may be required to ensure that subclinical infections are eliminated in amphibian collections. PMID:23805558

Georoff, Timothy A; Moore, Robert P; Rodriguez, Carlos; Pessier, Allan P; Newton, Alisa L; McAloose, Denise; Calle, Paul P

2013-06-01

239

Long-term follow-up study for a patient with Floating-Harbor syndrome due to a hotspot SRCAP mutation.  

PubMed

Floating-Harbor syndrome (FHS) is a rare autosomal dominant disorder characterized by short stature, skeletal malformations, speech delay, and dysmorphic facial appearance. Recently, mutations in SRCAP encoding a coactivator for cAMP-response element binding protein (CREB)-binding protein have been identified in small number of patients with FHS. Here, we report on long-term follow-up data of a male patient with a SRCAP mutation. The patient presented with mild hypothyroidism and renal hypouricemia, in addition to several FHS-compatible features including growth impairment, cognitive disability, facial dysmorphisms, and hypertension. He showed delayed bone age from infancy to 9 years of age and markedly accelerated bone age with the formation of cone-shaped epiphyses and early epiphysial fusions after the onset of puberty. His pubertal sexual development was almost age appropriate. Two-year treatment with growth hormone (GH) did not significantly improve the growth velocity. Molecular analysis identified a de novo heterozygous nonsense mutation (p.R2444X) in the last exon of SRCAP, which has been most common mutation detected in patients from other ethnic groups. These results indicate that perturbed skeletal maturation from infancy through adolescence is a characteristic feature in patients with SRCAP mutations. Furthermore, our data imply that GH therapy exerted only a marginal effect on the growth of this patient, and that renal hypouricemia may be a novel complication of FHS. PMID:24375913

Nagasaki, Keisuke; Asami, Tadashi; Sato, Hidetoshi; Ogawa, Yohei; Kikuchi, Toru; Saitoh, Akihiko; Ogata, Tsutomu; Fukami, Maki

2014-03-01

240

Long-term follow-up of functional outcomes and radiographic changes at adjacent levels following lumbar spine fusion for degenerative disc disease.  

PubMed

There are very few studies with more than 20 years' follow-up of lumbar spine fusions for disc degeneration. Currently, there is a lot of interest in the subject of degenerative changes above the level of fusion; this study is concerned with such changes in the very long term (30 years). Twenty-eight patients showing sound fusion on radiographs following posterior midline spinal fusion performed by a single surgeon between 1968 and 1970 were compared with an age- and gender-matched group of 28 patients who had undergone surgery for degenerative disc disease without fusion during the same period, by the same surgeon and using similar criteria for evaluation (Short Form 36 and Oswestry Disability Index; functional testing using self-paced walk and timed up-and-go; flexion and extension lateral radiographs of the lumbar spine). In this study, the incidence of radiographic changes at levels above the level of previous involvement was twice as high in the fusion group as in the non-fusion group. However, there was no statistically significant difference between the two groups in the outcomes measured using validated scales and functional testing. The study emphasises the importance of complete evaluation of these patients using validated outcome measurement instruments against the background of radiographic changes and subjective assessment of back pain. It also shows that radiographic changes do not necessarily mean functional impairment in all patients following lumbar spine fusion for degenerative disc disease. PMID:11563616

Kumar, M N; Jacquot, F; Hall, H

2001-08-01

241

Allogeneic stem cell transplantation for patients with chronic myeloid leukemia: risk stratified approach with a long-term follow-up.  

PubMed

The use of allogeneic stem cell transplantation (SCT) for chronic myeloid leukemia (CML) was almost abandoned in recent years for very effective targeted therapy with tyrosine kinase inhibitors (TKIs). However, approximately one third of patients still need another treatment including SCT. 38 consecutive CML patients were treated (most in preimatinib era) with allogeneic SCT, using partial T cell depletion (TCD) and preemptive donor lymphocyte infusion (DLI), without post-transplant graft-versus-host disease (GvHD) prophylaxis. Conditioning included busulfan, cyclophosphamide, antithymocytic globulin, and fludarabine followed by donor stem cell transfusion. With a median follow up of 90.5 months (1-134), 32 patients are alive. 97% engrafted. 5-year leukemia free survival (LFS) and overall survival (OS) were 78.95% and 84.2%, respectively. All patients are in major molecular remission and 78% in complete molecular remission. Transplant-related mortality (TRM) was 13%. Twenty-four patients received DLI for residual disease. Acute GvHD, mostly Grades I-II, occurred in 18% of patients post-transplant and in 24% of patients receiving DLI. In conclusion, the risk-adapted approach using only partial TCD and preemptive escalated dose of DLI precluded the need for immunosuppressive medications and reduced the risk of significant GvHD without compromising engraftment and long-term disease control. Am. J. Hematol. 2012. © 2012 Wiley Periodicals, Inc. PMID:22847303

Zuckerman, Tsila; Katz, Tamar; Haddad, Nuhad; Fineman, Riva; Dann, Eldad J; Avivi, Irit; Ofran, Yishai; Gavish, Israel; Faibish, Tal; Sahar, Dvora; Hertz, Eti; Sabo, Edmond; Reisner, Yair; Rowe, Jacob M

2012-09-01

242

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

SciTech Connect

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.

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

243

Long-term Follow-up of Breast-conserving Therapy in Patients with Inflammatory Breast Cancer Treated with Neoadjuvant Chemotherapy.  

PubMed

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer. Currently, multimodality treatment is recommended, but the optimal surgical management has not been fully elucidated. In this study, we investigated the long-term outcomes of using breast-conserving therapy in patients with IBC undergoing neoadjuvant chemotherapy (NAC). Twenty-four patients with IBC were treated from 2002 to 2006. NAC was initiated with doxorubicin and cyclophosphamide followed by paclitaxel. In addition, HER2/neu-positive patients received trastuzumab, whereas HER2/neu-negative patients received bevacizumab. Clinical response was assessed by dynamic contrast-enhanced magnetic resonance imaging before surgery and pathologic response after surgery. A partial mastectomy with sentinel lymph node biopsy and/or axillary lymph node dissection or a modified radical mastectomy was performed based on the surgeon's recommendations and patient's preference. All patients received adjuvant radiation. Of the 24 patients, seven (29%) underwent a partial mastectomy and 17 (71%) underwent a mastectomy. The overall survival rate for partial mastectomy and for mastectomy patients was 59 and 57 per cent (P = 0.49), respectively, at a median follow-up of 60 months (range, 48 to 92 months). Breast-conserving therapy can be considered in a selected group of patients who demonstrate a good response to NAC. PMID:25264634

Bonev, Valentina; Evangelista, Maristella; Chen, Jeon-Hor; Su, Min-Ying; Lane, Karen; Mehta, Rita; Butler, John; Hsiang, David

2014-10-01

244

Liver Transplantation for Classical Maple Syrup Urine Disease: Long-Term Follow-Up in 37 Patients and Comparative United Network for Organ Sharing Experience  

PubMed Central

Objective To assess clinical and neurocognitive function in children who have undergone liver transplantation for classical maple syrup urine disease (MSUD). Study design A total of 35 patients with classical MSUD (age 9.9 ± 7.9 years) underwent liver transplantation between 2004 and 2009. Six patients donated their liver to recipients without MSUD (“domino” transplant). We analyzed clinical outcomes for our cohort and 17 additional cases from the national United Network for Organ Sharing registry; 33 patients completed IQ and adaptive testing before transplantation, and 14 completed testing 1 year later. Results Patient and graft survival were 100% at 4.5 ± 2.2 years of follow-up. Liver function was normal in all patients. Branched-chain amino acid levels were corrected within hours after surgery and remained stable, with leucine tolerance increasing more than 10-fold. All domino transplant recipients were alive and well with normal branched-chain amino acid homeostasis at the time of this report. Patient and graft survival for all 54 patients with MSUD undergoing liver transplantation in the United States during this period were 98%and 96%, respectively. One-third of our patients were mentally impaired (IQ ? 70) before transplantation, with no statistically significant change 1 year later. Conclusion Liver transplantation is an effective long-term treatment for classical MSUD and may arrest brain damage, but will not reverse it. PMID:21839471

Mazariegos, George V.; Morton, D. Holmes; Sindhi, Rakesh; Soltys, Kyle; Nayyar, Navdeep; Bond, Geoffrey; Shellmer, Diana; Shneider, Benjamin; Vockley, Jerry; Strauss, Kevin A.

2012-01-01

245

Long term follow-up of health-related quality of life in young adults born very preterm or with a very low birth weight  

PubMed Central

Background The purpose was, first, to evaluate changes in health-related quality of life (HRQL) in a cohort of very low birth weight (VLBW; <1500 g.) or very preterm (< 32 weeks of gestation) children between ages 14 and 19, and second, to identify correlates of HRQL at age 19. Methods HRQL was assessed using the Health Utilities Index Mark 3 (HUI3). In order to explore correlates of HRQL, we performed a hierarchical regression analysis. Results Surviving VLBW children (n?=?959) from a 1983 Dutch nation-wide cohort were eligible; 630 participated both at age 14 and 19; 54 at age 19 only. The mean HRQL score decreased from 0.87 to 0.86. The HRQL of 45% was stable, 25% were better and 30% were worse. A regression model showed internalizing problems were related most strongly to HRQL. Conclusions In the transition from adolescence to young adulthood, HRQL in Dutch VLBW children was stable at the group level but varied at the individual level. HRQL was negatively associated with internalizing problems and also with physical handicaps. Long-term follow-up studies on the impact of VLBW on HRQL are all the more called for, given the growing number of vulnerable infants surviving the neonatal period. PMID:22587364

2012-01-01

246

A case of cleidocranial dysplasia with peculiar dental features: pathogenetic role of the RUNX2 mutation and long term follow-up.  

PubMed

This report deals with a case of Cleidocranial Dysplasia (CCD) associated to a rare mutation of the RUNX2 gene and a peculiar dental phenotype, namely no supernumerary teeth. The aim consists in evaluating the long-term follow-up after treatment and discussing the pathogenetic mechanism of the mutation. We have carried out a clinical evaluation after treatment and attempted to analyze the potential pathogenetic effect of the mutation, based upon the available experimental structure of RUNX family domain and the highly conserved homology of RUNX1-3. Clinically the treatment has led to tooth development in crowns an roots, correction of cross-bite and eruption of the central maxillary incisor. The structural analysis has pointed out impairment in the DNA binding capability of the mutant protein. The described mutation, c.391C>T (p.R131C) appears to influence both structure and function of the protein by hampering the interaction of RUNX2 with DNA. The impaired function could explain the peculiar reported CCD phenotype. The dental condition of our patient has largely improved after treatment. PMID:24984680

Callea, Michele; Bellacchio, Emanuele; Di Stazio, Mariateresa; Fattori, Fabiana; Bertini, Enrico; Yavuz, Izzet; Clarich, Gabriella; Gunay, Ayse

2014-06-01

247

Maximum likelihood analysis of bioassay data from long-term follow-up of two refractory PuO2 inhalation cases.  

PubMed

The U.S. Transuranium and Uranium Registries' tissue donors 0202 and 0407 are the two most highly exposed of the 18 registrants who were involved in the 1965 plutonium fire accident at a defense nuclear facility. Material released during the fire was well characterized as "high fired" refractory plutonium dioxide with 0.32-?m mass median diameter. The extensive bioassay data from long-term follow-up of these two cases were used to evaluate the applicability of the Human Respiratory Tract Model presented by International Commission on Radiological Protection in Publication 66 and its revision proposed by Gregoratto et al. in order to account for the observed long-term retention of insoluble material in the lungs. The maximum likelihood method was used to calculate the point estimates of intake and tissue doses and to examine the effect of different lung clearance, blood absorption, and systemic models on the goodness-of-fit and estimated dose values. With appropriate adjustments, Gregoratto et al. particle transport model coupled with the customized blood absorption parameters yielded a credible fit to the bioassay data for both cases and predicted the Case 0202 liver and skeletal activities measured postmortem. PuO2 particles produced by the plutonium fire are extremely insoluble. About 1% of this material is absorbed from the respiratory tract relatively rapidly, at a rate of about 1 to 2 d (half-time about 8 to 16 h). The remainder (99%) is absorbed extremely slowly, at a rate of about 5 × 10(-6) d (half-time about 400 y). When considering this situation, it appears that doses to other body organs are negligible in comparison to those to tissues of the respiratory tract. About 96% of the total committed weighted dose equivalent is contributed by the lungs. Doses absorbed by these workers' lungs were high: 3.2 Gy to AI and 6.5 Gy to LNTH for Case 0202 (18 y post-intake) and 3.2 Gy to AI and 55.5 Gy to LNTH for Case 0407 (43 y post-intake). This evaluation supports the Gregoratto et al. proposed revision to the ICRP 66 model when considering situations of extremely insoluble particles. PMID:22647919

Avtandilashvili, Maia; Brey, Richard; James, Anthony C

2012-07-01

248

Diisocyanate-induced asthma in Switzerland: long-term course and patients' self-assessment after a 12-year follow-up  

PubMed Central

Background Isocyanates are among the most common causes of occupational asthma (OA) in Switzerland. Patients with OA have been shown to have unfavourable medical, socioeconomic and psychological outcomes. We investigated long-term asthma and the socio-economic outcomes of diisocyanate-induced asthma (DIA) in Switzerland. Patients and methods We conducted an observational study on 49 patients with DIA and followed 35 of these patients over a mean exposure-free interval of 12?±?0.5 (range 11.0-13.0) years. At the initial and follow-up examinations, we recorded data on respiratory symptoms and asthma medication; measured the lung function; and tested for bronchial hyperreactivity. We allowed the patients to assess their state of health and overall satisfaction using a visual analogue scale (VAS) at these visits. Results The 35 patients whom we could follow had a median symptomatic exposure time of 12 months, interquartile range (IQR) 26 months and a median overall exposure time of 51 (IQR 104) months. Their subjective symptoms (p?follow-up period were similar to the findings in the literature. The same hold true for some prognostic factors, whereas the patients’ self-assessment of their state of health and overall satisfaction improved considerably. PMID:24949081

2014-01-01

249

597 Long Term Follow-up of Patients with Common Variable Immunodeficiency (Cvid) in Rio De Janeiro, Brazil: Clinical Phenotypes and Prognosis  

PubMed Central

Background CVID comprises a variety of clinical phenotypes that may influence the prognosis of the disease. Our goal was to investigate the clinical phenotypes and prognosis of a series of patients with CVID. Methods We evaluated 11 patients with CVID, according to the PAGID criteria in long-term clinical follow-up (> 10 years). Most patients were on regular use of intravenous immunoglobulin (IVIg), provided free of charge by the government. Clinical evaluation was performed monthly and exams every 6 months to 1 year, including immunological evaluation, hematologic, biochemical, autoimmune, stool, urine analysis, chest CT, abdominal ultrasound and specific investigations of infectious diseases and malignancies, when needed. Results The average follow-up was 21.9 years (12–34). Among the 11 patients, the mean current age was 39.8 years (16 to 62), 73% were female and 82% white. The age at symptoms onset ranged from 4 to 31 years (mean = 18) and diagnosis occurred between ages 11 and 47 (mean = 28). Most patients (55%) had the phenotype of infectious complications only, 27% had infections and immune thrombocytopenic purpura and 18% had infections and solid neoplasias. The most common infections were recurrent sinusitis (100%), pneumonia (82%), giardiasis (36%) and tuberculosis (18%). None of the patients developed lymphoproliferative and / or inflammatory complications. With regard to immunological changes, we observed that 4 patients (36%) experienced an increase in CD8 T lymphocytes and inversion of CD4/CD8 ratio. Adherence to the use of IVIg was good in 50% of patients, fair in 38% and unsatisfactory in 12%. All patients have good quality of life, performing their routine activities of study, work and leisure. Conclusions In the population studied, the most frequent phenotypes were infectious complications or infectious complications + autoimmunity. Tuberculosis can be an important infectious complication in patients with CVID in endemic areas. The delay in the diagnosis of CVID, around 10 years, indicates the need to improve the diagnosis of PID in our country. With proper clinical management and good adherence to the use of IVIg, patients with CVID in developing countries may have survival and quality of life similar to those described in developed countries.

Seba, Amanda; de Paula Motta Rubini, Norma; Capelo, Albertina Varandas; Miranda da Silva, Eliane; Campos de Magalhaes, Marilza; Sion, Fernando Samuel; Morais de Sa, Carlos Alberto

2012-01-01

250

Efficacy of a third coronary angioplasty for a second restenosis: short-term results, long-term follow up, and correlates of a third restenosis.  

PubMed Central

OBJECTIVE--To report on the short-term and long-term results of patients who underwent a third coronary balloon angioplasty for a second restenosis and to identify the correlates of a third clinical restenosis. DESIGN--A retrospective analysis of clinical, angiographic, and procedure related variables of a consecutive series of patients. PATIENTS--62 patients (mean (range) age 53 (31-72) years; 84% men) who underwent a third coronary balloon angioplasty of a single coronary artery segment at which restenosis had occurred after two previous angioplasty procedures between 1986 and 1992. RESULTS--Procedure success was achieved in 56 patients (90%). Complications included one myocardial infarction (2%) and one emergency coronary artery bypass surgery (2%). Complete follow up data were available (median (range) 48 (12-94) months). During the follow up period, four patients (6%) died, two (3%) had a non-fatal myocardial infarction, and five (8%) underwent elective coronary artery bypass surgery. Nine patients (14%) underwent a fourth angioplasty for a third clinical restenosis, and three (5%) had a fourth angioplasty procedure for new coronary lesions. The cumulative probability of survival for all 62 patients was 97% and 95% at 1 and 5 years, respectively. The 1 and 5 year freedom from death, infarction, bypass surgery, and repeat angioplasty was 82% and 66.6%, respectively. At census, of the 58 survivors, 31 (53%) were asymptomatic and only eight (14%) complained of angina grade III or IV (P < 0.001). A third clinical restenosis occurred in 22 (39%) of the 56 patients who had initially successful procedures. Multiple stepwise logistic regression analysis identified the interval between the second and third angioplasty procedure as the only independent predictor of a third clinical restenosis (P = 0.004). CONCLUSIONS--A third coronary angioplasty for a second restenosis can be performed safely and effectively and should be considered as an integral part of the overall coronary angioplasty revascularisation strategy. The incidence of a third clinical restenosis remains high, however, and is correlated with the interval between the previous angioplasty procedures. PMID:7756065

Tan, K. H.; Sulke, N.; Taub, N.; Karani, S.; Sowton, E.

1995-01-01

251

Usefulness of Intraluminal Brachytherapy Combined With External Beam Radiation Therapy for Submucosal Esophageal Cancer: Long-Term Follow-Up Results  

SciTech Connect

Purpose: To assess the efficacy of radiation therapy (RT) by using intraluminal brachytherapy (IBT) combined with external beam RT (EBRT) for submucosal esophageal cancer. Methods and Materials: Between 1991 and 2005, 59 consecutive patients received definitive RT without chemotherapy. IBT was performed after patients completed EBRT as a booster therapy for 17 patients, using low-dose-rate Cs-137 sources until 1997, and for 19 patients, using high-dose-rate Ir-192 sources thereafter. The long-term outcomes were investigated with a median follow-up time of 61 months. Results: Logoregional recurrences and distant metastases were observed in 14 patients and in 2 patients in the lung, respectively, and 5 patients were rescued by salvage treatments. The 5-year logoregional control and cause-specific survival rates were 75% and 76%, respectively. The 5-year cause-specific survival rate in the EBRT group was 62%, whereas the corresponding rate in the IBT group was 86% (p = 0.04). Multivariate analysis revealed that IBT was the most powerful predictor of survival but did not reach a significant level (p = 0.07). There were five esophageal ulcers in the IBT group, but no ulcers developed with small fractions of 3 Gy. Grade 2 or higher cardiorespiratory complications developed in 2 patients (5.6%) in the IBT group and in 3 patients (13.0%) in the EBRT group. Conclusions: Combining IBT with EBRT is suggested to be one of the preferable treatment modalities for medically inoperable submucosal esophageal cancer because of its preferable local control and survival probabilities, with appreciably less morbidity.

Ishikawa, Hitoshi, E-mail: hisikawa@med.gunma-u.ac.j [Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 (Japan); Nonaka, Tetsuo; Sakurai, Hideyuki [Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 (Japan); Tamaki, Yoshio; Kitamoto, Yoshizumi [Department of Radiation Oncology, Gunma Cancer Center, 617-1 Takabayashi-nishi, Ota, Gunma 373-8550 (Japan); Ebara, Takeshi; Shioya, Mariko; Noda, Shin-Ei [Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 (Japan); Shirai, Katsuyuki [Department of Radiation Oncology, Gunma Cancer Center, 617-1 Takabayashi-nishi, Ota, Gunma 373-8550 (Japan); Suzuki, Yoshiyuki; Takahashi, Takeo; Nakano, Takashi [Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 (Japan)

2010-02-01

252

Does Mechanical Thrombectomy in Acute Embolic Stroke Have Long-term Side Effects on Intracranial Vessels? An Angiographic Follow-up Study  

SciTech Connect

Purpose. Mechanical thrombectomy (mTE) proved to be effective treating acute vessel occlusions with an acceptable rate of procedural complications. Potential long-term side effects of the vessel wall trauma caused by mechanical irritation of the endothelium are unknown up to now. Methods. From a retrospectively established database of 640 acute stroke treatments, we selected 261 patients with 265 embolic vessel occlusions treated successfully by mTE without permanent implantation of a stent. Analysis comprised the type of devices used and the number of passes performed. Digital subtraction angiography immediately after treatment was evaluated for vasospasm, dissection, and extravasation. Control angiographic images were evaluated for any morphological change compared to the immediate posttreatment angiographic run. Results. Recanalization was achieved with a median of one (range 1-10) mTE maneuvers. Vasospasm occurred in 69 territories (26.0 %) and was treated with glyceroltrinitrate in three. Dissection was observed in one vessel (0.4 %). Intraprocedural hemorrhage in two patients (0.8 %) was either wire or device induced. Follow-up digital subtraction angiography was available for 117 territories after a median of 107 days, revealing target vessel occlusion in one segment (0.9 %) and a de novo stenosis of four segments (3.4 %). All findings were clinically asymptomatic. Posttreatment vasospasm was more frequent in patients with de novo stenosis and occlusion (p = 0.038). Conclusion. De novo stenoses and occlusions occur in a small proportion of patients after mTE. Because all lesions were clinically asymptomatic, this finding does not affect the overall benefit of the treatment. Vasospasm may predict late vessel wall changes.

Kurre, Wiebke, E-mail: w.kurre@klinikum-stuttgart.de; Perez, Marta Aguilar; Horvath, Diana [Klinikum Stuttgart, Klinik fuer Diagnostische und Interventionelle Neuroradiologie (Germany); Schmid, Elisabeth; Baezner, Hansjoerg [Klinikum Stuttgart, Neurologische Klinik (Germany); Henkes, Hans, E-mail: HHHenkes@aol.com [Klinikum Stuttgart, Klinik fuer Diagnostische und Interventionelle Neuroradiologie (Germany)

2013-06-15

253

Is Simpson Grade I Removal Necessary in All Cases of Spinal Meningioma? Assessment of Postoperative Recurrence during Long-Term Follow-up.  

PubMed

It is generally accepted that the first choice of treatment for spinal meningiomas is "radical" surgical removal. However, Simpson grade I removal is sometimes difficult, especially in cases with ventral dural attachment, because of the risk of spinal cord damage or the difficulty of dural repair after radical resection. In addition, there is no consensus on a surgical strategy for radicality, whether or not Simpson grade I resection should be performed in all cases of spinal meningioma. In this study, we retrospectively analyzed clinical and radiological data of surgically treated 14 patients with spinal meningioma, to assess the influence of the Simpson grade to tumor recurrences during long-term follow-up (median 8.2 years, 1.3-27.9). The number of patients in Simpson grades I, II, III, and IV were 2, 8, 0, and 3, respectively; Simpson grading was not applicable to one patient with non-dura-based meningioma. No postoperative permanent neurological worsening was encountered. The recurrence rate was 21.4% (3 out of 14 cases). Of these 3 recurrent cases, 1 was a case of non-dura-based meningioma and another was a case of neurofibromatosis type 2 (NF2); both of them are known as risk factors for recurrence after surgical removal of spinal meningiomas. Considering this background of these two recurrences, the clinical results of the present study are consistent with previous results. Therefore, we propose that surgeons do not always have to achieve Simpson grade I removal if dural repair is complicated and postoperative cerebrospinal fluid (CSF) leakage or neurological worsening are estimated after resection of dural attachment and repair of dural defect. PMID:24759095

Tsuda, Kyoji; Akutsu, Hiroyoshi; Yamamoto, Tetsuya; Nakai, Kei; Ishikawa, Eiichi; Matsumura, Akira

2014-11-15

254

Hyperbaric Oxygen Treatment of Chronic Refractory Radiation Proctitis: A Randomized and Controlled Double-Blind Crossover Trial With Long-Term Follow-Up  

SciTech Connect

Purpose: Cancer patients who undergo radiotherapy remain at life-long risk of radiation-induced injury to normal tissues. We conducted a randomized, controlled, double-blind crossover trial with long-term follow-up to evaluate the effectiveness of hyperbaric oxygen for refractory radiation proctitis. Methods and Materials: Patients with refractory radiation proctitis were randomized to hyperbaric oxygen at 2.0 atmospheres absolute (Group 1) or air at 1.1 atmospheres absolute (Group 2). The sham patients were subsequently crossed to Group 1. All patients were re-evaluated by an investigator who was unaware of the treatment allocation at 3 and 6 months and Years 1-5. The primary outcome measures were the late effects normal tissue-subjective, objective, management, analytic (SOMA-LENT) score and standardized clinical assessment. The secondary outcome was the change in quality of life. Results: Of 226 patients assessed, 150 were entered in the study and 120 were evaluable. After the initial allocation, the mean SOMA-LENT score improved in both groups. For Group 1, the mean was lower (p 0.0150) and the amount of improvement nearly twice as great (5.00 vs. 2.61, p = 0.0019). Similarly, Group 1 had a greater portion of responders per clinical assessment than did Group 2 (88.9% vs. 62.5%, respectively; p 0.0009). Significance improved when the data were analyzed from an intention to treat perspective (p = 0.0006). Group 1 had a better result in the quality of life bowel bother subscale. These differences were abolished after the crossover. Conclusion: Hyperbaric oxygen therapy significantly improved the healing responses in patients with refractory radiation proctitis, generating an absolute risk reduction of 32% (number needed to treat of 3) between the groups after the initial allocation. Other medical management requirements were discontinued, and advanced interventions were largely avoided. Enhanced bowel-specific quality of life resulted.

Clarke, Richard E. [Baromedical Research Foundation, Columbia, SC (United States)], E-mail: dick.clarke@palmettohealth.org; Tenorio, L. M. Catalina [Department of Radiation Oncology, Instituto Nacional de Cancerologia, Mexico City (Mexico); Hussey, James R. [Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC (United States); Toklu, Akin S. [Department of Underwater and Hyperbaric Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul (Turkey); Cone, D. Lindsie [Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC (United States); Hinojosa, Jose G. [Department of Radiation Oncology, Instituto Nacional de Cancerologia, Mexico City (Mexico); Desai, Samir P. [Baromedical Research Foundation, Columbia, SC (United States); Dominguez Parra, Luis [Department of Surgery, Instituto Nacional de Cancerologia, Mexico City (Mexico); Rodrigues, Sylvia D. [Department of Radiation Oncology, University of Pretoria Medical Centre, Pretoria, Republic of South Africa (South Africa); Long, Robert J. [Wesley Centre for Hyperbaric Medicine, Wesley Medical Centre, Brisbane (Australia); Walker, Margaret B. [Department of Diving and Hyperbaric Medicine, Royal Hobart Hospital, Tasmania (Australia)

2008-09-01

255

Long-term association of food and nutrient intakes with cognitive and functional1 decline: a 13-year follow-up study of elderly French women2  

E-print Network

1 Long-term association of food and nutrient intakes with cognitive and functional1 decline: a 13 The objective of this study was to determine the potential long-term impact of dietary habits36 on age, lifestyle and41 health factors were performed to evaluate associations between habitual dietary intakes and

Boyer, Edmond

256

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

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

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

1998-01-01

257

Evaluating Aspects of Online Medication Safety in Long-Term Follow-Up of 136 Internet Pharmacies: Illegal Rogue Online Pharmacies Flourish and Are Long-Lived  

PubMed Central

Background A growing number of online pharmacies have been established worldwide. Among them are numerous illegal websites selling medicine without valid medical prescriptions or distributing substandard or counterfeit drugs. Only a limited number of studies have been published on Internet pharmacies with regard to patient safety, professionalism, long-term follow-up, and pharmaceutical legitimacy verification. Objective In this study, we selected, evaluated, and followed 136 Internet pharmacy websites aiming to identify indicators of professional online pharmacy service and online medication safety. Methods An Internet search was performed by simulating the needs of potential customers of online pharmacies. A total of 136 Internet pharmacy websites were assessed and followed for four years. According to the LegitScript database, relevant characteristics such as longevity, time of continuous operation, geographical location, displayed contact information, prescription requirement, medical information exchange, and pharmaceutical legitimacy verification were recorded and evaluated. Results The number of active Internet pharmacy websites decreased; 23 of 136 (16.9%) online pharmacies ceased operating within 12 months and only 67 monitored websites (49.3%) were accessible at the end of the four-year observation period. However, not all operated continuously, as about one-fifth (31/136) of all observed online pharmacy websites were inaccessible provisionally. Thus, only 56 (41.2%) Internet-based pharmacies were continuously operational. Thirty-one of the 136 online pharmacies (22.8%) had not provided any contact details, while only 59 (43.4%) displayed all necessary contact information on the website. We found that the declared physical location claims did not correspond to the area of domain registration (according to IP address) for most websites. Although the majority (120/136, 88.2%) of the examined Internet pharmacies distributed various prescription-only medicines, only 9 (6.6%) requested prior medical prescriptions before purchase. Medical information exchange was generally ineffective as 52 sites (38.2%) did not require any medical information from patients. The product information about the medicines was generally (126/136, 92.6%) not displayed adequately, and the contents of the patient information leaflet were incomplete in most cases (104/136, 76.5%). Numerous online operators (60/136, 44.1%) were defined as rogue Internet pharmacies, but no legitimate Internet-based pharmacies were among them. One site (0.7%) was yet unverified, 23 (16.9%) were unapproved, while the remaining (52/136, 38.2%) websites were not available in the LegitScript database. Contrary to our prior assumptions, prescription or medical information requirement, or the indication of contact information on the website, does not seem to correlate with “rogue pharmacy” status using the LegitScript online pharmacy verification standards. Instead, long-term continuous operation strongly correlated (P<.001) with explicit illegal activity. Conclusions Most Internet pharmacies in our study sample were illegal sites within the definition of “rogue” Internet pharmacy. These websites violate professional, legal, and ethical standards and endanger patient safety. This work shows evidence that online pharmacies that act illegally appear to have greater longevity than others, presumably because there is no compelling reason for frequent change in order to survive. We also found that one in five websites revived (closed down and reopened again within four years) and no-prescription sites with limited medicine and patient information are flourishing. PMID:24021777

2013-01-01

258

Long-term follow-up and consequences for severe road traffic injuries—treatment costs and health impairment in Sweden in the 1960s and the 1990s  

Microsoft Academic Search

The purpose of this study is to provide information from two prospective long-term follow-ups for severe road traffic injuries in Sweden. The long-term consequences, in terms of loss of health and costs of care, are presented for severe injuries in Sweden in the early 1990s and are compared with information on injury severity and health care utilisation 25 years ago.

Pia Maraste; Ulf Persson; Monica Berntman

2003-01-01

259

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

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

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

260

A self-reported long-term follow-up of patients operated with either shortening techniques or a TachoSil grafting procedure  

Microsoft Academic Search

The aim of this article is to analyse the long-term results of different surgical techniques for correction of penile deviations in Peyronie's disease. Patients who underwent surgery for a penile deviation in Peyronie's disease between 1997 and 2007 were included into this study. Cases were retrospectively analysed by chart review. The current situation was evaluated by a 16-item standardized questionnaire

Marcus Horstmann; Matthias Kwol; Bastian Amend; Joerg Hennenlotter; Arnulf Stenzl

2011-01-01

261

Early outcome and intermediate follow-up of vascular stents in the femoral and popliteal arteries without long-term anticoagulation  

Microsoft Academic Search

Purpose: The role of arterial stenting in the treatment of femoral and popliteal arterial disease is controversial and has been hampered by recommendations for patients to be given anticoagulants (oral warfarin) for several months or more. This study was undertaken to evaluate the immediate and midterm outcomes of vascular stents implanted percutaneously in the femoral and popliteal arteries, without long-term

Geoffrey H. White; Stephen C. C. Liew; Richard C. Waugh; Michael S. Stephen; John P. Harris; Jenifer Kidd; Toos Sachinwalla; Weiyun Yu; James May

1995-01-01

262

Perceived control and long-term changes in disability in late middle-aged and older persons: An eight-year follow-up study  

Microsoft Academic Search

This article examined the predictive role of perceived control in long-term changes in disability among 1541 independently living older persons. Disability referred to self-reported difficulties with (instrumental) activities of daily living. Perceived control referred to the extent to which one assumes oneself as having control over one's life chances, unlike the fatalistic assumption that one's life is ruled by external

Gertrudis I. J. M. Kempen; Adelita V. Ranchor; Johan Ormel; Eric Van Sonderen; Cornelia H. M. Van Jaarsveld; Robbert Sanderman

2005-01-01

263

Long-term follow-up of remission duration, mortality, and second malignancies in hairy cell leukemia patients treated with pentostatin  

Microsoft Academic Search

The nucleoside analogue, pentostatin, has demonstrated high complete response rates and long relapse-free survival times in patients with hairy cell leukemia, a disease that historically had been unre- sponsive to treatment. Long-term data on duration of overall survival and relapse- free survival and incidence of subse- quent malignancies with this agent are lacking. Patients completing the treat- ment phase of

Ian W. Flinn; Kenneth J. Kopecky; M. Kathryn Foucar; David Head; John M. Bennett; Robert Hutchison; William Corbett; Peter Cassileth; Thomas Habermann; Harvey Golomb; Kanti Rai; Elizabeth Eisenhauer; Frederick Appelbaum; Bruce Cheson; Michael R. Grever

2000-01-01

264

Risk factors for long-term posttraumatic stress reactions in unarmed UN military observers: a four-year follow-up study.  

PubMed

Follow-up data from 187 male Norwegian veteran officers from unarmed UN military observer missions were compared with follow-up data from 211 male veteran officers from Norwegian contingents of the UNIFIL peacekeeping mission in South Lebanon on stress exposure, posttraumatic stress symptoms, level of alcohol consumption, and problems with social adaptation after redeployment from the mission. Observer mission veterans reported exposure to significantly higher levels of war zone stressors than veterans from peacekeeping units did. Observer veterans also reported significantly more posttraumatic stress symptoms at follow-up, higher alcohol consumption levels during service and at follow-up, and more problems with social adaptation to their lives at home in the years after their UN military service. All of these difficulties were most prominent in observers having served in missions with high-intensity stress exposure. Multivariate analyses demonstrated stress exposure during the mission and problems with social adaptation after homecoming to predict posttraumatic stress symptoms at follow-up. PMID:17041295

Mehlum, Lars; Koldsland, Bjorn O; Loeb, Mitchell E

2006-10-01

265

Long-Term Impact of Drug Abuse Resistance Education (D.A.R.EResults of a 6Year Follow-Up  

Microsoft Academic Search

The long-term effectiveness of Drug Abuse Resistance Education (D.A.R.E.) was assessed by contrasting drug use and other D.A.R.E.-related attitudinal latent variables among 356 twelfth- grade students who had received the program in the 6th grade with 264 others who did not receive it. A prior study of these subjects when they were in 9th grade had shown no significant differences.

Richard L. Dukes; Judith A. Stein; Jodie B. Ullman

1997-01-01

266

Long?term efficacy of cognitive training for age?associated memory impairment: A six?month follow?up study  

Microsoft Academic Search

The purpose of this investigation was to assess the impact of pretraining on the long?term effect of an imagery?based mnemonic in persons with age?associated memory impairment (AAMI). Eighty?two participants were randomly assigned to one of six groups: (1) verbal judgment pretraining plus mnemonic training, (2) visual imagery elaboration pretraining plus mnemonic training, (3) relaxation pretraining plus mnemonic training, (4) nonspecific

Javaid I. Sheikh; Robert D. Hill; Jerome A. Yesavage

1986-01-01

267

Long-term follow-up of advanced-stage low-grade lymphoma patients treated upfront with high-dose sequential chemotherapy and autograft  

Microsoft Academic Search

Long-term outcome, after first line intensified high-dose sequential (i-HDS) chemotherapy, was evaluated in 46 patients, aged ?65 years, with advanced low-grade lymphoma. Seventeen patients had small lymphocytic lymphoma (SLL), 29 had follicular lymphoma (FL), 10 of them with histologic transformation. I-HDS included: (1) tumor debulkying, by 2 APO+2 DHAP courses; (2) sequential administration of high-dose (hd) etoposide, methotrexate, and cyclophosphamide,

C Tarella; D Caracciolo; P Corradini; F Zallio; M Ladetto; A Cuttica; G Rossi; D Novero; P Gavarotti; A Pileri

2000-01-01

268

Arterial Events after Ischemic Stroke at a Young Age: A Cross-Sectional Long-Term Follow-Up of Patients and Controls in Western Norway  

Microsoft Academic Search

Background: There is little information in the literature on the risk of vascular events among patients after ischemic stroke at a young age. Methods: We examined 144 (77%) of 187 long-term survivors of ischemic stroke and compared them with 167 controls. Mean age of the 187 survivors at inclusion was 41.0 years and mean age of the participating patients was

Ulrike Waje-Andreassen; Halvor Naess; Lars Thomassen; Geir Egil Eide; Christian A. Vedeler

2007-01-01

269

Early Adherence to Antiretroviral Medication as a Predictor of Long-Term HIV Virological Suppression: Five-Year Follow Up of an Observational Cohort  

Microsoft Academic Search

ObjectivePrevious studies have demonstrated a cross-sectional relationship between antiretroviral adherence and HIV virological suppression. We assessed the predictive value of baseline adherence in determining long-term virological failure.DesignWe assessed baseline adherence via an adherence questionnaire between administered to all consenting patients attending antiretroviral clinics in Khayelitsha township, South Africa, between May 2002 and March 2004. Virological status was ascertained after five

Nathan Ford; Marta Darder; Tim Spelman; Emi Maclean; Edward Mills; Andrew Boulle

2010-01-01

270

Autotransplantation for relapsed or refractory non-Hodgkin’s lymphoma (NHL): long-term follow-up and analysis of prognostic factors  

Microsoft Academic Search

One hundred and thirty-six patients autografted for relapsed or refractory non-Hodgkin’s lymphoma (NHL) were evaluated to assess long-term event-free survival and to identify important prognostic factors. High-dose therapy consisted primarily of carmustine (BCNU), etoposide, cytarabine, and cyclophosphamide (BEAC) followed by unpurged autologous stem cell rescue. The 5-year Kaplan–Meier event-free survival (EFS) for the entire cohort was 34% (95% confidence interval:

AP Rapoport; R Lifton; LS Constine; RE Duerst; CN Abboud; JL Liesveld; CH Packman; S Eberly; RF Raubertas; BA Martin; WR Flesher; PA Kouides; JF DiPersio; JM Rowe

1997-01-01

271

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

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

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

2003-01-01

272

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

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…

Edmond, Tonya; Rubin, Allen

2004-01-01

273

Unsustained or Slowly Progressive Puberty in Young Girls: Initial Presentation and Long-Term Follow-Up of 20 Untreated Patients  

Microsoft Academic Search

A small number of young girls with unsustained or slowly pro- gressive puberty have been described, but few data regarding their final heights and adult reproductive function have been reported. We have conducted a study that delineates the initial presentation and 12-yr follow-up of 20 patients who initially presented with un- sustained or slowly progressive puberty as young girls. The

MARK R. PALMERT; HOLLY V. MALIN; PAUL A. BOEPPLE

274

Effects of Vocationally Oriented Medical Rehabilitation for Aircraft Maintenance Personnel—A Preliminary Study of Long-Term Effects with 5-year Follow-Up  

Microsoft Academic Search

Changes in the physical capacity, musculoskeletal symptoms, and perceived work ability of Finnish Air Force maintenance personnel were studied after vocationally oriented medical rehabilitation (VOMR® ). Twenty persons with chronic musculoskeletal symptoms in their back or neck took part in VOMR® courses. The measurements were carried out at the beginning of the rehabilitation course and after two follow-up periods (0.5

Kaj Holopainen; Nina Nevala; Pentti Kuronen; Jari P. A. Arokoski

2004-01-01

275

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

SciTech Connect

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.

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

276

Long-term efficacy of plasma-derived hepatitis B vaccine: a 15-year follow-up study among Chinese children  

Microsoft Academic Search

To determine necessity and timing of booster of hepatitis B vaccine, we need to observe the duration of its protection. We report the results of a 15-year follow-up of a cohort of 649 children who participated a randomized, double blind, placebo-controlled trial on a plasma-derived hepatitis B vaccine in 1982. During the 15 years after vaccination, more vaccinated children had

Su-su Liao; Rong-cheng Li; Hui Li; Jin-ye Yang; Xian-jia Zeng; Jian Gong; Shu-sheng Wang; Yan-ping Li; Kong-lai Zhang

1999-01-01

277

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

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

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

1997-01-01

278

Long-term health and psychosocial outcomes from surgically induced weight loss: results obtained in patients not attending protocolled follow-up visits  

Microsoft Academic Search

Objective:Obesity management is focused at weight loss to obtain health, psychological and social benefits. Outcomes from controlled trials, however, do not reflect the everyday routine practice. Therefore, we aimed to investigate the results from surgically induced weight loss in patients devoid of a protocol-wise follow-up, who were visited at home.Patients and methods:Patients who underwent a vertical banded gastroplasty or a

E M H Mathus-Vliegen; EMH Mathus-Vliegen

2007-01-01

279

The PRaCTICaL study of nurse led, intensive care follow-up programmes for improving long term outcomes from critical illness: a pragmatic randomised controlled trial  

Microsoft Academic Search

Objectives To test the hypothesis that nurse led follow-up programmes are effective and cost effective in improving quality of life after discharge from intensive care.Design A pragmatic, non-blinded, multicentre, randomised controlled trial.Setting Three UK hospitals (two teaching hospitals and one district general hospital).Participants 286 patients aged ?18 years were recruited after discharge from intensive care between September 2006 and October

B H Cuthbertson; J Rattray; M K Campbell; M Gager; S Roughton; A Smith; A Hull; S Breeman; J Norrie; D Jenkinson; R Hernández; M Johnston; E Wilson; C Waldmann

2009-01-01

280

A 15 year follow-up study of patients with non-insulin dependent diabetes mellitus (NIDDM) in Osaka, Japan long-term prognosis and causes of death  

Microsoft Academic Search

A 15 year follow-up study of diabetic patients was performed in Osaka, Japan. The subjects studied were 1939 patients with non-insulin dependent diabetes mellitus (NIDDM), of whom 1000 (51.5%) were alive, 880 (45.4%) had died and 59 (3.0%) were untraceable at the end of 1993. The mortality rate per 1000 person-years of the subjects increased from 28.94 in 1960–1984 to

Akira Sasaki; Masuko Uehara; Naruto Horiuchi; Kyoichi Hasegawa; Takao Shimizu

1996-01-01

281

Long-Term Effect of Xylitol Chewing Gum in the Prevention of Dental Caries: A Follow-Up 5 Years after Termination of a Prevention Program  

Microsoft Academic Search

About 65% of the original 258 children who participated in 1982–1984 in a caries prevention program involving the use of xylitol chewing gum were retrieved in 1989 for a follow-up study. Ninety-five subjects from the original xylitol (X) group and 70 subjects from the original control (no-gum, C) group were available. In 1984, when the children completed the program at

P. Isogangas; K. K. Mäkinen; J. Tiekso; P. Alanen

1993-01-01

282

Sex offender treatment outcome, actuarial risk, and the aging sex offender in Canadian corrections: a long-term follow-up.  

PubMed

The present study is an examination of sex offender treatment outcome in a large national cohort of Canadian Federally incarcerated sex offenders followed up an average of 11.7 years postrelease. A brief actuarial risk scale (BARS), which predicted sexual and violent recidivism, was created for the purposes of the present study to control for risk-related differences between treated and untreated offenders. In total, 732 offenders were identified as having completed (n = 625) or not attended (n = 107) a sex offender treatment program and for whom sufficient information was available to complete the scale. Controlling for risk and individual differences in follow-up time using Cox regression survival analyses and an 8-year fixed follow-up period, treated sex offenders demonstrated significantly lower rates of violent, but not sexual, recidivism. When the treated and untreated groups were stratified by risk level, significant differences were observed only among moderate or high risk offenders. Some significant group differences also emerged on indicators of recidivism severity, with treated offenders demonstrating slower times to sexual reoffense and lower scores on a quantified metric of sexual and violent recidivism severity after controlling for risk. Differences in recidivism base rates between treated and untreated offenders were also larger in magnitude for younger offenders (i.e., under age 50 at release), than for older offenders; however, interactions between age and treatment were not found. The findings are consistent with the risk principle and have possible implications regarding the dynamic nature of sexual violence risk. PMID:23136142

Olver, Mark E; Nicholaichuk, Terry P; Gu, Deqiang; Wong, Stephen C P

2013-08-01

283

Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: four-year follow-up study of 41 patients.  

PubMed

This is a prognostic study on 41 patients with anorexia nervosa (including three males) who satisfied defined diagnostic criteria. The patients had all been admitted to a metabolic unit where the mainstay of treatment was nursing care aimed at rapid restoration of body weight. A follow-up was conducted after a minimum lapse of four years after each patient's discharge from hospital. The outcome of the patient's illness was expressed in terms of an 'average outcome score' and a 'general outcome'. The series included a relatively high proportion of patients with a long illness who had received previous psychiatric treatment. Their families tended to come from higher social classes; a disturbed relationship with the patient was frequent. Premorbid disturbances in personality development were also common. The immediate response to treatment was excellent, with the majority of the patients returning to a normal weight, but relapses after discharge were common and readmissions were necessary in half the patients. At follow-up, the patients fell into the following defined categories: 'good' (39%), 'intermediate' (27%), 'poor' (29%), died (5%). Most of the patients who failed to recover continued to display the clinical features characteristic of anorexia nervosa. Among predictors of an unfavourable outcome were found a relatively late age of onset, a longer duration of illness, previous admissions to psychiatric hospitals, a disturbed relationship between the patient and other members of the family, and premorbid personality difficulties. It is suggested according to the severity of their illness, rather than on the method of treatment itself. The illness may last several years before eventual improvement or recovery, and a follow-up study must be extended over at least four years to be meaningful. An accurate prediction of eventual outcome is almost impossible, but late recoveries justify an optimistic outlook and continued therapeutic endeavour. PMID:1197538

Morgan, H G; Russell, G F

1975-11-01

284

Quantification of tumour and circulating vascular endothelial growth factor (VEGF) in patients with oesophagogastric cancer: a long-term follow-up study.  

PubMed

Vascular endothelial growth factor (VEGF) is an angiogenic cytokine that regulates tumour angiogenesis. The prognostic significance of VEGF expression remains incompletely investigated for patients with oesophagogastric cancer. This study assesses the significance of tumour VEGF (T-VEGF) and circulating VEGF (C-VEGF) expression in a 10-year follow-up of patients with oesophagogastric cancer. Patients undergoing surgical resection were prospectively recruited between February 1999 and August 2000. Circulating VEGF, derived both from plasma (P-VEGF) and serum (S-VEGF), and T-VEGF were assessed using a commercial enzyme-linked immunosorbent assay (ELISA). As platelet count may contribute to C-VEGF, pre-operative platelet levels were also recorded to exclude a confounding effect. Patients were followed up over a 10-year period using the Northern Ireland Cancer Registry. Sixty-one patients were recruited (men=45) with a mean age of 65.7 years. The 10-year survival was 19.7% (n=12) with a median follow-up of 808 days (inter-quartile range [IQR]: 349.5-2358.5). Union for International Cancer Control (UICC) tumour staging was Stage I=9 (14.8%), Stage II=15 (24.6%), Stage III=33 (54.1%) and Stage IV=4 (6.6%). The only significant relationship between clinicopathological features and the study variables was for S-VEGF, which was elevated in patients with advanced T-stage (P = 0.05). Circulating VEGF did not correlate with platelet count. Although a trend towards decreased survival was observed for patients who had positive lymph nodes (P = 0.08) and advanced UICC stage (P = 0.09) on univariate analysis, only lymphovascular invasion significantly predicted poor prognosis in this cohort (P = 0.05). Therefore, ELISA quantification of circulatory or tumour VEGF does not appear to be a significant predictor of mortality in patients with oesophagogastric cancer. PMID:22872931

Gray, R T; O'Donnell, M E; McGuigan, J A; Spence, G M

2012-01-01

285

Late-Onset Immune-Mediated Adverse Effects after Poly-L-Lactic Acid Injection in Non-HIV Patients: Clinical Findings and Long-Term Follow-Up  

Microsoft Academic Search

Background: It has been thought that poly-L-lactic acid (PLLA) injections do not have inflammatory side effects. Recent evidence shows that local\\/regional\\/systemic delayed adverse effects may appear with its use. Objective: To evaluate the clinical complaints, treatment response and long-term follow-up of non-HIV patients with delayed immune-mediated adverse effects related to PLLA injections. Methods: Prospective, case series study of 10 patients

Jaume Alijotas-Reig; Victor Garcia-Gimenez; Miquel Vilardell-Tarres

2009-01-01

286

History of blood transfusion before 1990 is associated with increased risk for cancer mortality independently of liver disease: a prospective long-term follow-up study  

Microsoft Academic Search

Objectives  The aim of this work is to investigate the association between transfusion history and cancer mortality in a prospective follow-up\\u000a study.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We conducted a prospective cohort study in four areas of Akita Prefecture, Japan, in 10,451 individuals (4,401 men and 6,050\\u000a women, aged 40–79 years) without history of cancer. The subjects were followed until 31 December 2003 and the number of

Yusuke Inoue; Yasuhiko Wada; Yutaka Motohashi; Akio Koizumi

2010-01-01

287

Long-term follow up of patients with dilated heart muscle disease treated with human leucocytic interferon alpha or thymic hormones initial results.  

PubMed Central

OBJECTIVE: To determine whether giving interferon-alpha or thymomodulin in addition to conventional treatment improves cardiac function in patients with idiopathic myocarditis and idiopathic dilated cardiomyopathy. DESIGN: Single-centre, randomised, open label, parallel group comparison of conventional treatment plus interferon-alpha, conventional treatment plus thymomodulin, and conventional treatment alone. PATIENTS: 38 patients aged 19-54 years (23 men) with biopsy-proven myocarditis or dilated cardiomyopathy. 12 were treated with conventional treatment alone, 13 were treated with interferon-alpha and conventional treatment, and 13 with thymomodulin and conventional treatment. SETTING: Tertiary cardiac referral centre. MAIN OUTCOME MEASURES: Clinical evaluation, echocardiography, and Holter monitoring at baseline, 6 months, and 1 and 2 years. Radionuclide ventriculography at rest and during exercise after 2 years. Endomyocardial biopsy at baseline and after a year if the initial diagnosis was myocarditis. RESULTS: Left ventricular ejection fraction was improved in 21 (81%) of 26 patients after interferon-alpha or thymomodulin administration and in 8 (66%) of 12 conventionally treated patients (P < 0.05) at 2 year follow up. The maximum exercise time was significantly longer at 2-year follow up in patients treated with immunomodulators (mean (SEM) 5.1 (0.6) minutes for interferon-alpha and 5.0 (0.4) minutes for thymomodulin) than in conventionally treated patients (3.3 (0.4) minutes). Left ventricular ejection fraction during exercise (assessed by radionuclide ventriculography) improved in 9 of 12 patients treated with interferon-alpha, 10 of 12 patients treated with thymomodulin, and 3 of 9 conventionally treated patients at 2 year follow up. The electrocardiogram was normal in 21 (88%) of 24 patients after interferon-alpha or thymomodulin treatment and 2 (22%) of 9 conventionally treated patients. At 2 year follow up, 19 (73%) of 26 patients treated with immunomodulators and 4 (25%) of 12 conventionally treated patients had improved their functional class. CONCLUSIONS: The results suggest that treatment of idiopathic myocarditis and/or idiopathic dilated cardiomyopathy with interferon-alpha or thymomodulin induces an earlier and significantly superior clinical improvement than conventional treatment alone. PMID:8697164

Miric, M.; Vasiljevic, J.; Bojic, M.; Popovic, Z.; Keserovic, N.; Pesic, M.

1996-01-01

288

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

PubMed Central

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

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

2012-01-01

289

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

PubMed Central

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

Ko, Dong-Yeob; Kim, Ki-Ho

2014-01-01

290

Accuracy and reliability of sentinel node biopsy in patients with breast cancer. Single centre study with long term follow-up.  

PubMed

The aim of our study is to evaluate the frequency of false-negative (FN) sentinel node procedures in patients with breast cancer. A total of 791 breast cancer patients underwent sentinel lymph node (SLN) biopsy at our institution between July 1997 and February 2005. A 2-day protocol was used to localise the sentinel node with the injection of 99mTc-nanocolloid. There were two phases in the study: the learning phase (50 patients) and the application phase (741 patients). In the learning phase, a complete lymphadenectomy was always performed. In the application phase, sentinel nodes were studied postoperatively with breast cancer and lymphadenectomy was performed when considered warranted by the pathological postoperative results. The median follow-up duration in the 741 patients studied during the application phase was 32.3 months (range 6-72 months). In this phase a total of 787 sentinel nodes (719 axillary and 68 intramammary chain) were obtained (range 0-5 per patient, mean 1.01), with 153 (41 with micrometastasis) positive sentinel nodes. We observed a total of three FN SLN results (0.5%). All three presented as an axillary recurrence into 24 months from operation. After a median follow-up of 32.3 months we observed only three clinical recurrences among 741 patients. Our results indicate that the sentinel node protocol can give an adequate local control. PMID:16244784

Carcoforo, P; Sortini, D; Soliani, G; Basaglia, E; Feggi, L; Liboni, A

2006-01-01

291

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

PubMed Central

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

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

2011-01-01

292

Rapid response to and long-term effectiveness of anti-CD20 antibody in conventional therapy resistant Graves' orbitopathy: A five-year follow-up study.  

PubMed

Abstract The aim of this investigations was to study the effectiveness of anti-CD20 antibody therapy in Graves' orbitopathy (GO) resistant to glucocorticoids. Five patients were entered in the study. The protocol required no improvement of orbital status after a recent course of glucocorticoids. Activity of GO was confirmed by three independent techniques: clinical activity score (CAS), (99m)Tc-labeled diethylene triamine pentaacetic acid ((99m)Tc DTPA) single photon emission computed tomography and magnetic resonance imaging. Rituximab (RTX) was given as weekly infusions of 375?mg/m(2) body surface area for four weeks. The mean follow-up period was 67 (range 58-81) months. Improvement of GO has been observed in all patients: CAS before therapy was 6.5?±?1.7 and decreased to 3.4?±?1.6 by one month (p?follow-up visits. The mean DTPA uptake before therapy was 16.52?±?4.51?MBq/cm(3) and decreased to 11.97?±?2.36?MBq/cm(3) at one year (p?follow-up of RTX treatment in GO. PMID:25039242

Erdei, Annamaria; Paragh, Gyorgy; Kovacs, Peter; Karanyi, Zsolt; Berenyi, Ervin; Galuska, Laszlo; Lenkey, Agota; Szabados, Lajos; Gyory, Ferenc; Ujhelyi, Bernadett; Berta, Andras; Boda, Judit; Berta, Eszter; Bodor, Miklos; Gazdag, Annamaria; Nagy, Endre V

2014-12-01

293

Disc Height and Sagittal Alignment in Operated and Non-Operated Levels in the Lumbar Spine at Long-Term Follow-Up: A Case-Control Study  

PubMed Central

Purpose: To compare lumbar disc degeneration at 9-year follow-up in patients with chronic low back pain who had instrumented lumbar fusion or no fusion. Material and methodology: The main outcomes were disc height and sagittal alignment measured by Distortion Compensated Roentgen Analysis (DCRA). Secondary outcome included the Oswestry Disability Index and VAS back pain. Results: Forty-eight patients with baseline and 9-year radiographs from L2- S1 were included. Twenty-three had lumbar fusion and 25 had no fusion. Disc height was reduced at all levels independent of fusion. No difference in disc height and sagittal alignment was observed between patients fused and not fused. There were weak correlations, ranging from 0.04 to 0.36, between clinical and radiological parameters. Conclusion: Lumbar disc degeneration increased at all measured levels independent of fusion and correlated poorly with clinical outcome. PMID:23961300

Froholdt, Anne; Brox, Jens Ivar; Reikerås, Olav; Leivseth, Gunnar

2013-01-01

294

Orthodontic treatment combined with tooth transplantation for an adult patient with a missing mandibular first molar: long-term follow-up.  

PubMed

A Japanese woman, age 29 years 8 months, had a missing mandibular left first molar, bimaxillary dentoalveolar protrusion, and crowding. She had a skeletal Class II relationship and a long face with a steep mandible. She had previously undergone root canal treatment for the mandibular right second premolar, and the mandibular left third molar was impacted. The maxillary left first premolar was extracted for autotransplantation to the mandibular left first molar region. After confirmation of a favorable prognosis for the transplanted tooth, the maxillary right first premolar, the mandibular right second premolar, and the impacted mandibular left third molar were extracted for orthodontic treatment. The active orthodontic treatment period was 32 months. The patient returned for follow-up records 12 years 7 months after the active treatment, and her facial profile and occlusion were well maintained. At 13 years 9 months after transplantation, no abnormalities were observed with the transplanted tooth in the radiographic and clinical evaluations. PMID:24680019

Watanabe, Yohei; Mohri, Tamaki; Yoshida, Rumi; Yamaki, Masaki; Saito, Isao

2014-04-01

295

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

SciTech Connect

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.

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

296

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

PubMed Central

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

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

2013-01-01

297

Reinfarction Following PCI or Medical Management using the Universal Definition in Patients With Total Occlusion After Myocardial Infarction: Results from Long Term Follow up of the OAT Cohort  

PubMed Central

Background The Occluded Artery Trial (OAT) randomized 2201 patients with a totally occluded infarct-related artery on days 3–28 (>24 hours) following myocardial infarction (MI) to percutaneous coronary intervention (PCI) or medical treatment (MED). There was no difference in the primary endpoint of death, reinfarction or heart failure at 2.9 year or 6-year mean follow-up. However in patients randomized to PCI there was a trend for an increase in reinfarction. Methods We analyzed the characteristics and types of reinfarction according to the universal definition. Independent predictors of reinfarction were determined using Cox proportional hazard models with follow up to 9 years. Results There were 169 reinfarctions; 9.4% PCI vs 8.0% MED, HR 1.31, 95% CI 0.97 ?1.77, p=0.08. Spontaneous reinfarction (type 1) occurred with similar frequency in the groups; 4.9% PCI vs 6.7% MED, HR 0.78, 95% CI 0.53 – 1.15, p=0.21. Rates of type 2 (secondary) and 3 (sudden death) MI were similar in both groups. There was an increase in type 4a reinfarctions (related to protocol or repeat PCI), 0.8% PCI vs 0.1% MED, p=0.01 and type 4b reinfarctions (stent thrombosis); 2.7% PCI vs 0.6% MED, p<0.001. Multivariate predictors of reinfarction were history of PCI prior to study entry (p=0.001), diabetes (p=0.005), and absence of new Q waves with the index infarction (p=0.01). Conclusions There was a trend for reMI to be more frequent with PCI. Opening an occluded infarct-related artery in stable patients late post-MI exposes them to a risk of subsequent reinfarction related to reocclusion and stent thrombosis. PMID:22520521

White, Harvey D.; Reynolds, Harmony R.; Carvalho, Antonio C.; Pearte, Camille A.; Liu, Li; Martin, C. Edwin; Knatterud, Genell L.; Džavík, Vladimír; Kruk, Mariusz; Steg, Philippe Gabriel; Cantor, Warren J.; Menon, Venu; Lamas, Gervasio A.; Hochman, Judith S.

2014-01-01

298

Early Treatment for Women with Alcohol Addiction (EWA) Reduces Mortality: A Randomized Controlled Trial with Long-Term Register Follow-up  

PubMed Central

Aims: To compare the mortality of female alcoholics randomly assigned to the woman-only programme ‘Early treatment for Women with Alcohol Addiction’ (EWA) versus those who received mixed gender ‘Treatment As Usual’ (TAU). Methods: Randomized controlled trial involving 2-year follow-up by personal interview and mortality register data through 27 years of 200 women first time treated for alcohol use disorder (AUD; EWA, n = 100 and TAU, n = 100), who were consecutively recruited during 1983–1984. Data from the Causes of Death Register were used to test for mortality differences related to group interaction predictors such as age, inpatient versus outpatient status at intake and 2-year drinking outcome. Results: Significantly lower mortality was found among younger women who participated in EWA compared with those who received TAU. This difference lasted nearly 20 years after intake to treatment. For women who only needed outpatient treatment, reduced mortality was found in the EWA group, even for older women. Increased mortality was found for TAU women who did not attend the 2-year follow-up compared with those who attended; no such difference was found for EWA women. This indicates different attrition mechanisms in the two groups. Thus, previously reported treatment effects may have been underestimated. EWA was a more comprehensive programme than TAU while also being single gender. Conclusions: EWA, specifically developed to meet a broad spectrum of problems among women with AUDs, was more effective than TAU, a mixed gender programme. It was not possible to separate whether this was in part because it was a more comprehensive programme, as well as being single gender. PMID:21273301

Gjestad, Rolf; Franck, Johan; Lindberg, Staffan; Haver, Brit

2011-01-01

299

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

PubMed Central

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

Hyun, Seung-Jae

2010-01-01

300

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

PubMed Central

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 I123 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

Dunne, Christopher

2014-01-01

301

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

SciTech Connect

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.

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

302

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

PubMed Central

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

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

1997-01-01

303

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

SciTech Connect

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.

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

304

The effect of acute kidney injury on long-term health-related quality of life: a prospective follow-up study  

PubMed Central

Introduction Acute kidney injury (AKI) is a serious complication in critically ill patients admitted to the Intensive Care Unit (ICU). We hypothesized that ICU survivors with AKI would have a worse health-related quality of life (HRQOL) outcome than ICU survivors without AKI. Methods We performed a long-term prospective observational study. Patients admitted for > 48 hours in a medical-surgical ICU were included and divided in two groups: patients who fulfilled RIFLE criteria for AKI and patients without AKI. We used the Short-Form 36 to evaluate HRQOL before admission (by proxy within 48 hours after admission of the patient), at ICU discharge, hospital discharge, 3 and 6 months following ICU discharge (all by patients). Recovery in HRQOL from ICU-admission onwards was assessed using linear mixed modelling. Results Between September 2000 and January 2007 all admissions were screened for study participation. We included a total of 749 patients. At six months after ICU discharge 73 patients with AKI and 325 patients without AKI could be evaluated. In survivors with and without AKI, the pre-admission HRQOL (by proxy) and at six months after ICU discharge was significantly lower compared with an age matched general population. Most SF-36 dimensions changed significantly over time from ICU discharge. Change over time of HRQOL between the different AKI Rifle classes (Risk, Injury, Failure) showed no significant differences. At ICU discharge, scores were lowest in the group with AKI compared with the group without AKI for the physical functioning, role-physical and general health dimensions. However, there were almost no differences in HRQOL between both groups at six months. Conclusions The pre-admission HRQOL (by proxy) of AKI survivors was significantly lower in two dimensions compared with the age matched general population. Six months after ICU discharge survivors with and without AKI showed an almost similar HRQOL. However, compared with the general population with a similar age, HRQOL was poorer in both groups. PMID:23356544

2013-01-01

305

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

PubMed Central

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

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

2014-01-01

306

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

PubMed Central

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

2014-01-01

307

Increased P-Wave and QT Dispersions Necessitate Long-Term Follow-up Evaluation of Down Syndrome Patients With Congenitally Normal Hearts.  

PubMed

Reports state that Down syndrome (DS) patients with congenitally normal hearts might experience the development of cardiac abnormalities such as cardiac autonomic dysfunction, valvular lesions, bradycardia, and atrioventricular block. However, the presence of any difference in terms of P-wave dispersion (PWd) and QT dispersion (QTd) was not evaluated previously. This study prospectively investigated 100 DS patients with structurally normal hearts and 100 age- and sex-matched healthy control subjects. Standard 12-lead electrocardiograms were used to assess and compare P-wave and QT durations together with PWd and QTd. The median age of the DS patients and control subjects was 48 months. Heart rates and P-wave and QT dispersions were significantly greater in the DS group than in the control group (113 ± 22.9 vs 98.8 ± 16.6 bpm, p < 0.001; 31.3 ± 9.5 vs 24 ± 8.6 ms, p < 0.001; and 46.6 ± 15.9 vs 26 ± 9.1 ms, p < 0.001, respectively). A positive correlation was found between PWd and age in the DS patients (p < 0.05; r = 0.2). All children with DS should be followed up carefully with electrocardiography in terms of increased P-wave and QT dispersions even in the absence of concomitant congenital heart disease for management of susceptibility to arryhthmias. PMID:24859169

Karadeniz, Cem; Ozdemir, Rahmi; Demir, Fikri; Yozgat, Y?lmaz; Küçük, Mehmet; Oner, Talia; Karaarslan, Utku; Me?e, Timur; Unal, Nurettin

2014-12-01

308

A clinically recognizable neuronal migration disorder: congenital bilateral perisylvian syndrome. Case report with long-term clinical and EEG follow-up.  

PubMed

Congenital bilateral perisylvian syndrome (CBPS) is a recently described, neuronal migration disorder, characterized by pseudobulbar palsy, epilepsy and mental retardation and bilateral perisylvian dysplasia. A 15-year-old boy was diagnosed with CBPS according to the typical clinical, and magnetic resonance imaging (MRI) features. The patient was suffering from atypical absence seizures, repeating daily in spite of antiepileptic drug therapy, since age 7 years. He had also experienced rare generalized tonic-clonic seizures and complex partial seizures. Neurological examination showed severe restriction of tongue movements, severe dysarthria, dysphagia, facial diplegia, mild pyramidal signs and moderate mental retardation. A computed tomographic (CT) scan demonstrated bilateral perisylvian enlargement. The diagnosis was corrected with MRI after six years. Frequent irregular generalized spike and wave abnormalities and focal sharp and slow waves over the posterior regions of both hemispheres were shown by electroencephalograms (EEG). The patient was treated with Na-Valproate, carbamazepine and lamotrigine but did now show any significant change in seizure frequency in the eight-year follow-up period. Intractable seizures, mental retardation and particularly congenital pseudobulbar palsy suggest this congenital entity. Those patients who exhibit these typically clinical features, must have MRI. PMID:9530947

Baykan-Kurt, B; Sarp, A; Gökyi?it, A; Tunçay, R; Cali?kan, A

1997-12-01

309

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

PubMed Central

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

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

2013-01-01

310

Long-term follow-up of imatinib in pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia: Children's Oncology Group study AALL0031.  

PubMed

We previously reported preliminary findings that post induction imatinib mesylate (340?mg/m(2)/day), in combination with intensive chemotherapy, resulted in outcomes similar to blood and marrow transplant (BMT) for pediatric patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). We now report 5-year outcomes of imatinib plus intensive chemotherapy in 91 children (1-21 years) with and without allogeneic BMT (N=91). We explore the impacts of additional chromosomal abnormalities and minimal residual disease (MRD) by flow cytometry on outcomes. The 5-year disease-free survival was similar for Cohort 5 patients, treated with chemotherapy plus imatinib (70%±12%, n=28), sibling donor BMT patients (65%±11%, n=21) and unrelated donor BMT patients (59±15%; P=0.60, n=13). Patients with additional cytogenetic abnormalities had worse outcomes (P=0.05). End induction (pre-imatinib) MRD was not prognostic for Cohort 5 or allogeneic BMT patients, although limited by small numbers. The re-induction rate following relapse was similar to other higher-risk ALL groups. Longer-term follow-up confirms our initial observation of substantially good outcomes for children and adolescents with Ph+ ALL treated with imatinib plus intensive chemotherapy with no advantage for allogeneic BMT. PMID:24441288

Schultz, K R; Carroll, A; Heerema, N A; Bowman, W P; Aledo, A; Slayton, W B; Sather, H; Devidas, M; Zheng, H W; Davies, S M; Gaynon, P S; Trigg, M; Rutledge, R; Jorstad, D; Winick, N; Borowitz, M J; Hunger, S P; Carroll, W L; Camitta, B

2014-07-01

311

Thymus and Mediastinal Node Involvement in Childhood Langerhans Cell Histiocytosis: Long-Term Follow-Up From the French National Cohort  

PubMed Central

Background Mediastinal involvement (MI) in Langerhans cell histiocytosis (LCH) has been rarely reported. Here, we describe the clinical, radiological, and biological presentation, and the outcome of childhood LCH with MI. Method From the French LCH register, which includes 1,423 patients aged less than 18 years, we retrieved the medical charts of patients with mediastinal enlargement detected on chest X-rays. Results Thirty-seven patients were retrieved, including 18 males; median age of diagnosis was 0.7 years, and median follow-up time was 6.2 years. The prevalence of MI varied with the age at diagnosis, ranging from 7% below 1 year old to less than 1% at >5 years. Thirteen cases (35%) were diagnosed because of MI-related symptoms, including respiratory distress (N?=?4), superior venous cava syndrome (N?=?2), and/or cough and polypnea (N?=?10). CT scans performed in 32 cases at diagnosis showed tracheal compression (N?=?5), cava thrombosis (N?=?2), and/or calcification (N?=?16). All patients presented multi-system disease at LCH diagnosis, and 35/37 were initially treated with vinblastine and corticosteroids. Death occurred in five cases, due to MI (N?=?1) or hematological refractory involvement (N?=?4). The overall 5-year survival was 87.1%, and immunodeficiency was not detected as a sequel. Conclusions MI in LCH mainly occurs in young children, and diagnosis was based on CT showing thymus enlargement and calcifications. Pediatr Blood Cancer 2013;60:1759–1765. © 2013 Wiley Periodicals, Inc. PMID:23813854

Ducassou, Stephane; Seyrig, Fanny; Thomas, Caroline; Lambilliotte, Anne; Marec-Berard, Perrine; Berger, Claire; Plat, Genevieve; Brugiere, Laurence; Ouache, Marie; Barkaoui, Mohamed; Armari-Alla, Corinne; Lutz, Patrick; Leverger, Guy; Rialland, Xavier; Mansuy, Ludovic; Pacquement, Helene; Jeziorski, Eric; Gandemer, Virginie; Chalard, Francois; Chateil, Jean Francois; Tazi, Abdellatif; Emile, Jean Francois; Donadieu, Jean

2013-01-01

312

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

PubMed Central

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

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

313

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

SciTech Connect

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.

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

314

Effects of prophylactic ilioinguinal nerve excision in mesh groin hernia repair: short- and long-term follow-up of a randomized clinical trial.  

PubMed

We conducted a randomized clinical trial on the impact of prophylactic ilioinguinal nerve excision (INE) on neuralgia, hypoesthesia, and analgesia requirement after open herniorrhaphy as well as on sustainability of a selective approach. Ninety-seven consecutive patients undergoing a Lichtenstein procedure were treated with INE (n = 45) or preservation (NP) (n = 52). Impact of patients' age, gender, type of anesthesia, and hernia on outcomes was also evaluated by logistic regression analysis (LRA). Patients receiving INE reported less pain on postoperative days (POD) 1 and 7 and at 1 month and required less analgesia on POD 1. Overall younger patients (40 years old or younger) had more postoperative discomfort at LRA. Pain intensity was similar at 6 and 12 months after INE or NP: moderate to severe pain in 4.4 versus 11.5 per cent (P = 0.279) and 4.4 versus 9.6 per cent (P = 0.445), respectively. Hypoesthesia was more frequent after INE on POD 1 and 7:68.9 and 53.3 per cent versus 13.5 and 9.6 per cent, respectively (P < 0.0001), but no longer at 1 month: 11.1 versus 3.8 per cent (P = 0.244) as well as at 6 and 12 months (0% in both study groups). No further correlation was found by LRA. INE prevents inguinodynia up to 1 month follow-up regardless of patient variables. Moreover, the increase of hypoesthesia proved to be a short-term complication. PMID:21140698

Crea, Nicola; Pata, Giacomo

2010-11-01

315

Cohort profile: The Japan Diabetes Complications Study: a long-term follow-up of a randomised lifestyle intervention study of type 2 diabetes.  

PubMed

The Japan Diabetes Complications Study, a randomised lifestyle intervention study of type 2 diabetes conducted at 59 institutes throughout Japan that enrolled 2033 eligible patients from January 1995 to March 1996, was directed at: (i) determining the incidence and progression rates of complications of diabetes; (ii) exploring clinical risk factors for complications of diabetes; and (iii) determining the association between lifestyle factors, including diet and physical activity, and complications of diabetes, in addition to comparing, in a randomised manner, the effects on type 2 diabetes of an extensive lifestyle intervention and conventional treatment. The protocol for the study originally specified four study populations according to primary outcomes, consisting of: (1) a macroangiopathy group (N = 1771); (ii) a nephropathy group (N = 1607); (iii) a retinopathy-incident group (N = 1221); and (iv) a retinopathy-progression group (N = 410). The primary outcomes were: (i) development of retinopathy; (ii) progression of retinopathy; (iii) development of overt nephropathy; and (iv) occurrence of macroangiopathic events including proven coronary heart disease and stroke. The study was originally planned to follow patients for 8 years, and an extended follow-up is ongoing. Information about primary outcomes, laboratory tests, and other clinical variables for each patient was collected at a central data centre through an annual report from each investigator. Additionally, extensive lifestyle surveys were conducted at baseline and 5 years after the beginning of the study intervention in both the intervention and conventional treatment groups. A description of the occurrence of complications of diabetes and of all-cause mortality, provided in this paper, demonstrated a clear gender-based difference in cardiovascular disease and all-cause mortality. PMID:23687126

Tanaka, Shiro; Tanaka, Sachiko; Iimuro, Satoshi; Yamashita, Hidetoshi; Katayama, Shigehiro; Ohashi, Yasuo; Akanuma, Yasuo; Yamada, Nobuhiro; Sone, Hirohito

2014-08-01

316

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

SciTech Connect

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.

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

317

Use of long rods and a short arthrodesis for burst fractures of the thoracolumbar spine. A long-term follow-up study.  

PubMed

Thirteen patients who had a burst fracture of the thoracolumbar spine (the twelfth thoracic to the fifth lumbar vertebra) were managed with the use of long rods and a short arthrodesis (the so-called rod-long, fuse-short technique). The patients were followed for an average of seventy-four months (range, thirty-four to 118 months). Six months after the operation, the rods were removed and the fusion mass was explored. At that time, twelve patients had a solid fusion at all levels of the arthrodesis. Of the eighty-eight facet joints that had been spanned by the rods but had not been included in the arthrodesis, two had nevertheless progressed to fusion, as determined radiographically. Physiological motion was present in forty-three of the forty-four segments for which a fusion had not been intended. Before the operation, the average anterior height of the fractured vertebrae was 61 per cent of the estimated height before the injury; this improved after the operation to an average of 83 per cent (median, 87 per cent) of the height before the injury. At the latest follow-up examination, the anterior height was an average of 78 per cent of the estimated height before the injury (median, 82 per cent; range, 51 to 93 per cent), a slight decrease compared with the value immediately after the operation. Kyphosis of the injured segment before the operation, measured for twelve of the thirteen patients, averaged 15 degrees (median, 12 degrees; range, 0 to 33 degrees); as a result of the operation, this improved an average of 15 degrees, to 0 degrees of kyphosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7962022

Akbarnia, B A; Crandall, D G; Burkus, K; Matthews, T

1994-11-01

318

[Case study of 10 subjects diagnosed with autism spectrum disorders in adulthood and currently under long-term follow-up].  

PubMed

This study involved 10 adults with autism spectrum disorders (ASD) who were referred to a specialized developmental disability clinic and were being treated for periods extending to years. Checks included past diagnoses, the chief complaint at the first examination, psychiatric symptoms, medication, employment, and whether a diagnosis of ASD would have been possible during their formative years. Their age at referral was 21-30 and, at the time of this study, they were aged 25-40. There were eight males and two females, and their treatment periods were between four and 16 years. Using DSM-IV-TR criteria, six were diagnosed with autistic disorders and four with PDDNOS. Wing and Gould criteria showed nine with Asperger syndrome and one with autism. Their IQ ranged from 88 to 121, with the mean score being 103 (SD = 10.0). Eight of the 10 had previously been examined in psychiatric clinics, which identified two as having depression, two with schizophrenia, one with Obsessive-Compulsive Disorder, and one with autism/Asperger syndrome, and there was no diagnosis for the other two. For these eight cases, the PDD-Autism Society Japan Rating Scale (PARS) was used. The PARS early childhood peak score ranged from 9 to 41, so all reached the cutoff point of 9. At the time of this study, the following psychiatric symptoms were noted: three cases of depression, two of anxiety, one with auditory hallucinations, and one who displayed odd behavior and facial expressions that became apparent during the follow-up. In two cases there seemed to be no apparent psychiatric co-morbidity. The current PARS scores of 8 cases were between 12 and 38, and four cases exceeded the cutoff point of 20. One was taking anti-psychotic drugs for auditory hallucinations, four were using SSRI for anxiety and depression, and one was occasionally prescribed medication for anxiety. Four were not on medication. When diagnosing ASD in adulthood, interviewing using such instruments as PARS seemed useful. We should keep in mind that families tend not to recognize co-morbid psychotic symptoms. PMID:23944118

Uchiyama, Tokio

2013-01-01

319

Long-Term Endovascular Treatment Outcome of 46 Patients with Cavernous Sinus Dural Arteriovenous Fistulas Presenting with Ophthalmic Symptoms. A Non-Controlled Trial with Clinical and Angiographic Follow-up.  

PubMed

Ocular symptoms are regularly observed in patients with cavernous sinus dural arteriovenous fistulas (cDAVF). We aimed to evaluate the long-term efficacy and safety of endovascular approaches in patients with cDAVF presenting with different ocular symptoms. In a prospective study between June 2008 and March 2013, 46 patients with ocular symptoms due to cDAVF who were not eligible for conservative therapy, met the inclusion criteria and underwent endovascular treatment. They underwent a transarterial approach with histoacryl glue injections or transvenous coil embolization, all in one session. They were followed up for a mean period of 17.3 months (range 7 to 30 months) clinically and using angiography. The mean age of patients was 36.8 years (18-60) and 65% of them were male. All patients showed venous drainage into the superior and inferior orbital veins. Access to the cavernous sinus was transvenous in ten patients, transarterial in 26 patients, and mixed in ten patients. Initial symptoms were improved in 97.8% of patients and did not recur during the study follow-up. The procedural complications included: blurred vision, transient sixth nerve palsy and exacerbation of chemoproptosis in two, one and two patients respectively that completely resolved in initial weeks with no recurrence. No patient worsened or developed new symptoms suggestive of a recurrent fistula during the follow-up period. One patient experienced intracranial dissection of the internal carotid artery and ischemic stroke with an unfinished procedure. The relief of early presentation was durable in long-term follow-up and the cured lesions were stable in angiographic controls. Favorable and durable outcomes could be obtained following endovascular approaches for cDAVF presenting with different ocular symptoms. PMID:25196621

Pashapour, Ali; Mohammadian, Reza; Salehpour, Firooz; Sharifipour, Ehsan; Mansourizade, Reza; Mahdavifard, Ali; Salehi, Mohamadgharib; Mirzaii, Farhad; Sariaslani, Payam; Ardalani, Ghasem Fatahzade; Altafi, Davar

2014-09-01

320

The search and destroy strategy prevents spread and long-term carriage of methicillin-resistant Staphylococcus aureus: results from the follow-up screening of a large ST22 (E-MRSA 15) outbreak in Denmark.  

PubMed

In the aftermath of a methicillin-resistant Staphylococcus aureus (MRSA) ST22 hospital outbreak, we investigated the prevalence of long-term carriage, the efficacy of MRSA decolonization treatment (DT) and the spread of MRSA to households of patients and healthcare workers (HCWs). Furthermore, we evaluated the efficacy of repeated DT in long-term MRSA carriers. Of 250 index persons (58 HCWs and 192 patients), 102 persons (19 HCWs and 83 patients) and 67 household members agreed to participate. Samples from all 169 persons were taken from the nose, throat, wounds and devices/catheters, and urine samples were additionally taken from index persons. Samples from companion animals (n = 35) were taken from the nostrils and anus. Environmental sites (n = 490) screened were telephone, television remote control, toilet flush handle, favourite chair and skirting board beside the bed. Sixteen (19%) patients and two household members, but no HCWs, were ST22-positive. The throat was the most frequent site of colonization. In a multivariate analysis, chronic disease (p <0.001) and pharyngeal carriage (p <0.001) were associated with long-term MRSA carriage. MRSA was found in the environments of four long-term carriers. All animals tested were negative. MRSA-positive households were decolonized using nasal mupirocin TID and daily chlorhexidine body and hair wash for 5 days. Pharyngeal MRSA carriers also received fucidic acid (500 mg TID) combined with rifampicin (600 mg BID) or clindamycin (600 mg BID) for 7 days. The home environment was cleaned on days 2 and 5. At the end of follow-up, ten of 16 long-term carriers and the two household contacts were MRSA-negative. In conclusion, decolonization of MRSA carriers is possible, but should include treatment of household members and the environment. PMID:20041904

Böcher, S; Skov, R L; Knudsen, M A; Guardabassi, L; Mølbak, K; Schouenborg, P; Sørum, M; Westh, H

2010-09-01

321

Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up  

PubMed Central

Summary Background Our aim was to assess the long-term risks of death, disability, and rebleeding in patients randomly assigned to clipping or endovascular coiling after rupture of an intracranial aneurysm in the follow-up of the International Subarachnoid Aneurysm Trial (ISAT). Methods 2143 patients with ruptured intracranial aneurysms were enrolled between 1994 and 2002 at 43 neurosurgical centres and randomly assigned to clipping or coiling. Clinical outcomes at 1 year have been previously reported. All UK and some non-UK centres continued long-term follow-up of 2004 patients enrolled in the original cohort. Annual follow-up has been done for a minimum of 6 years and a maximum of 14 years (mean follow-up 9 years). All deaths and rebleeding events were recorded. Analysis of rebleeding was by allocation and by treatment received. ISAT is registered, number ISRCTN49866681. Findings 24 rebleeds had occurred more than 1 year after treatment. Of these, 13 were from the treated aneurysm (ten in the coiling group and three in the clipping group; log rank p=0·06 by intention-to-treat analysis). There were 8447 person-years of follow-up in the coiling group and 8177 person-years of follow-up in the clipping group. Four rebleeds occurred from a pre-existing aneurysm and six from new aneurysms. At 5 years, 11% (112 of 1046) of the patients in the endovascular group and 14% (144 of 1041) of the patients in the neurosurgical group had died (log-rank p=0·03). The risk of death at 5 years was significantly lower in the coiling group than in the clipping group (relative risk 0·77, 95% CI 0·61–0·98; p=0·03), but the proportion of survivors at 5 years who were independent did not differ between the two groups: endovascular 83% (626 of 755) and neurosurgical 82% (584 of 713). The standardised mortality rate, conditional on survival at 1 year, was increased for patients treated for ruptured aneurysms compared with the general population (1·57, 95% CI 1·32–1·82; p<0·0001). Interpretation There was an increased risk of recurrent bleeding from a coiled aneurysm compared with a clipped aneurysm, but the risks were small. The risk of death at 5 years was significantly lower in the coiled group than it was in the clipped group. The standardised mortality rate for patients treated for ruptured aneurysms was increased compared with the general population. Funding UK Medical Research Council. PMID:19329361

Molyneux, Andrew J; Kerr, Richard SC; Birks, Jacqueline; Ramzi, Najib; Yarnold, Julia; Sneade, Mary; Rischmiller, Joan

2009-01-01

322

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

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.

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

323

Cytochrome P450 2C19*2 polymorphism in patients with stable coronary heart disease and risk for secondary cardiovascular disease events: results of a long-term follow-up study in routine clinical care  

PubMed Central

Background CYP2C19*2 polymorphism is related to metabolizer phenotypes resulting in reduced effectiveness in converting the antiplatelet drug clopidogrel to active drug. An association of the genotype itself with adverse outcomes is discussed. We investigated the prognostic value of carriage of the CYP2C19*2 allele in a high risk group of patients with prevalent coronary heart disease (CHD) at baseline during long-term follow-up under conditions of routine clinical care. Methods In n=1050 patients with stable CHD at baseline genotyping of CYP2C19 allele *2 (rs4244285; 681G>A) was performed. The Cox-proportional hazards model was employed to investigate the association of CYPC19*2 allele status with cardiovascular disease (CVD) events during eight year follow-up. The analysis was also performed in patients who did not take clopidogrel or ticlopidin. Results Only the very few patients homozygous for a loss-of-function variant of CYP2C19, allele *2 (2.6%), had a statistically significantly higher incidence rate for secondary CVD events during long-term follow-up than wild-type carriers (50.8 versus 21.5 per 1000 patients years; rate for heterozygous carries 17.2 per 1000 patient years). The hazard ratio after adjustment for covariates compared to the wild-type carriers was 2.59 (95% confidence interval (CI) 1.27-5.28) and 0.80 (95% CI 0.52-1.23) for homozygous and heterozygous allele carriers, respectively. Conclusions In this medium-size group of patients with stable CHD homozygous carriers of the loss-of-function allele CYP2C19*2 were at increased risk for subsequent CVD events during 8 year follow-up independent of other risk factors. As only few patients carried the homozygous loss-of-function variant and we found overall no evidence for improved clinical utility, a benefit of genotyping in this patient population seems unlikely. PMID:23981380

2013-01-01

324

Long-term follow-up of the imatinib GRAAPH-2003 study in newly diagnosed patients with de novo Philadelphia chromosome-positive acute lymphoblastic leukemia: a GRAALL study.  

PubMed

We report here the results of the GRAAPH-2003 trial with long-term follow-up in 45 patients with de novo Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). Imatinib-based strategy improved the 4-year overall survival (OS) up to 52% versus 20% in the pre-imatinib LALA-94 trial (P = .0001). Despite the selection in patients who actually underwent transplantation, these results suggest that allogeneic or autologous stem cell transplants (SCTs) still have a place in overcoming the poor prognosis of Ph+ ALL in the era of imatinib therapy. OS was 50% after allogeneic SCT (24 patients), 33% in patients without a transplantation (9 patients), and 80% after autologous SCT (10 patients without allogeneic donor or >55 years, including 7 patients in complete molecular response). PMID:22960387

Tanguy-Schmidt, Aline; Rousselot, Philippe; Chalandon, Yves; Cayuela, Jean-Michel; Hayette, Sandrine; Vekemans, Marie-Christiane; Escoffre, Martine; Huguet, Françoise; Réa, Delphine; Delannoy, André; Cahn, Jean-Yves; Vernant, Jean-Paul; Ifrah, Norbert; Dombret, Hervé; Thomas, Xavier

2013-01-01

325

Long-Term Follow-Up of Preoperative Pelvic Radiation Therapy and Concomitant Boost Irradiation in Locally Advanced Rectal Cancer Patients: A Multi-Institutional Phase II Study (KROG 04-01)  

SciTech Connect

Purpose: To perform a prospective phase II study to investigate the efficacy and safety of preoperative pelvic radiation therapy and concomitant small-field boost irradiation with 5-fluorouracil and leucovorin for 5 weeks in locally advanced rectal cancer patients. Methods and Materials: Sixty-nine patients with locally advanced, nonmetastatic, mid-to-lower rectal cancer were prospectively enrolled. They had received preoperative chemoradiation therapy and total mesorectal excision. Pelvic radiation therapy of 43.2 Gy in 24 fractions plus concomitant boost radiation therapy of 7.2 Gy in 12 fractions was delivered to the pelvis and tumor bed for 5 weeks. Two cycles of 5-fluorouracil and leucovorin were administered for 3 days in the first and fifth week of radiation therapy. The pathologic response, survival outcome, and treatment toxicity were evaluated for the study endpoints. Results: Of 69 patients, 8 (11.6%) had a pathologically complete response. Downstaging rates were 40.5% for T classification and 68.1% for N classification. At the median follow-up of 69 months, 36 patients have been followed up for more than 5 years. The 5-year disease-free survival (DFS) and overall survival rates were 66.0% and 75.3%, respectively. Higher pathologic T (P = .045) and N (P = .032) classification were significant adverse prognostic factors for DFS, and high-grade histology was an adverse prognostic factor for both DFS (P = .025) and overall survival (P = .031) on the multivariate analysis. Fifteen patients (21.7%) experienced grade 3 or 4 acute toxicity, and 7 patients (10.1%) had long-term toxicity. Conclusion: Preoperative pelvic radiation therapy with concomitant boost irradiation with 5-fluorouracil and leucovorin for 5 weeks showed acceptable acute and long-term toxicities. However, the benefit of concomitant small-field boost irradiation for 5 weeks in rectal cancer patients was not demonstrated beyond conventional irradiation for 6 weeks in terms of tumor response and survival.

Lee, Jong Hoon [Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul (Korea, Republic of) [Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul (Korea, Republic of); Department of Radiation Oncology, St. Vincent's Hospital, Catholic University of Korea, Suwon (Korea, Republic of); Kim, Dae Yong [Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Go-Yang (Korea, Republic of)] [Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Go-Yang (Korea, Republic of); Nam, Taek-Keun [Department of Radiation Oncology, Chonnam National University Hospital, Hwa-Sun (Korea, Republic of)] [Department of Radiation Oncology, Chonnam National University Hospital, Hwa-Sun (Korea, Republic of); Yoon, Sei-Chul [Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul (Korea, Republic of)] [Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul (Korea, Republic of); Lee, Doo Seok [Department of Colorectal Surgery, Daehang Hospital, Seoul (Korea, Republic of)] [Department of Colorectal Surgery, Daehang Hospital, Seoul (Korea, Republic of); Park, Ji Won; Oh, Jae Hwan; Chang, Hee Jin [Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Go-Yang (Korea, Republic of)] [Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Go-Yang (Korea, Republic of); Yoon, Mee Sun; Jeong, Jae-Uk [Department of Radiation Oncology, Chonnam National University Hospital, Hwa-Sun (Korea, Republic of)] [Department of Radiation Oncology, Chonnam National University Hospital, Hwa-Sun (Korea, Republic of); Jang, Hong Seok, E-mail: hsjang11@catholic.ac.kr [Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul (Korea, Republic of)

2012-11-15

326

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

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.

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

327

High-dose-rate brachytherapy and hypofractionated external beam radiotherapy combined with long-term hormonal therapy for high-risk and very high-risk prostate cancer: outcomes after 5-year follow-up.  

PubMed

The purpose of this study was to report the outcomes of high-dose-rate (HDR) brachytherapy and hypofractionated external beam radiotherapy (EBRT) combined with long-term androgen deprivation therapy (ADT) for National Comprehensive Cancer Network (NCCN) criteria-defined high-risk (HR) and very high-risk (VHR) prostate cancer. Data from 178 HR (n = 96, 54%) and VHR (n = 82, 46%) prostate cancer patients who underwent (192)Ir-HDR brachytherapy and hypofractionated EBRT with long-term ADT between 2003 and 2008 were retrospectively analyzed. The mean dose to 90% of the planning target volume was 6.3 Gy/fraction of HDR brachytherapy. After five fractions of HDR treatment, EBRT with 10 fractions of 3 Gy was administered. All patients initially underwent ? 6 months of neoadjuvant ADT, and adjuvant ADT was continued for 36 months after EBRT. The median follow-up was 61 months (range, 25-94 months) from the start of radiotherapy. The 5-year biochemical non-evidence of disease, freedom from clinical failure and overall survival rates were 90.6% (HR, 97.8%; VHR, 81.9%), 95.2% (HR, 97.7%; VHR, 92.1%), and 96.9% (HR, 100%; VHR, 93.3%), respectively. The highest Radiation Therapy Oncology Group-defined late genitourinary toxicities were Grade 2 in 7.3% of patients and Grade 3 in 9.6%. The highest late gastrointestinal toxicities were Grade 2 in 2.8% of patients and Grade 3 in 0%. Although the 5-year outcome of this tri-modality approach seems favorable, further follow-up is necessary to validate clinical and survival advantages of this intensive approach compared with the standard EBRT approach. PMID:24222312

Ishiyama, Hiromichi; Satoh, Takefumi; Kitano, Masashi; Tabata, Ken-ichi; Komori, Shouko; Ikeda, Masaomi; Soda, Itaru; Kurosaka, Shinji; Sekiguchi, Akane; Kimura, Masaki; Kawakami, Shogo; Iwamura, Masatsugu; Hayakawa, Kazushige

2014-05-01

328

Nonresected Non-Small-Cell Lung Cancer in Stages I Through IIIB: Accelerated, Twice-Daily, High-Dose Radiotherapy-A Prospective Phase I/II Trial With Long-Term Follow-Up  

SciTech Connect

Purpose: Our purpose was to investigate the tolerability of accelerated, twice-daily, high-dose radiotherapy. The secondary endpoints were survival and locoregional tumor control. Methods and Materials: Thirty consecutive patients with histologically/cytologically proven non-small-cell lung cancer were enrolled. Tumor Stage I, II, IIIA, and IIIB was found in 7, 3, 12, and 8 patients, respectively. We applied a median of 84.6 Gy (range, 75.6-90.0 Gy) to the primary tumors, 63.0 Gy (range, 59.4-72.0 Gy) to lymph nodes, and 45 Gy to nodes electively (within a region of about 6 cm cranial to macroscopically involved sites). Fractional doses of 1.8 Gy twice daily, with an interval of 11 hours, were given, resulting in a median treatment time of 35 days. In the majority of patients the conformal target-splitting technique was used. In 19 patients (63%) two cycles of induction chemotherapy were given. The median follow-up time of survivors is 72 months (range, 62-74 months). Results: We found Grade 1, 2 and 3 acute esophageal toxicity in 11 patients (37%), 2 patients (7%), and 2 patients (7%), respectively. Grade 2 acute pneumonitis was seen in 2 patients (7%). No late toxicity greater than Grade 1 was observed. The actual overall survival rates at 2 and 5 years are 63% and 23%, respectively; the median overall survival, 27.7 months. In 9 patients a local failure occurred, 7 of them presenting initially with an atelectasis without availability of 18-fluorodeoxyglucose-positron emission tomography staging at that time. In 4 patients recurrence occurred regionally. Conclusions: This Phase I/II trial with long-term follow-up shows low toxicity with promising results for survival and locoregional tumor control.

Wurstbauer, Karl, E-mail: k.wurstbauer@salk.a [Department of Radiation Oncology, Paracelsus Medical University, Salzburg (Austria); radART-Institute for Research and Development on Advanced Radiation Technologies, Paracelsus Medical University, Salzburg (Austria); Deutschmann, Heinz; Kopp, Peter; Kranzinger, Manfred; Merz, Florian; Nairz, Olaf [Department of Radiation Oncology, Paracelsus Medical University, Salzburg (Austria); radART-Institute for Research and Development on Advanced Radiation Technologies, Paracelsus Medical University, Salzburg (Austria); Studnicka, Michael [Department of Pneumology, Paracelsus Medical University, Salzburg (Austria); Sedlmayer, Felix [Department of Radiation Oncology, Paracelsus Medical University, Salzburg (Austria); radART-Institute for Research and Development on Advanced Radiation Technologies, Paracelsus Medical University, Salzburg (Austria)

2010-08-01

329

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

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.

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

330

High-dose busulfan and cyclophosphamide as a conditioning regimen for autologous peripheral blood stem cell transplantation in childhood non-Hodgkin lymphoma patients: a long-term follow-up study.  

PubMed

We analyzed the outcome in 22 children with refractory or relapsed non-Hodgkin lymphoma who underwent autologous peripheral blood progenitor cell transplantation between 1994 and 2009. The conditioning regimen used in all patients consisted of busulfan and cyclophosphamide. Median age was 6 years (range 2 to 16 y). The most common histologic subtype was Burkitt lymphoma. Ten patients were in complete remission and 12 in partial remission at the time of transplant. The median dose of CD34+ cells that was infused was 4.6 × 10/kg (range 2.1 to 58.7 × 10/kg). All the patients were engrafted, with a median time for neutrophils and platelets recovery of 11 (range, 8 to 15 d) and 14 (range, 9 to 60 d) days, respectively. Nonhematologic treatment-related toxicity included severe mucositis in 3 patients and hepatic sinusoidal obstruction syndrome in 1 patient. There were no transplant-related mortalities. With a median follow-up of 60 months (range, 4 to 180 d) the disease-free survival was 90 ± 6.5% for the whole group. This retrospective study shows a high long-term survival using busulfan/cyclophosphamide as conditioning regimen in children with refractory or relapsed non-Hodgkin lymphoma. PMID:21358341

Andion, Maitane; Molina, Blanca; Gonzalez-Vicent, Marta; Alonso, Laura; Hernandez, Carmen; Lassaletta, Alvaro; Lopez-Ibor, Blanca; Villa, Marta; Diaz, Miguel Angel

2011-04-01

331

Altered right ventricular function in the long-term follow-up evaluation of patients after delayed aortic reimplantation of the anomalous left coronary artery from the pulmonary artery.  

PubMed

This study aimed to evaluate regional and global ventricular functions in the long term after aortic reimplantation of the anomalous left coronary artery from the pulmonary artery (ALCAPA) and to assess whether the time of surgical repair influences ventricular performance.The study examined 20 patients with a median age of 15 years (range 3-37 years) who had a corrected ALCAPA and 20 age-matched control subjects using echocardiography and tissue Doppler imaging (TDI). The median follow-up period after corrective surgery was 6 years (range 2.6-15 years). Seven patients underwent surgery before the age of 3 years (early-surgery group), whereas 13 patients had surgery after that age (late-surgery group). The TDI-derived myocardial strain of the interventricular septum (IVS), lateral wall of the left ventricle (LV), and lateral wall of the right ventricle (RV) in the basal and mid regions were examined, and a mean was calculated. The pulsed Doppler-derived Tei index was used to assess global left ventricular function. No significant differences were found between the early-surgery group and the control group regarding the regional myocardial strain or the Tei index. Compared with the early-surgery group, the late-surgery group had a significantly higher Tei index (mean 0.37; range 0.31-0.42 vs. mean 0.52; range 0.39-0.69; p < 0.005), a lower strain percentage of the lateral wall of the LV (mean 29; range 17-30 vs. mean 9; range 7-23), IVS (mean 23; range 21-31 vs. mean 19; range 13-25), and lateral wall of the RV (mean 23; range 21-31 vs. mean 19; range 13-25). The age at operation correlated significantly with the Tei index (r = 0.84, p < 0.001) and inversely with the mean strain of the lateral wall of the LV (r = -0.53, p = 0.028), IVS (r = -0.68, p = 0.003), and lateral wall of the RV (r = -0.68, p = 0.003). At the midterm follow-up evaluation after corrective surgery of ALCAPA, not only the left but also the right ventricular function seemed to be affected in patients with delayed diagnosis and late surgical repair but preserved among the younger patients with early diagnosis and corrective surgery. PMID:24196911

Schuck, Rita; Abd El Rahman, Mohamed Y; Rentzsch, Axel; Hui, Wei; Weng, Yuguo; Alexi-Meskishvili, Vladimir; Lange, Peter E; Berger, Felix; Abdul-Khaliq, Hashim

2014-03-01

332

Long-term (6 and 12 months) follow-up of two prospective, randomized, controlled phase III trials of photodynamic therapy with BF-200 ALA and methyl aminolaevulinate for the treatment of actinic keratosis  

PubMed Central

Background Two phase III trials of photodynamic therapy (PDT) with BF-200 ALA, a recently approved nanoemulsion formulation of 5-aminolaevulinic acid (ALA) demonstrated high clearance rates in mild-to-moderate actinic keratosis (AK). The comparison to a registered methyl aminolaevulinate (MAL) cream demonstrated significantly superior total patient clearance rates. Objectives To evaluate long-term efficacy and safety of PDT for AK 6 and 12 months after the last PDT with BF-200 ALA, MAL or placebo. Methods The follow-up phase (FUP) was performed with patients of two phase III studies. Both studies compared BF-200 ALA with placebo, one of the studies additionally with MAL. Overall recurrence rates and various subgroups (light source, lesion severity, lesion location, complete responders after first PDT) were assessed 6 and 12 months after the last PDT. Results Recurrence rates were similar for BF-200 ALA and MAL, with a tendency to lower recurrence rates for BF-200 ALA. The proportion of patients who were fully cleared during PDT and remained completely clear for at least 12 months after PDT were 47% for BF-200 ALA (both studies) and 36% for MAL treatment. The subgroup that was illuminated with narrow wavelength LED lamps reached 69% and 53% for BF-200 ALA (both studies, respectively) and 41% for MAL. No safety concerns were reported. Conclusions The FUP data confirmed the high efficacy and safety of PDT with BF-200 ALA. The slightly lower recurrence rates after BF-200 ALA treatment compared with MAL treatment enhanced the better treatment outcome due to the significantly superior efficacy. PMID:23252768

Dirschka, T; Radny, P; Dominicus, R; Mensing, H; Bruning, H; Jenne, L; Karl, L; Sebastian, M; Oster-Schmidt, C; Klovekorn, W; Reinhold, U; Tanner, M; Grone, D; Deichmann, M; Simon, M; Hubinger, F; Hofbauer, G; Krahn-Senftleben, G; Borrosch, F; Reich, K; Berking, C; Wolf, P; Lehmann, P; Moers-Carpi, M; Honigsmann, H; Wernicke-Panten, K; Hahn, S; Pabst, G; Voss, D; Foguet, M; Schmitz, B; Lubbert, H; Szeimies, R-M

2013-01-01

333

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

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.

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

334

Long-term Effects of an Early Childhood Intervention on Educational Achievement and Juvenile Arrest -A 15-Year Follow-up of Low-Income Children in Public Schools  

E-print Network

STUDY #1: Long-term Effects of an Early Childhood Intervention on Educational Achievement of the long-term effects of early childhood educational interventions are of demonstration programs rather children born in 1980 and enrolled in alternative early childhood programs in 25 sites in Chicago, Ill

Utts, Jessica

335

Gender, Living Arrangements, and Social Circumstances as Determinants of Entry into and Exit from Long-Term Institutional Care at Older Ages: A 6-Year Follow-Up Study of Older Finns  

ERIC Educational Resources Information Center

Purpose: Due to population aging, the need for long-term institutional care is increasing. We study the potentially modifiable sociodemographic factors that affect the rate of entry into and exit from long-term care. Design and Methods: A 40% sample from the population registration data of Finns aged 65 and older living in private households at…

Martikainen, Pekka; Moustgaard, Heta; Murphy, Michael; Einio, Elina K.; Koskinen, Seppo; Martelin, Tuija; Noro, Anja

2009-01-01

336

Quasi-experimental study on the effectiveness of psychoanalysis, long-term and short-term psychotherapy on psychiatric symptoms, work ability and functional capacity during a 5-year follow-up  

Microsoft Academic Search

BackgroundPsychotherapy is apparently an insufficient treatment for some patients with mood or anxiety disorder. In this study the effectiveness of short-term and long-term psychotherapies was compared with that of psychoanalysis.

Paul Knekt; Olavi Lindfors; Maarit A. Laaksonen; Camilla Renlund; Peija Haaramo; Tommi Härkänen; Esa Virtala

2011-01-01

337

Endovascular treatment combined with stratified surgery is effective in the management of venous thoracic outlet syndrome complications: a long term ultrasound follow-up study in patients with thrombotic events due to venous thoracic outlet syndrome  

Microsoft Academic Search

Thoracic outlet syndrome (TOS) is caused by compression of peripheral nerves and vascular structures along their course through\\u000a the upper thoracic aperture to the axilla. The aim of our study was to analyze long-term outcomes of different treatments\\u000a stratified by symptom severity. We performed a retrospective analysis of a cohort of 73 consecutive patients treated at our\\u000a institution presenting with

Lenka Skalicka; Jean-Claude Lubanda; Simon Jirat; Petr Varejka; Stanislav Beran; Ondrej Dostal; Pavel Prochazka; Vratislav Mrazek; Ales Linhart

338

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

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

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

339

[Long-term follow-up of 2 therapeutic programs for the treatment of high-risk childhood acute lymphoblastic leukemia. Experience at the 20 de Noviembre National Medical Center].  

PubMed

This paper reports the long-term, disease-free survival of children with high-risk (HR) acute lymphoblastic leukemia (ALL) treated with two different chemotherapy regimens. HR was defined in children with ALL, younger than 2 or older than 10 years, with or without initial extrahematopoietic disease, with a leukocyte count higher than 25 x 10(9)L, or with L3 FAB type. The first group, LAL1, included 67 patients; they received induction with vincristine (VCR) and prednisone (PDN), early consolidation with 3 cycles of 6-mercaptopurine (6MP), citarabine (ARA) and VCR: central nervous system (CNS) prophylaxis (PFX) consisted of both chemotherapy in induction, consolidation and maintenance, radiotherapy (RT) in consolidation. Maintenance was given with 6MP, methotrexate (MTX), VCR adriamycin (ADR), ARA, cyclophosphamide (CFA) and PDN. The second group, LAL2, with 45 patients, received induction with VCR, PDN, CFA, epirrubicin (EPI), L-Asparaginase (L-ASP); early and late consolidation with 6MP, ARA, VCR, carmustine (BCNU), CFA, EPI, MTX and teniposide 8VM26): CNS PFX consisted of both chemotherapy in induction, consolidation and maintenance, RT in consolidation, maintenance with 6MP, MTX, EPI, CFA, ARA VM26 and BCNU. At the time of diagnosis, both groups were comparable. Disease-free survival probability, for LAL1 group was 0.41 at 14 years and for LAL2 group 0.34 at 8 years (p = 0.45). In the LAL1 group there were three failures and 20 relapses, and in the LAL2 group, there were two failures and 22 relapses. CNS relapses were one and seven in LAL1 and LAL2 groups respectively (p = 0.04). In the LAL2, group relapses were more frequent in patients with dose reduction or difered dose due to marrow toxicity (p = 0.02). We believe that the increase in CNS relapse in the LAL2 group was caused by the late administration of CNS PFX. We also believe that although intensive chemotherapy can increase long-term survival, dose adjustments due to marrow toxicity have a negative effect on long-term, relapse-free survival. PMID:10425822

de Diego-Floreschapa, J; López-Hernández, M; Borbolla-Escoboza, J R; Trueba-Christy, E; Carrillo-Rosales, T; González-Avante, M

1999-01-01

340

A retrospective comparative study of mortality and causes of death among patients with metal-on-metal and metal-on-polyethylene total hip prostheses in primary osteoarthritis after a long-term follow-up  

PubMed Central

Background All patients with total hip arthroplasty (THA), especially those with metal-on-metal (MM) THA, are exposed to metallic particles and ions, which may cause total or site-specific mortality. We analyzed the causes of total and site-specific mortality among a cohort of patients with MM and with metal-on-polyethylene (MP) THA after a long follow-up time. Methods Standardized mortality ratios (SMR) of total and site-specific causes of death were calculated for 579 patients with MM (McKee-Farrar) and 1585 patients with MP (Brunswik, Lubinus) THA for primary osteoarthritis. Results Mean follow-up time was 17.9 years for patients with MM and 16.7 years for patients with MP. Overall SMR was 0.95 for the MM cohort and 0.90 for the MP cohort, as compared to the normal population. Both cohorts showed significantly decreased mortality for the first decade postoperatively, equal mortality over the next 10 years, and significantly increased mortality after 20 years. Patients with MM THA had higher cancer mortality (SMR 1.01) than those with MP THA (SMR 0.66) during the first 20 years postoperatively, but not thereafter. Conclusion Both MM and MP prostheses are safe based on total and site-specific mortality of recipients during the first 20 postoperative years in comparison with the general population. PMID:20416065

2010-01-01

341

Impact of a pharmacist-directed educational program on the long-term knowledge and use of folic acid among college women: a 12-month follow-up study  

PubMed Central

Few studies have examined the impact of educational interventions on participants’ long-term knowledge and use of folic acid for prevention of neural tube defects (NTD). Objective The objective of this pilot study was to evaluate changes in knowledge and behaviors in a sample of college women one year after such a program. Methods Female students of a residential college campus voluntarily attended the event, which was advertised to the campus community as a women’s health seminar. Participants completed a multiple-choice test assessing knowledge of folic acid and NTD and frequency of multivitamin use before and immediately after a 30-minute oral presentation. Following 3 reminder messages sent via email or mail, knowledge and multivitamin use were re-assessed 1-month and 12-months post-intervention. Results Thirty-two college women participated in the educational intervention; 27 (84%) completed the 12-month post-test. At 12 months, statistically significant increases in knowledge from baseline remained for questions pertaining to food high in folic acid (p=0.023); completion of spinal column (p=0.011); and 2 questions on NTD prevention (p=0.044). Increases in knowledge regarding recommended daily allowance of folic acid (p=0.817) and difficulty in receiving adequate folic acid from diet alone (p=0.617) were not statistically significant from baseline. Regular multivitamin use (?4 times per week) was not statistically significantly increased from baseline (p=0.592). Conclusions Although it was encouraging that the women retained much of the information learned during the program, it appears that the changes in multivitamin use seen at 1-month were not sustained at 12-months. Further study with larger groups of college women is recommended. PMID:24155825

Murphy, Bethany L.; DiPietro, Natalie A.

342

Single administration of stem cell factor, FLT-3 ligand, megakaryocyte growth and development factor, and interleukin-3 in combination soon after irradiation prevents nonhuman primates from myelosuppression: long-term follow-up of hematopoiesis.  

PubMed

Preservation of hematopoietic stem and progenitor cell survival is required for recovery from radiation-induced myelosuppression. We recently showed that short-term injection of antiapoptotic cytokine combinations into mice soon after lethal gamma irradiation promoted survival. The present study investigated the hematopoietic response of cynomolgus monkeys to a single dose of stem cell factor, FLT-3 ligand, megakaryocyte growth and development factor, and interleukin-3 in combination (4F, each factor given intravenously at 50 microg/kg) administered 2 hours after 5-Gy gamma irradiation. Treated monkeys (n = 4) experienced no thrombocytopenia. Only 1 in 4 displayed a transient period of neutropenia (neutrophil [ANC] count < 0.5 x 10(9)/L), whereas all irradiated controls (n = 4) experienced neutropenia (5-12 days) and thrombocytopenia (platelet [PLT] count < 20 x 10(9)/L, 5-31 days). Treated animals exhibited an impressive 2-wave PLT response that peaked at days 8 and 22 after total body irradiation (TBI). Areas under the curve (AUC) of PLTs, ANCs, white blood cells (WBCs), and red blood cells (RBCs) between days 0 and 90 were significantly higher in treated animals than in controls. Humeral bone marrow-derived clonogenic activity was significantly spared at 24 hours and 4 days after TBI in treated monkeys. No apparent impairment of the hematopoietic status and stem cell pool, in terms of long-term culture-initiating cells (LTC-ICs) and side population (SP) cells, was observed after 15 months. These results strongly suggest that the 4F cytokine combination, as a single dose regimen, could act as an emergency treatment for nuclear accident or terrorism victims. PMID:14525791

Drouet, Michel; Mourcin, Frédéric; Grenier, Nancy; Leroux, Valérie; Denis, Josianne; Mayol, Jean-François; Thullier, Philippe; Lataillade, Jean-Jacques; Herodin, Francis

2004-02-01

343

Apolipoprotein B/Apolipoprotein A-I Ratio and Apolipoprotein B: Long-Term Predictors of Myocardial Infarction in Initially Healthy Middle-Aged Men-a 13-Year Follow-Up.  

PubMed

We investigated whether serum concentrations of apolipoprotein (apo) B and apoA-I and the apoB/apoA-I ratio provided predictive information on myocardial infarction (MI) and ischemic stroke during 13 years of follow-up in a group of initially clinically healthy 58-year-old men, free from previous cardiovascular disease, diabetes, other established disease, or treatment with cardiovascular drugs. Multivariate logistic regression analysis showed that the apoB/apoA-I ratio and apoB were significant and independent determinants of MI (exponentiation of the B coefficient [Exp(?)] 3.1, 95% confidence interval [CI] 1.6-6.3, P = .001, Exp(?) 2.8, 95% CI 1.1-7.7, P = .045, respectively). The area under the receiver-operating characteristics curve as a relative measure of test efficiency was highest and significant for both apoB/apoA-I ratio and apoB (area under the curve = 0.75, P < .001). In conclusion, the apoB/apoA-I ratio and apoB are independent risk factors for MI and has the highest efficiencies for predicting MI in initially healthy middle-aged men. PMID:24277914

Schmidt, Caroline; Bergström, Göran

2014-11-01

344

Long-term follow-up and factors influencing outcomes after related HLA-identical cord blood transplantation for patients with malignancies: an analysis on behalf of Eurocord-EBMT.  

PubMed

We analyzed risk factors influencing outcomes after related (R) human leukocyte antigen-identical cord blood transplantation (CBT) for 147 patients with malignancies reported to Eurocord-European Group for Blood and Marrow Transplantation. CBT has been performed since 1990; median follow-up was 6.7 years. Median patient age was 5 years. Acute leukemia was the most frequent diagnosis (74%). At CBT, 40 patients had early, 70 intermediate, and 37 advanced disease. CB grafts contained a median of 4.1 × 10(7)/kg total nucleated cells (TNCs) after thawing. The cumulative incidence (CI) of neutrophil recovery was 90% at day +60. CIs of acute and chronic graft-versus-host disease (GVHD) were 12% and 10% at 2 years, respectively. At 5 years, CIs of nonrelapse mortality and relapse were 9% and 47%, respectively; the probability of disease-free survival (DFS) and overall survival were 44% and 55%, respectively. Among other factors, higher TNCs infused was associated with rapid neutrophil recovery and improved DFS. The use of methotrexate as GVHD prophylaxis decreased the CI of engraftment. Patients without advanced disease had improved DFS. These results support banking and use of CB units for RCBT. Cell dose, GVHD prophylaxis not including methotrexate, and disease status are important factors for outcomes after RCBT. PMID:20538797

Herr, Andrée-Laure; Kabbara, Nabil; Bonfim, Carmem M S; Teira, Pierre; Locatelli, Franco; Tiedemann, Karin; Lankester, Arjan; Jouet, Jean-Pierre; Messina, Chiara; Bertrand, Yves; Díaz de Heredia, Cristina; Peters, Christina; Chaves, Wagnara; Nabhan, Samir K; Ionescu, Irina; Gluckman, Eliane; Rocha, Vanderson

2010-09-16

345

Long-term reduction in pain and disability after surgery with the interspinous device for intervertebral assisted motion (DIAM) spinal stabilization system in patients with low back pain: 4-year follow-up from a longitudinal prospective case series.  

PubMed

Patients with low back pain (LBP) suffer chronic disability. In 40% of LBP patients degenerative disc disease (DDD) seems to be the cause. This prospective case series assessed the efficacy of the interspinous device for intervertebral assisted motion (DIAM™) in patients with LBP resulting from DDD. All patients were initially assessed by physical examinations, magnetic resonance imaging, dynamic X-rays and provocative discography. Eligible patients (n = 52) had LBP for a minimum of 4 months, and received surgery with the DIAM™ system 2-4 weeks after diagnosis. Patients were evaluated pre-/post-operatively for pain severity using a visual analogue scale (VAS), and for dysfunction and disability with the Roland-Morris Disability Questionnaire (RMDQ). VAS and RMDQ score changes were assessed using the appropriate contrasts and Bonferroni-corrected P values. As a result, significant (P < 0.0001) pain score reductions were observed between baseline values, and 2 (3.7, 95% CI 3.1; 4.2) and 48 (3.1, 95% CI 2.5; 3.6) months follow-up (intent-to-treat population). Disability scores were significantly (P < 0.0001) reduced between baseline and 2 (8.6, 95% CI 7.4; 9.9) and 48 (7.5, 95% CI 6.1; 8.9) months. Disability scores were similar from months 2 to 48. At 48 months, 67.3% of patients reached the minimum clinically important difference (MCID; ?1.5-unit improvement) in VAS score and 78.9% of patients reached the MCID (?30% improvement) in RMDQ score. No complications were associated with surgery. In conclusion, patients with LBP treated with the interspinous DIAM™ system showed significant and clinically meaningful improvements in pain and disability for up to 4 years. PMID:21279392

Buric, Josip; Pulidori, Massimiliano

2011-08-01

346

Long-term clinical evaluation of endodontically treated teeth by 15 F CO2 laser microprobe: three years clinical follow-up of 1512 root canals--in-vivo study  

NASA Astrophysics Data System (ADS)

The purpose of this study was to determine the efficiency of 15 F CO2 laser microprobe, in cases of periapical lesions, by eliminating the pathological reaction caused by certain species of bacteria, reduction of reinfection and stimulation of osteogenesis in the periapical region. Until now, no suitable delivery fiber existed for CO2 laser endodontic radiation in the apical region where it is most difficult to eliminate the pulp tissue using conventional methods. To overcome this problem, Sharplan laser designed a microprobe that reaches closer to the apex, distributing the energy density to a smaller area of the root canal, thus favorably increasing the thermal effects. The study was conducted on 900 teeth, divided in two groups. 468 were new case, carefully selected according to strict parameters such as: wide periapical translucency over 1mm, supported by digital x-ray, with a lesion of 3mm and more. All root canals were mechanically prepared in the conventional method up to size 35, Physiological saline solution served as finding solution and were treated by 15 F CO2 laser microprobe for 60 pulses repeatedly. The temperature at the surrounding tissue of the root did not exceed 38 degrees C filling of the canal was possible at the same appointment, without antibiotical treatment. 432 of the cases, which were referred to us by other dentists, after an unsuccessful treatment according to the classical therapy, were treated by the same laser therapy. Follow up was performed by clinical examination, and digital x-ray taken, during and after treatment as well as after 3, 6, 9, 12 month. The result demonstrate 98% success rate in both study groups, according to objective criteria for a successful treatment such as: reduction of apical translucency after 2- 6 months, freedom form clinical complains, and no need for periapical surgery.

Kesler, Gavriel; Koren, Rumelia; Kesler, Anat; Hay, Nissim; Gal, Rivka

1999-05-01

347

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

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.

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

348

New-Onset Atrial Fibrillation is Associated With Cardiovascular Events Leading to Death in a First Time Myocardial Infarction Population of 89 703 Patients With Long-Term Follow-Up: A Nationwide Study  

PubMed Central

Background New?onset atrial fibrillation (AF) is reported to increase the risk of death in myocardial infarction (MI) patients. However, previous studies have reported conflicting results and no data exist to explain the underlying cause of higher death rates in these patients. Methods and Results All patients with first acute MI between 1997 and 2009 in Denmark, without prior AF, were identified from Danish nationwide administrative registers. The impact of new?onset AF on all?cause mortality, cardiovascular death, fatal/nonfatal stroke, fatal/nonfatal re?infarction and noncardiovascular death, were analyzed by multiple time?dependent Cox models and additionally in propensity score matched analysis. In 89 703 patients with an average follow?up of 5.0±3.5 years event rates were higher in patients developing AF (n=10 708) versus those staying in sinus?rhythm (n=78 992): all?cause mortality 173.9 versus 69.4 per 1000 person?years, cardiovascular death 137.2 versus 50.0 per 1000 person?years, fatal/nonfatal stroke 19.6/19.9 versus 6.2/5.6 per 1000 person?years, fatal/nonfatal re?infarction 29.0/60.7 versus 14.2/37.9 per 1000 person?years. In time?dependent multiple Cox analyses, new?onset AF remained predictive of increased all?cause mortality (HR: 1.9 [95% CI: 1.8 to 2.0]), cardiovascular death (HR: 2.1 [2.0 to 2.2]), fatal/nonfatal stroke (HR: 2.3 [2.1 to 2.6]/HR: 2.5 [2.2 to 2.7]), fatal/nonfatal re?infarction (HR: 1.7 [1.6 to 1.8]/HR: 1.8 [1.7 to 1.9]), and non? cardiovascular death (HR: 1.4 [1.3 to 1.5]) all P<0.001). Propensity?score matched analyses yielded nearly identical results (all P<0.001). Conclusions New?onset AF after first?time MI is associated with increased mortality, which is largely explained by more cardiovascular deaths. Focus on the prognostic impact of post?infarct AF is warranted. PMID:24449803

Bang, Casper N.; Gislason, Gunnar H.; Greve, Anders M.; Bang, Christian A.; Lilja, Alexander; Torp-Pedersen, Christian; Andersen, Per K.; K?ber, Lars; Devereux, Richard B.; Wachtell, Kristian

2014-01-01

349

Long Term Follow-up of Near Earth Objects  

NASA Astrophysics Data System (ADS)

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

Trueblood, Mark; Crawford, Robert; Bell, David; Lebofsky, Larry

2014-02-01

350

Long-term follow-up of children with craniopharyngioma  

Microsoft Academic Search

Management of craniopharyngiomas is still controversial. 28 children with this tumor were studied. GH deficiency was present in 22 patients following surgery, 10 of these GH-lacking patients had normal or accelerated growth (usually associated with rapid weight gain) postoperatively. Somatomedin levels were normal in three of six normally growing patients. After craniotomy their basal and TRH-stimulated prolactin levels were in

N. Stahnke; G. Grubel; I. Lagenstein; R. P. Willig

1984-01-01

351

Long Term Follow-up of Near Earth Objects  

NASA Astrophysics Data System (ADS)

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

Trueblood, Mark; Crawford, Robert; Lebofsky, Larry

2013-02-01

352

Long Term Follow-up of Near Earth Objects  

NASA Astrophysics Data System (ADS)

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.

Trueblood, Mark; Crawford, Robert; Lebofsky, Larry

2012-02-01

353

Long Term Follow-up of Near Earth Objects  

NASA Astrophysics Data System (ADS)

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

Trueblood, Mark; Bell, David; Lebofsky, Larry

2013-08-01

354

Follow-Up Testing  

Cancer.gov

Provides possible follow-up testing, next steps and treatments for women who receive abnormal cervical screening test results, including estrogen cream, colposcopy, endocervical curettage biopsy, punch biopsy, and cone biopsy.

355

Long-Term Outcome of Fetal Hydrocephaly  

Microsoft Academic Search

Long-term outcome of 25 fetuses with ventriculomegaly diagnosed before delivery who survived the neonatal period up to school age was examined at 10.1 (standard deviation, 2.6) years of age. Twelve children had normal motor and mental development, seven were severely handicapped, and six showed intermediate outcome. The fetuses with severe handicaps on long-term follow-up had more severe ventricular dilation than

Pertti Kirkinen; Willy Serlo; Pentti Jouppila; Markku Ryynänen; Anneli Martikainen

1996-01-01

356

Natural history of childhood asthma. 20-year follow-up  

Microsoft Academic Search

Of 417 asthmatic children seen in hospital from 1941 to 1947, only 208 (50%) were still attending the hospital and were available for long-term follow-up, whereas a 91% follow-up was achieved from a personal follow-up of 267 asthmatic children seen in an East London group practice from 1948 to 1952 and followed for more than 20 years to December 1972.

H Blair

1977-01-01

357

Long Term Ecological Resources  

NSDL National Science Digital Library

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.

Cooper, Scott

358

Long Term Prognosis  

MedlinePLUS

... TERM PROGNOSIS The long-term outlook of pediatric cardiomyopathy continues to be unpredictable because it occurs with ... a child also depends on the type of cardiomyopathy and the stage the disease is first diagnosed. ...

359

Long-term effectiveness and side effects of laser resurfacing  

NASA Astrophysics Data System (ADS)

Laser resurfacing have been used for treatment of photoaged facial skin since 1994. Very few long-term follow-up studies regarding the effectiveness and side effects of the laser resurfacing exist. We investigated the long-term effectiveness and side effects of laser resurfacing in our patients who underwent this procedure since our pioneering invention.

Manuskiatti, Woraphong; Fitzpatrick, Richard E.; Goldman, Mitchel P.; Krejci-Papa, Niels

1998-07-01

360

Long term physical sequelae after adult-onset cancer  

Microsoft Academic Search

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

Sophie D. Fosså; Rena Vassilopoulou-Sellin; Alv A. Dahl

2008-01-01

361

[Bariatric surgery - significance, risks, long term consequences].  

PubMed

In recent years the number of bariatric surgery has markedly increased in industrial nations. Surgery provides a more rapid decrease of body weight than conservative approach. However a long term conservative follow up therapy is mandatory to stabilize reduced weight. Due to increasing knowledge from long term follow up of surgically treated obese patients there is a growing body of evidence that frequently there is necessity of reoperations and of substitution both of trace elementsand of minerals or vitamins due to their hampered enteral resorption. Additionally therapy of surgery induced endocrine alterations not seldom is necessary.These insights are of outstanding importance because meanwhile an enlargement of the indications for bariatric surgery as a therapeutic option for metabolic disorders is being discussed. This review refers to the recent internationally published papers concerning consequences of bariatric surgery. PMID:23678666

Schubert, T; Jahn, U; Eben, E; Deuber, H J

2013-03-21

362

Long term results of inflatable mammary implants  

Microsoft Academic Search

In this retrospective study, the long term results of 167 inflatable mammary implants in 77 patients who underwent either breast reconstruction or augmentation between 1972 and 1990 were evaluated. All inflatable implants were manufactured by Heyer-Schulte\\/Mentor company, and were equipped with a posterior leaf valve (style 1800). The mean follow-up was 9 years (SD = 4.3).Complete deflation was found in

A. Worseg; R. Kuzbari; G. Tairych; K. Korak; J. Holle

1995-01-01

363

Long-term follow-up of gastric variceal sclerotherapy: an eleven-year experience  

Microsoft Academic Search

Background: Bleeding from gastric varices is often a serious medical emergency. The role of endoscopy in the management of gastric variceal bleeding is still controversial. The types of gastric varices and their respective management strategies have not been identified. Methods: Gastric varices were observed in 209 patients with portal hypertension. Seventy-one patients (with cirrhosis 33, noncirrhotic 38) underwent gastric variceal

Shiv K. Sarin

1997-01-01

364

Long-Term Follow-Up of Prolactinomas: Normoprolactinemia after Bromocriptine Withdrawal  

Microsoft Academic Search

Bromocriptine (BRC) and other dopamine agonist drugs are the first-choice treatment for prolactinomas. However, the major disadvantage is the need for prolonged therapy. We retrospectively studied 131 patients (62 microprolactinoma (MIC), 69 macroprolactinoma (MAC)), who achieved serum prolactin (PRL) normalization during BRC use. Twenty-seven percent of them (31% MIC and 69% MAC) underwent previous surgery. Twenty-seven patients (20.6%: 25.8% MIC

VANESSA Q. PASSOS; JEAN J. S. SOUZA; NINA R. C. MUSOLINO; MARCELLO D. BRONSTEIN

365

Long-Term follow up after intra-Uterine transfusionS; the LOTUS study  

Microsoft Academic Search

BACKGROUND: The Leiden University Medical Center (LUMC) is the Dutch national referral centre for pregnancies complicated by haemolytic disease of the fetus and newborn (HDFN) caused by maternal alloimmunization. Yearly, 20-25 affected fetuses with severe anaemia are transfused with intra-uterine blood transfusions (IUT). Mothers of whom their fetus has undergone IUT for HDFN are considered high responders with regard to

Esther P Verduin; Irene TM Lindenburg; Vivianne EHJ Smits-Wintjens; Jeanine MM van Klink; Henk Schonewille; Inge L van Kamp; Dick Oepkes; Frans J Walther; Humphrey HH Kanhai; Ilias IN Doxiadis; Enrico Lopriore; Anneke Brand

2010-01-01

366

Long-Term Follow-Up of a Pseudohypoparathyroidism Type 1A Patient with Missense Mutation  

E-print Network

Pseudohypoparathyroidism (PHP) refers to end-organ resistance that primarily impairs the renal actions of parathyroid hormone (PTH). The patients with PHP type Ia (PHP-Ia), one of the 4 types of PHP, show

unknown authors

367

Long-term histologic follow-up of phenol face peels.  

PubMed

Deep phenol peels were done on 11 middle-aged white women with severe actinic damage. Subsequently, face lifts were carried out after periods of 1.5 to 20 years. This made it possible to obtain a full-thickness specimen extending several centimeters on either side of the border between peeled and unpeeled skin. In contrast to the markedly abnormal elastotic appearance of unpeeled skin, a new band of connective tissue 2 to 3 mm in width was laid down in the subepidermal region. Fine elastic fibers formed a dense network in the band of regenerated collagen. The disarray and cytologic abnormalities of sun-damaged epidermis were also largely corrected. Melanocytes were not eliminated, but melanin synthesis was evidently impaired, accounting for the bleaching effects. The effects of a phenol peel are very long lasting and adequately account for the effacement of wrinkles and obliteration of actinic keratoses, mottling, and freckling. PMID:3983273

Kligman, A M; Baker, T J; Gordon, H L

1985-05-01

368

MR Imaging After Aneurysmal Subarachnoid Hemorrhage and Surgery: A Long-term Follow-up Study  

Microsoft Academic Search

BACKGROUND AND PURPOSE: We assumed that patients with surgically treated aneu- rysmal subarachnoid hemorrhage (SAH) might have more lesions than those revealed by CT that could be visible on MR images. METHODS: We conducted a retrospective study of a series of 147 patients with aneurysmal SAH who were treated surgically within 3 days of the onset of SAH. One hundred

Riku P. Kivisaari; Oili Salonen; Antti Servo; Taina Autti; Juha Hernesniemi; Juha Ohman

369

Examining the Effectiveness of Boot Camps: A Randomized Experiment with a Long-Term Follow Up  

Microsoft Academic Search

The boot camp model became a correctional panacea for juvenile offenders during the early 1990s, promising the best of both worlds—less recidivism and lower operat- ing costs. Although there have been numerous studies of boot camp programs since that time, most have relied on nonrandomized comparison groups. The California Youth Authority's (CYA's) experimental study of its juvenile boot camp and

JEAN BOTTCHER; MICHAEL E. EZELL

2005-01-01

370

Personality Development and Learning Disabilities: Long Term Follow-Up of Pschotherapeutic Remediation.  

ERIC Educational Resources Information Center

The authors describe their clinical experiences in working with learninq disabled children who have emotional disorders as well. Their approach, "psychotherapeutic remediation," is explained to combine psychodynamic psychotherapy methods with special education techniques, and to fuse the tutorial role of a remedial teacher and the therapeutic…

Schacht, Leatrice S.; And Others

371

Tai Chi for treating knee osteoarthritis: Designing a long-term follow up randomized controlled trial  

Microsoft Academic Search

BACKGROUND: Knee Osteoarthritis (KOA) is a major cause of pain and functional impairment among elders. Currently, there are neither feasible preventive intervention strategies nor effective medical remedies for the management of KOA. Tai Chi, an ancient Chinese mind-body exercise that is reported to enhance muscle function, balance and flexibility, and to reduce pain, depression and anxiety, may safely and effectively

Chenchen Wang; Christopher H Schmid; Patricia L Hibberd; Robert Kalish; Ronenn Roubenoff; Ramel Rones; Aghogho Okparavero; Timothy McAlindon

2008-01-01

372

Radiotherapy of nonfunctional adenomas of the pituitary gland. Results with long-term follow-up  

SciTech Connect

A total of 112 patients with the diagnosis of nonfunctional pituitary adenoma received radiation therapy at the University of Pittsburgh between 1964 and 1987. Postoperative radiation therapy was administered in 87 patients. Actuarial progression-free survival (tumor control) at 5, 10, 15, and 20 years was 97%, 89%, 87%, and 76%, respectively. Radiation prescribed to the 95% isodose ranged from 35.72 Gy to 62.32 Gy. Multivariate analysis showed decreased tumor control to be significantly associated with increasing field size (P = .036). No improvement in tumor control could be detected with increasing total radiation dose or nominal standard dose (NSD). One patient developed optic neuropathy and another developed a glioblastoma after doses in both patients of 4750 cGy in 25 fractions. External beam radiotherapy for nonfunctional pituitary adenomas was found to be effective and safe when doses less than 4750 cGy in 25 fractions were used.

Flickinger, J.C.; Nelson, P.B.; Martinez, A.J.; Deutsch, M.; Taylor, F.

1989-06-15

373

Vertebral artery angioplasty in patients younger than 55 years: Long-term follow-up  

Microsoft Academic Search

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

Gary Giangola; Anthony M. Imparato; Thomas S. Riles; Patrick J. Lamparello

1991-01-01

374

Permanently Damaged: Long-Term Follow-Up of Shaken Babies  

Microsoft Academic Search

Shaken baby syndrome (SBS) is a term denoting a particularly harmful form of child abuse. By definition, 1 these infants have intracranial and retinal hemorrhages in the absence of signs of head trauma or skull fracture. Most SBS victims appear to have significant neurologic damage at the time of diagnosis.2,3 The medical literature, however, does not describe these children as

Howard Fischer; David Allasio

1994-01-01

375

Microvascular decompression for trigeminal neuralgia: a long-term follow-up study.  

PubMed

In this report, we present our experience with microvascular decompression (MVD) as treatment for trigeminal neuralgia (TN) and discuss factors related to recurrence after this procedure. Between 1986 and 2004, 90 patients underwent MVD for treatment of idiopathic TN at the Marmara University Department of Neurosurgery and Marmara University Neurological Sciences Institute. Individuals with atypical and secondary forms of TN were excluded from the study. The patient characteristics, work-up findings, observations during surgery, and results of MVD for the 90 cases are reviewed. In 87 (97%) of the patients, exposure of the pontocerebellar angle revealed a vascular structure compressing the trigeminal nerve. In the patients with vascular compression, the problem vessel was an artery in 80 (92%) cases and a vein in 7 (8%) cases. In 77 cases, all symptoms were completely resolved by the operation. Ten patients experienced significant partial relief, and the intensity of the residual pain in these cases was not severe enough to require medication. Three patients experienced no improvement after MVD. There was no mortality associated with MVD in the 90 cases. The findings for our series of 90 patients with TN who underwent MVD indicate that this operation is an effective and reliable treatment for this condition. We recommend MVD as the first-line surgical approach for patients with TN who do not respond to medical management. PMID:17323260

Pamir, M N; Peker, S

2006-12-01

376