Rectal lymphoma in 11 dogs: a retrospective study.

PubMed

Van den Steen, N; Berlato, D; Polton, G; Dobson, J; Stewart, J; Maglennon, G; Hayes, A M; Murphy, S

2012-10-01

To retrospectively evaluate the clinical behaviour and immunophenotype of lymphoma of the rectum in dogs. Eleven dogs diagnosed with lymphoma of the rectum on histopathology were retrospectively reviewed. Immunohistochemistry with CD3 and CD79a antibodies was performed at diagnosis or retrospectively. Treatment protocol varied with six dogs undergoing surgery and adjuvant chemotherapy, two received chemotherapy after only incisional biopsy, one had surgical resection only, one was treated symptomatically and one dog was not treated. Chemotherapy treatment consisted of either a -low-dose COP (cyclophosphamide - prednisolone - vincristine) protocol (four dogs) or a six-week CHOP-based (cyclophosphamide - vincristine - -prednisolone - anthracycline) protocol (four dogs). Dogs that received chemotherapy lived significantly longer than dogs that did not receive chemotherapy (2352 versus 70 days). Median survival time was not reached, and there was an overall mean survival time of 1697 days. Immunohistochemistry was performed in 10 of 11 samples, and was consistent with B-cell -lymphoma in all cases. Canine lymphoma of the rectum is associated with a favourable prognosis. Immunohistochemical evaluation of these lesions was consistent with B-cell lymphoma in all cases in which it was examined. © 2012 British Small Animal Veterinary Association.

Does Study Design Affect Redislocation Rates After Primary Shoulder Dislocations? A Systematic Review Comparing Prospective and Retrospective Studies.

PubMed

Gohal, Chetan; Rofaiel, James; Abouali, Jihad; Ayeni, Olufemi R; Pinsker, Ellie; Whelan, Daniel

2017-10-01

To compare recurrence rates between prospectively collected and retrospectively collected data on primary anterior shoulder dislocations, as this could influence the timing of surgical decision making. A comprehensive literature search of Medline, Embase, CINAHL, and hand searches was performed. Recurrence rates of anterior shoulder dislocations were collected from relevant articles, along with follow-up length, age, and gender. An independent sample t test was conducted to evaluate our hypothesis. A multiple linear regression model was used to examine the variance in recurrence rates while controlling for covariates. A total of 1,379 articles were identified, of which 25 were relevant to our study-16 prospective and 9 retrospective. The average rate of recurrence of anterior shoulder dislocations in retrospective studies (mean [M] = 45.2, standard deviation [SD] = 31.67) was not significantly different from that in prospective studies (M = 56.7, SD = 22.55). The 95% confidence interval for the difference of the means ranged from -34.05 to 10.91. After controlling for covariates with the multiple linear regression, only 1.9% of the variance in recurrence rates was due to study type and was not significant (P = .42). The t test performed to evaluate our hypothesis was also not significant t(23) = -1.07, P = .298. When comparing prospective and retrospective studies, there was no significant difference in recurrence rates of primary anterior shoulder dislocations treated nonoperatively. The average redislocation rate was 56.7% in prospective studies and 45.2% in retrospective studies. Furthermore, the majority of this difference was accounted for by varying rates between age groups. Further research is needed to determine the risk of redislocation in specific age groups, to guide treatment decisions based on varying risk. Systematic review of Level II and III studies. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All

Hypothalamo-hypophysial dysfunction after traumatic brain injury in children and adolescents: a preliminary retrospective and prospective study.

PubMed

Einaudi, S; Matarazzo, P; Peretta, P; Grossetti, R; Giordano, F; Altare, F; Bondone, C; Andreo, M; Ivani, G; Genitori, L; de Sanctis, C

2006-05-01

With two study protocols, one retrospective and the other prospective, we evaluated hypothalamo-hypophysial dysfunction (HHD) in paediatric patients treated for traumatic brain injury (TBI) in the neurosurgical or intensive care department at our hospital. The retrospective group comprised 22 patients who had experienced TBI 0.7-7.25 years before the study. The prospective group included 30 patients assessed at TBI (T0), 26 of 30 after 6 months (T6), and 20 of 26 after 12 months (T12). Auxological and hormonal basal parameters of hypothalamo-hypophysial function were evaluated at recall in the retrospective group, and at T0, T6 and T12 in the prospective group. Basal data and standard dynamic tests in selected patients revealed one with precocious puberty, one with total anterior hypopituitarism, one with central hypogonadism, and one with growth hormone (GH) deficiency in the retrospective group; three patients with cerebral salt-wasting syndrome, one with diabetes insipidus and seven with low T3 syndrome at T0 (all transient), one with hypocorticism at T6 confirmed at T12, and one with GH deficiency at T12 in the prospective group. The results of our study show that post-TBI HHD in our paediatric cohort is not uncommon. Of the 48 patients who underwent a complete evaluation (22 retrospective study patients and 26 prospective study patients evaluated at T6) five (10.4%) developed HHD 6 months or more after TBI. HHD was newly diagnosed in one previously normal patient from the prospective group at 12 months after TBI. GH deficiency was the most frequent disorder in our paediatric cohort.

Retrospective Correlates for Bulimia Nervosa: A Matched Case-Control Study.

PubMed

Gonçalves, Sónia; Machado, Barbara C; Martins, Carla; Hoek, Hans W; Machado, Paulo P P

2016-05-01

There have been few studies investigating the risk factors for bulimia nervosa (BN), and most have been in Anglo-Saxon countries. This study aimed to (i) replicate the uncontested retrospective correlates for BN and clarify the role of factors with inconsistent findings and (ii) evaluate the strength of these factors in a different culture. A case-control design was used to compare 60 women who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for BN to 60 healthy controls and 60 participants with other psychiatric disorders. Retrospective correlates were assessed by interviewing each person with the Oxford Risk Factor Interview. The primary retrospective correlates identified from the comparison of BN participants to healthy controls were general high maternal expectations, negative attitudes about parental weight and obesity in childhood and adolescence. Compared with participants with other psychiatric disorders, those with BN also reported higher rates of childhood obesity, deliberate self-harm, family conflicts, general high maternal expectations and feeling fat in childhood. The common findings across cultures suggest that, at least, individuals subjectively experience a number of similar factors that increase risk for developing BN. In addition, the difference regarding self-harm is notable. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Carbon dioxide field flooding: a retrospective study.

PubMed

Frados, A

2001-05-01

The carbon dioxide surgical field flooding technique has long been tried with varying degrees of success. A recent revival of the technique that began over 40 years ago in cardiac surgery, has brought promise as well as improved results attributable to improved technology. Studies at JFK Medical Center have been very successful using the carbon dioxide surgical field-flooding technique. Establishing new guidelines will assist other institutions in attempting this "old" technique with renewed success. Modern, more efficient equipment make use of carbon dioxide to displace intracardiac gases a safe procedure. The carbon dioxide field-flooding technique is safer, easier, and more efficacious than traditional de-airing techniques. This study shows that a long-standing procedure is valuable by observing the results, and, retrospectively evaluating stroke rates among cardiac valve cases at the hospital.

Retrospective evaluation of continental-scale streamflow nudging with WRF-Hydro National Water Model V1

NASA Astrophysics Data System (ADS)

McCreight, J. L.; Wu, Y.; Gochis, D.; Rafieeinasab, A.; Dugger, A. L.; Yu, W.; Cosgrove, B.; Cui, Z.; Oubeidillah, A.; Briar, D.

2016-12-01

The streamflow (discharge) data assimilation capability in version 1 of the National Water Model (NWM; a WRF-Hydro configuration) is applied and evaluated in a 5-year (2011-2015) retrospective study using NLDAS2 forcing data over CONUS. This talk will describe the NWM V1 operational nudging (continuous-time) streamflow data assimilation approach, its motivation, and its relationship to this retrospective evaluation. Results from this study will provide a an analysis-based (not forecast-based) benchmark for streamflow DA in the NWM. The goal of the assimilation is to reduce discharge bias and improve channel initial conditions for discharge forecasting (though forecasts are not considered here). The nudging method assimilates discharge observations at nearly 7,000 USGS gages (at frequency up to 1/15 minutes) to produce a (univariate) discharge reanalysis (i.e. this is the only variable affected by the assimilation). By withholding 14% nested gages throughout CONUS in a separate validation run, we evaluate the downstream impact of assimilation at upstream gages. Based on this sample, we estimate the skill of the streamflow reanalysis at ungaged locations and examine factors governing the skill of the assimilation. Comparison of assimilation and open-loop runs is presented. Performance of DA under both high and low flow regimes and selected flooding events is examined. Preliminary evaluation of nudging parameter sensitivity and its relationship to flow regime will be presented.

Innovations for Evaluation Research: Multiform Protocols, Visual Analog Scaling, and the Retrospective Pretest-Posttest Design.

PubMed

Chang, Rong; Little, Todd D

2018-06-01

In this article, we review three innovative methods: multiform protocols, visual analog scaling, and the retrospective pretest-posttest design that can be used in evaluation research. These three techniques have been proposed for decades, but unfortunately, they are still not utilized readily in evaluation research. Our goal is to familiarize researchers with these underutilized research techniques that could reduce personnel effort and costs for data collection while producing better inferences for a study. We begin by discussing their applications and special unique features. We then discuss each technique's strengths and limitations and offer practical tips on how to better implement these methods in evaluation research. We then showcase two recent empirical studies that implement these methods in real-world evaluation research applications.

Weatherization Works--Summary of Findings from the Retrospective Evaluation of the U.S. DOE's Weatherization Assistance Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tonn, Bruce Edward; Carroll, David; Pigg, Scott

This report presents a summary of the studies and analyses that compose the retrospective evaluation of the U.S. Department of Energy s low-income Weatherization Assistance Program (WAP). WAP provides grants to Grantees (i.e., states) that then provide grants to Subgrantees (i.e., local weatherization agencies) to weatherize low-income homes. This evaluation focused on the WAP Program Year 2008. The retrospective evaluation produced twenty separate reports, including this summary. Four separate reports address the energy savings, energy cost savings, and cost effectiveness of WAP across four housing types: single family, mobile home, small multifamily, and large multifamily. Other reports address the environmentalmore » emissions, macroeconomic, and health and household-related benefits attributable to WAP, and characterize the program, its recipients, and those eligible for the program. Major field studies are also summarized, including a major indoor air quality study and a follow-up ventilation study, an in-depth in-field assessment of weatherization work and quality, and a study that assesses reasons for variations in energy savings across homes. Results of surveys of weatherization staff, occupants, occupants satisfaction with weatherization services provided, and weatherization trainees are summarized. Lastly, this report summarizes a set of fifteen case studies of high-performing and unique local weatherization agencies.« less

Alopecia areata treated with hydroxychloroquine: A retrospective study of nine pediatric cases.

PubMed

Yun, Duri; Silverberg, Nanette B; Stein, Sarah L

2018-05-01

Alopecia areata is a common hair loss condition that is often emotionally devastating for patients. There is a paucity of effective treatments available. Hydroxychloroquine has been reported as variably effective in inducing significant hair regrowth in adults with alopecia areata. The objective of this retrospective study was to assess the benefit and tolerability of hydroxychloroquine in pediatric alopecia areata. We conducted a retrospective review of nine children with a history of alopecia areata treated with hydroxychloroquine. Clinical data were obtained from patients treated at two tertiary care centers in the United States between July 1, 2013, and July 1, 2015. Alopecia scores of five patients improved by 6 months of treatment. Four patients experienced no improvement from baseline evaluation. The most common side effect associated with treatment was gastrointestinal intolerance and headache. This retrospective series suggests that hydroxychloroquine can be considered as a treatment option for alopecia areata in children. © 2018 Wiley Periodicals, Inc.

Retrospective Evaluation of a Teleretinal Screening Program in Detecting Multiple Nondiabetic Eye Diseases.

PubMed

Maa, April Y; Patel, Shivangi; Chasan, Joel E; Delaune, William; Lynch, Mary G

2017-01-01

Diabetic teleretinal screening programs have been utilized successfully across the world to detect diabetic retinopathy (DR) and are well validated. Less information, however, exists on the ability of teleretinal imaging to detect nondiabetic ocular pathology. This study performed a retrospective evaluation to assess the ability of a community-based diabetic teleretinal screening program to detect common ocular disease other than DR. A retrospective chart review of 1,774 patients who underwent diabetic teleretinal screening was performed. Eye clinic notes from the Veterans Health Administration's electronic medical record, Computerized Patient Record System, were searched for each of the patients screened through teleretinal imaging. When a face-to-face examination note was present, the physical findings were compared to those obtained through teleretinal imaging. Sensitivity, specificity, and positive and negative predictive values were calculated for suspicious nerve, cataract, and age-related macular degeneration. A total of 903 patients underwent a clinical examination. The positive predictive value was highest for cataract (100%), suspicious nerve (93%), and macular degeneration (90%). The negative predictive value and the percent agreement between teleretinal imaging and a clinical examination were over 90% for each disease category. A teleretinal imaging protocol may be used to screen for other common ocular diseases. It may be feasible to use diabetic teleretinal photographs to screen patients for other potential eye diseases. Additional elements of the eye workup may be added to enhance accuracy of disease detection. Further study is necessary to confirm this initial retrospective review.

Retrospective Case Study in Northeastern Pennsylvania

EPA Pesticide Factsheets

The EPA chose Bradford County, and parts of neighboring Susquehanna County, as a retrospective case study location because of the extensive hydraulic fracturing activities occurring there, coincident with the large number of homeowner complaints.

Trauma in elderly patients evaluated in a hospital emergency department in Konya, Turkey: a retrospective study

PubMed Central

Kara, Hasan; Bayir, Aysegul; Ak, Ahmet; Akinci, Murat; Tufekci, Necmettin; Degirmenci, Selim; Azap, Melih

2014-01-01

Purpose Trauma is a common cause of admission to the hospital emergency department. The purpose of this study was to evaluate the cause of admission, clinical characteristics, and outcomes of patients aged ≥65 years admitted to an emergency department in Turkey because of blunt trauma. Materials and methods Medical records were retrospectively reviewed for 568 patients (314 women and 254 men) aged ≥65 years who were admitted to an emergency department of a tertiary care hospital. Results Trauma was caused by low-energy fall in 379 patients (67%), traffic accident in 79 patients (14%), high-energy fall in 69 patients (12%), and other causes in 41 patients (7%). The most frequent sites of injury were the lower extremity, thorax, upper extremity, and head. The femur was the most frequent fracture site. After evaluation in the emergency department, 377 patients (66%) were hospitalized. There were 31 patients (5%) who died. Risk of hospitalization after trauma was significantly associated with trauma to the lower extremity, thorax, and spine; fractures of the femur and rib; and intracranial injury. Conclusion Emergency department admission after trauma in patients aged ≥65 years is common after low-energy falls, and most injuries occur to the extremities. It is important to focus on prevention of falls to decrease the frequency of trauma in the elderly. PMID:24376346

Cervical spine injuries from diving accident: a 10-year retrospective descriptive study on 64 patients.

PubMed

Chan-Seng, E; Perrin, F E; Segnarbieux, F; Lonjon, N

2013-09-01

Ninety percent of the lesions resulting from diving injuries affect the cervical spine and are potentially associated with spinal cord injuries. The objective is to determine the most frequent lesion mechanisms. Evaluate the therapeutic alternatives and the biomechanical evolution (kyphotic deformation) of diving-induced cervical spine injuries. Define epidemiological characteristics of diving injuries. A retrospective analysis over a period of 10 years was undertaken for patients admitted to the Department of Neurosurgery of Montpellier, France, with cervical spinal injuries due to a diving accident. Patients were re-evaluated and clinical and radiological evaluation follow-ups were done. This study included 64 patients. Cervical spine injuries resulting from diving predominantly affect young male subjects. They represent 9.5% of all the cervical spine injuries. In 22% of cases, patients presented severe neurological troubles (ASIA A, B, C) at the time of admission. A surgical treatment was done in 85% of cases, mostly using an anterior cervical approach. This is a retrospective study (type IV) with some limitations. The incidence of diving injuries in our region is one of the highest as compared to reports in the literature. Despite an increase of our surgical indications, 55% of these cases end up with a residual kyphotic deformation but there is no relationship between the severity of late vertebral deformity and high Neck Pain and Disability Scale (NPDS) scores. Level IV, retrospective study. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Retrospective Evaluation of Cured-in-Place Pipe Technology for Municipal Gravity Sewer Rehabilitation

EPA Science Inventory

One of the top research needs identified at the September 2008 U.S. EPA International Technology Forum on Rehabilitation of Water and Wastewater Systems is to undertake a broad and quantitative retrospective evaluation of the performance of previously rehabilitated systems. Curr...

The residency interview is still paramount: results of a retrospective cohort study on concordance of dermatology residency applicant evaluators and influence of the applicant interview.

PubMed

Kamangar, Faranak; Davari, Parastoo; Azari, Rahman; Fitzmaurice, Sarah; Li, Chin-Shang; Eisen, Daniel B; Fazel, Nasim

2017-05-22

Application to dermatology residency is a highly competitive process. Although factors associated with successfully matching have been studied, less is known regarding the ability of admissions committees to screen applicants in a uniform manner or the importance of the interview in ranking applicants. Our goal was to retrospectively measure our admission committee evaluators' concordance regarding residency application credentials and interview performance, and ultimately the effects on final applicant ranking.

Evaluation of preoperative geriatric assessment of elderly patients with colorectal carcinoma. A retrospective study.

PubMed

Indrakusuma, R; Dunker, M S; Peetoom, J J; Schreurs, W H

2015-01-01

Elderly patients with colorectal carcinoma are screened with the Identification of Seniors at Risk (ISAR) questionnaire to identify frail patients. These patients are more at risk for mortality and morbidity and are referred to the geriatric specialist for assessment (Dutch acronym: DOG). The DOG assessment aims to preoperatively optimize the patient in order to improve postoperative outcomes. This study evaluates if the DOG assessment influences postoperative outcome after colorectal surgery. Retrospective cohort and match-control study. Elderly patients who underwent elective resection between 01-01-2008 and 01-08-2013 in the Medical Centre Alkmaar were included. Patients with a positive ISAR score were referred to the geriatric specialists for DOG assessment (DOG patients). DOG assessment encompassed comprehensive geriatric assessment and interventions. Mortality, delirium and length of hospital stay. postoperative complications. Cohort ISAR- (2008-2010, no ISAR questionnaire) is compared with cohort ISAR+ (2011-2013, ISAR questionnaire). Match-control comparison: DOG patients are compared with matched controls from cohort ISAR-. Compared to their matched controls, DOG patients were older and had a higher prevalence of certain risk factors for postoperative delirium. In both comparisons, no statistical significant differences were found between the groups in mortality and postoperative delirium. Length of stay was significantly shorter in cohort ISAR+. While the DOG patients were significantly more at risk for postoperative complications, the DOG patients had comparable postoperative outcomes as their matched controls. We therefore conclude that the DOG assessment has a positive influence on the postoperative outcomes after colorectal surgery. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Ambulatory Integration of the Medical and Social (AIMS) model: A retrospective evaluation.

PubMed

Rowe, Jeannine M; Rizzo, Victoria M; Shier Kricke, Gayle; Krajci, Kate; Rodriguez-Morales, Grisel; Newman, Michelle; Golden, Robyn

2016-01-01

An exploratory, retrospective evaluation of Ambulatory Integration of the Medical and Social (AIMS), a care coordination model designed to integrate medical and non-medical needs of patients and delivered exclusively by social workers was conducted to examine mean utilization of costly health care services for older adult patients. Results reveal mean utilization of 30-day hospital readmissions, emergency department (ED) visits, and hospital admissions are significantly lower for the study sample compared to the larger patient population. Comparisons with national population statistics reveal significantly lower mean utilization of 30-day admissions and ED visits for the study sample. The findings offer preliminary support regarding the value of AIMS.

Retrospective Evaluation of Topical Bimatoprost and Iris Pigmentation Change.

PubMed

Zaleski-Larsen, Lisa A; Ruth, Nadine H; Fabi, Sabrina G

2017-12-01

Topical bimatoprost is a topical prostaglandin analog originally used to treat glaucoma and more recently used to cosmetically induce hypertrichosis of the eyelashes. Iris pigmentation change has been noted in the treatment of glaucoma but has not been assessed with the cosmetic periorbital application of bimatoprost. To evaluate for iris pigmentation change with the long-term cosmetic use of topical bimatoprost. A retrospective chart review in a cosmetic dermatology practice of women (N = 50) who consistently purchased topical bimatoprost over an average of 4.59 years was compared with that of age-matched non-bimatoprost patients (N = 50). A blinded evaluator assessed each patient for iris pigmentary change. No iris pigmentation change was noted with the cutaneous application of bimatoprost. The cutaneous application of bimatoprost appears to be safe with minimal risk for iris pigmentation change.

Northeastern Pennsylvania Retrospective Case Study Fact Sheet

EPA Pesticide Factsheets

EPA conducted a retrospective case study in northeastern Pennsylvania to investigate reported instances of contaminated drinking water resources in areas where hydraulic fracturing activities occurred

Protocol for the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) retrospective study of coronary catheterisation and percutaneous coronary intervention.

PubMed

Li, Jing; Dharmarajan, Kumar; Li, Xi; Lin, Zhenqiu; Normand, Sharon-Lise T; Krumholz, Harlan M; Jiang, Lixin

2014-03-07

During the past decade, the volume of percutaneous coronary intervention (PCI) in China has risen by more than 20-fold. Yet little is known about patterns of care and outcomes across hospitals, regions and time during this period of rising cardiovascular disease and dynamic change in the Chinese healthcare system. Using the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) research network, the Retrospective Study of Coronary Catheterisation and Percutaneous Coronary Intervention (China PEACE-Retrospective CathPCI Study) will examine a nationally representative sample of 11 900 patients who underwent coronary catheterisation or PCI at 55 Chinese hospitals during 2001, 2006 and 2011. We selected patients and study sites using a two-stage cluster sampling design with simple random sampling stratified within economical-geographical strata. A central coordinating centre will monitor data quality at the stages of case ascertainment, medical record abstraction and data management. We will examine patient characteristics, diagnostic testing patterns, procedural treatments and in-hospital outcomes, including death, complications of treatment and costs of hospitalisation. We will additionally characterise variation in treatments and outcomes by patient characteristics, hospital, region and study year. The China PEACE collaboration is designed to translate research into improved care for patients. The study protocol was approved by the central ethics committee at the China National Center for Cardiovascular Diseases (NCCD) and collaborating hospitals. Findings will be shared with participating hospitals, policymakers and the academic community to promote quality monitoring, quality improvement and the efficient allocation and use of coronary catheterisation and PCI in China. http://www.clinicaltrials.gov (NCT01624896).

Notification: Project Notification Memorandum for OIG Evaluation of EPA's Regulatory Flexibility Act Retrospective Reviews

EPA Pesticide Factsheets

Project #OPE-FY11-0024, January 6, 2012. Our overall evaluation objective remains to assess the efficiency and effectiveness of policies and procedures in place for conducting RFA Section 610 retrospective reviews and the concerns regarding past reviews.

Protocol for the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) retrospective study of coronary catheterisation and percutaneous coronary intervention

PubMed Central

Li, Jing; Dharmarajan, Kumar; Li, Xi; Lin, Zhenqiu; Normand, Sharon-Lise T; Krumholz, Harlan M; Jiang, Lixin

2014-01-01

Introduction During the past decade, the volume of percutaneous coronary intervention (PCI) in China has risen by more than 20-fold. Yet little is known about patterns of care and outcomes across hospitals, regions and time during this period of rising cardiovascular disease and dynamic change in the Chinese healthcare system. Methods and analysis Using the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) research network, the Retrospective Study of Coronary Catheterisation and Percutaneous Coronary Intervention (China PEACE-Retrospective CathPCI Study) will examine a nationally representative sample of 11 900 patients who underwent coronary catheterisation or PCI at 55 Chinese hospitals during 2001, 2006 and 2011. We selected patients and study sites using a two-stage cluster sampling design with simple random sampling stratified within economical-geographical strata. A central coordinating centre will monitor data quality at the stages of case ascertainment, medical record abstraction and data management. We will examine patient characteristics, diagnostic testing patterns, procedural treatments and in-hospital outcomes, including death, complications of treatment and costs of hospitalisation. We will additionally characterise variation in treatments and outcomes by patient characteristics, hospital, region and study year. Ethics and dissemination The China PEACE collaboration is designed to translate research into improved care for patients. The study protocol was approved by the central ethics committee at the China National Center for Cardiovascular Diseases (NCCD) and collaborating hospitals. Findings will be shared with participating hospitals, policymakers and the academic community to promote quality monitoring, quality improvement and the efficient allocation and use of coronary catheterisation and PCI in China. Registration details http://www.clinicaltrials.gov (NCT01624896). PMID:24607563

Complication rates in patients using absorbable collagen sponges in third molar extraction sockets: a retrospective study.

PubMed

Cho, Hoon; Jung, Hwi-Dong; Kim, Bok-Joo; Kim, Chul-Hoon; Jung, Young-Soo

2015-02-01

The purpose of this study is to retrospectively evaluate the postoperative complication rates for absorbable type-I collagen sponge (Ateloplug; Bioland) use in third molar extraction. From January to August 2013, 2,697 total patients undergoing third molar extraction and type-I collagen sponge application in the Department of Oral and Maxillofacial Surgery at Yonsei University Dental Hospital (1,163 patients) and Dong-A University Hospital (1,534 patients) were evaluated in a retrospective study using their operation and medical records. A total of 3,869 third molars in 2,697 patients were extracted and the extraction sockets packed with type-I collagen sponges to prevent postoperative complications. As a result, the overall complication rate was 4.52%, with 3.00% experiencing surgical site infection (SSI), 1.14% showing alveolar osteitis, and 0.39% experiencing hematoma. Of the total number of complications, SSI accounted for more than a half at 66.29%. Compared to previous studies, this study showed a relatively low incidence of complications. The use of type-I collagen sponges is recommended for the prevention of complications after third molar extraction.

Association pernicious anemia and autoimmune polyendocrinopathy: a retrospective study.

PubMed

Zulfiqar, A A; Andres, E

2017-01-01

To investigate the association between pernicious anemia and other autoimmune diseases. This retrospective and bicentric study was conducted at Reims and Strasbourg University Hospitals and involved 188 patients with pernicious anemia examined between 2000 and 2010 in order to search for other autoimmune diseases and to evaluate the role of pernicious anemia in autoimmune polyglandular syndrome. A total of 74 patients with a combination of pernicious anemia and other autoimmune diseases were included in the study. Our study revealed the privileged association of pernicious anemia with autoimmune thyroiditis. The association of pernicious anemia and autoimmune thyroiditis are a part of the autoimmune polyglandular syndrome type 3b. We suggest undertaking a systematic clinical examination and laboratory investigations in search of autoimmune thyroiditis in patient(s) with the diagnosis of pernicious anemia. The association of pernicious anemia and autoimmune thyroiditis is frequent and a part of autoimmune polyglandular 3b.

An analysis of firearms-related deaths between 1993-2010: a retrospective study.

PubMed

Toygar, Mehmet; Türker, Türker; Eroğlu, Murat; Kaldırım, Umit; Poyrazoğlu, Yavuz; Eyi, Yusuf Emrah; Durusu, Murat; Eryılmaz, Mehmet

2013-11-01

Firearm injuries (FI) are the most common cause of death among military personnel. In this study, postmortem examination and autopsy records of deaths resulting from firearm injuries recorded in the Department of Forensic Medicine of Gulhane Military Medical Academy between 1993-2010 were examined retrospectively. We evaluated the characteristics of 153 firearm deaths accounting for 36.6% of all medical-legal autopsies. The cases included 152 men (99.3%) and 1 woman (0.7%). The mean age of the cases was 23.1 years (±4.7; range, 20-43 years). The manner of death was determined in all cases with 41.8% of cases identified as suicide and 39.9% as homicide. The most common sites of firearm entrance wounds were the head and neck region (n=109, 71.2%), the chest (n=26, 17%), or the abdomen (n=14, 9.2%). The type of firearm was not clear in most cases. In conclusion, complete forensic and medical records will facilitate the rapid and accurate conclusion of the legal process and will enhance future retrospective studies.

Conference presentation to publication: a retrospective study evaluating quality of abstracts and journal articles in medical education research.

PubMed

Stephenson, Christopher R; Vaa, Brianna E; Wang, Amy T; Schroeder, Darrell R; Beckman, Thomas J; Reed, Darcy A; Sawatsky, Adam P

2017-11-09

There is little evidence regarding the comparative quality of abstracts and articles in medical education research. The Medical Education Research Study Quality Instrument (MERSQI), which was developed to evaluate the quality of reporting in medical education, has strong validity evidence for content, internal structure, and relationships to other variables. We used the MERSQI to compare the quality of reporting for conference abstracts, journal abstracts, and published articles. This is a retrospective study of all 46 medical education research abstracts submitted to the Society of General Internal Medicine 2009 Annual Meeting that were subsequently published in a peer-reviewed journal. We compared MERSQI scores of the abstracts with scores for their corresponding published journal abstracts and articles. Comparisons were performed using the signed rank test. Overall MERSQI scores increased significantly for published articles compared with conference abstracts (11.33 vs 9.67; P < .001) and journal abstracts (11.33 vs 9.96; P < .001). Regarding MERSQI subscales, published articles had higher MERSQI scores than conference abstracts in the domains of sampling (1.59 vs 1.34; P = .006), data analysis (3.00 vs 2.43; P < .001), and validity of evaluation instrument (1.04 vs 0.28; P < .001). Published articles also had higher MERSQI scores than journal abstracts in the domains of data analysis (3.00 vs 2.70; P = .004) and validity of evaluation instrument (1.04 vs 0.26; P < .001). To our knowledge, this is the first study to compare the quality of medical education abstracts and journal articles using the MERSQI. Overall, the quality of articles was greater than that of abstracts. However, there were no significant differences between abstracts and articles for the domains of study design and outcomes, which indicates that these MERSQI elements may be applicable to abstracts. Findings also suggest that abstract quality is generally preserved

Management of vaginal penetration phobia in Arab women: a retrospective study.

PubMed

Muammar, Tarfah; McWalter, Patricia; Alkhenizan, Abdullah; Shoukri, Mohamed; Gabr, Alia; Bin, Abdulaziz AlDanah

2015-01-01

Vaginal penetration phobia is a common and distressing problem world.wide. It interferes with vaginal penetrative sexual relations, and leads to unconsummated marriage (UCM). This problem may be heightened in Arab women, due to cultural taboos about pain and bleeding, that may be associated with the first coital experience after marriage. Data about this problem is scarce in Arab societies. The aim of this study was to evaluate the response of these women and their husbands to an individualized, psychotherapeutic assessment and treatment to resolve this problem. Retrospective descriptive in a general gynecology community setting over a 6-year period. The study involved a retrospective sequential cohort of 100 Arab couples with UCM due to the woman's VPP. They were evaluated by a female gynecologist in out patient clinics. Data was collected through chart review, and telephone interviews. Final analysis was performed on 100 Arab couples, who satisfied the inclusion criteria. They were followed up to assess their response to an individualized, structured treatment protocol. The treatment combined sex education with systematic desensitization, targeting fear and anxiety as.sociated with vaginal penetration. A total of 96% of the studied group had a successful outcome after an average of 4 sessions. Penetrative intercourse was reported by the tolerance of these women; further pregnancy was achieved in 77.8 % of the infertile couples. Insufficient knowledge of sexual intercourse is a major contributor to the development of VPP in the sampled population. It appears that they respond well to an individualized, structured treatment protocol as described by Hawten 1985 (regardless of other risk factors associated with vaginismus).

A retrospective study on annual evaluation of radiation processing for frozen bone allografts complying to quality system requirements.

PubMed

Ramalingam, Saravana; Mohd, Suhaili; Samsuddin, Sharifah Mazni; Min, N G Wuey; Yusof, Norimah; Mansor, Azura

2015-12-01

Bone allografts have been used widely to fill up essential void in orthopaedic surgeries. The benefit of using allografts to replace and reconstruct musculoskeletal injuries, fractures or disease has obtained overwhelming acceptance from orthopaedic surgeons worldwide. However, bacterial infection and disease transmission through bone allograft transplantation have always been a significant issue. Sterilization by radiation is an effective method to eliminate unwanted microorganisms thus assist in preventing life threatening allograft associated infections. Femoral heads procured from living donors and long bones (femur and tibia) procured from cadaveric donors were sterilized at 25 kGy in compliance with international standard ISO 11137. According to quality requirements, all records of bone banking were evaluated annually. This retrospective study was carried out on annual evaluation of radiation records from 1998 until 2012. The minimum doses absorbed by the bones were ranging from 25.3 to 38.2 kGy while the absorbed maximum doses were from 25.4 to 42.3 kGy. All the bones supplied by our UMMC Bone Bank were sterile at the required minimum dose of 25 kGy. Our analysis on dose variation showed that the dose uniformity ratios in 37 irradiated boxes of 31 radiation batches were in the range of 1.003-1.251, which indicated the doses were well distributed.

Raton Basin, Colorado Retrospective Case Study Fact Sheet

EPA Pesticide Factsheets

EPA conducted a retrospective case study in the Raton Basin of Colorado to investigate reported instances of contaminated drinking water resources in areas where hydraulic fracturing activities occurred.

Evaluation of 6 remote First Nations community-based buprenorphine programs in northwestern Ontario: Retrospective study.

PubMed

Mamakwa, Solomon; Kahan, Meldon; Kanate, Dinah; Kirlew, Mike; Folk, David; Cirone, Sharon; Rea, Sara; Parsons, Pierre; Edwards, Craig; Gordon, Janet; Main, Fiona; Kelly, Len

2017-02-01

To evaluate established opioid addiction treatment programs that use traditional healing in combination with buprenorphine-naloxone maintenance treatment in 6 First Nations communities in the Sioux Lookout region of northwestern Ontario. Retrospective cohort study. Six First Nations communities in northwestern Ontario. A total of 526 First Nations participants in opioid-dependence treatment programs. Buprenorphine-naloxone substitution therapy and First Nations healing programming. Retention rates and urine drug screening (UDS) results. Treatment retention rates at 6, 12, and 18 months were 84%, 78%, and 72%, respectively. We estimate that the rate at 24 months will also be more than 70%. The UDS programming varied and was implemented in only 1 community. Initially urine testing was voluntary and it then became mandatory. Screening with either method found the proportion of urine samples with negative results for illicit opioids ranged between 84% and 95%. The program's treatment retention rates and negative UDS results were higher than those reported for most methadone and buprenorphine-naloxone programs, despite a patient population where severe posttraumatic stress disorder is endemic, and despite the programs' lack of resources and addiction expertise. Community-based programs like these overcome the initial challenge of cultural competence. First Nations communities in other provinces should establish their own buprenorphinenaloxone programs, using local primary care physicians as prescribers. Sustainable core funding is needed for programming, long-term aftercare, and trauma recovery for such initiatives. Copyright© the College of Family Physicians of Canada.

Association pernicious anemia and autoimmune polyendocrinopathy: a retrospective study

PubMed Central

Zulfiqar, AA; Andres, E

2017-01-01

Objective: To investigate the association between pernicious anemia and other autoimmune diseases. Methods: This retrospective and bicentric study was conducted at Reims and Strasbourg University Hospitals and involved 188 patients with pernicious anemia examined between 2000 and 2010 in order to search for other autoimmune diseases and to evaluate the role of pernicious anemia in autoimmune polyglandular syndrome. Results: A total of 74 patients with a combination of pernicious anemia and other autoimmune diseases were included in the study. Our study revealed the privileged association of pernicious anemia with autoimmune thyroiditis. The association of pernicious anemia and autoimmune thyroiditis are a part of the autoimmune polyglandular syndrome type 3b. Conclusion: We suggest undertaking a systematic clinical examination and laboratory investigations in search of autoimmune thyroiditis in patient(s) with the diagnosis of pernicious anemia. The association of pernicious anemia and autoimmune thyroiditis is frequent and a part of autoimmune polyglandular 3b. PMID:29362601

Pain management in home hospice patients: A retrospective descriptive study.

PubMed

Campbell, Cathy L; Kelly, Meghan; Rovnyak, Virginia

2017-09-01

The development and evaluation of evidence-based, safe, and effective home-based pain management models for caregivers implementation is receiving greater attention in the literature because of international initiatives intended to increase the number of people who receive end-of-life care in home-based settings. The purpose of this "retrospective descriptive design" study was to describe pharmacological pain management and outcomes for 40 cancer and non-cancer patients receiving hospice care at home. While the median pain score was higher at admission in the cancer group than in the hospice care at home group, the difference was not significant at or within 48 hour of admission. Overall, there was a significant decrease in pain from the first measurement to the second. Within the last seven days of life, the majority of participants were not able to provide a pain severity score when asked to evaluate the effectiveness of pain management, thus their caregiver provided a proxy evaluation. Pain management was effective in the home setting. More research is needed on the best methods to teach lay caregivers to assess pain and evaluate the effectiveness of pharmacological modalities to manage pain. © 2017 John Wiley & Sons Australia, Ltd.

High prevalence of multidrug resistant tuberculosis in Djibouti: a retrospective study.

PubMed

Boyer-Cazajous, Géraldine; Martinaud, Christophe; Déhan, Céline; Hassan, Mohammed Osman; Gaas, Yassin; Chenilleau-Vidal, Marie-Caroline; Soler, Charles

2014-02-13

The Republic of Djibouti is an African country that exhibits one of the highest incidence rate of tuberculosis in the world. The aim of this study was to evaluate the prevalence of multidrug-resistant tuberculosis among new cases. We studied retrospectively every tuberculosis case diagnosed over a 12-month period in patients hospitalized at the French Military Hospital of Bouffard. During this period, 1,274 samples from 675 patients were tested. We isolated 266 mycobacteria corresponding to 180 cases of tuberculosis. Thirty-three were fully susceptible and 57% met the tuberculosis criteria, with 46% primary resistance. No extensively-drug-resistant tuberculosis was found. Our results highlight a major concern about the situation in this part of the world.

Retrospective study

PubMed Central

Lu, Chao; Lv, Xueyou; Lin, Yiming; Li, Dejian; Chen, Lihua; Ji, Feng; Li, Youming; Yu, Chaohui

2016-01-01

Abstract Conventional forceps biopsy (CFB) is the most popular way to screen for gastric epithelial neoplasia (GEN) and adenocarcinoma of gastric epithelium. The aim of this study was to compare the diagnostic accuracy between conventional forceps biopsy and endoscopic submucosal dissection (ESD). Four hundred forty-four patients who finally undertook ESD in our hospital were enrolled from Jan 1, 2009 to Sep 1, 2015. We retrospectively assessed the characteristics of pathological results of CFB and ESD. The concordance rate between CFB and ESD specimens was 68.92% (306/444). Men showed a lower concordance rate (63.61% vs 79.33%; P = 0.001) and concordance patients were younger (P = 0.048). In multivariate analysis, men significantly had a lower concordance rate (coefficient −0.730, P = 0.002) and a higher rate of pathological upgrade (coefficient −0.648, P = 0.015). Locations of CFB did not influence the concordance rate statistically. The concordance rate was relatively high in our hospital. According to our analysis, old men plus gastric fundus or antrum of CFB were strongly suggested to perform ESD if precancerous lesions were found. And young women with low-grade intraepithelial neoplasia could select regular follow-up. PMID:27472723

How Service Works. Summary of the W. K. Kellogg Foundation's "Service Works": A Retrospective Evaluation of Higher Education Service Programs.

ERIC Educational Resources Information Center

Kellogg Foundation, Battle Creek, MI.

Service learning is an undergraduate education strategy found across four program areas funded by the W. K. Kellogg Foundation (WKKF). This cross-foundation, retrospective evaluation examines 35 projects of $100,000 or more funded between 1985-95. Study information was based on qualitative data and approaches, with the majority of project…

Retrospective and prospective evaluation of the Carbapenem inactivation method for the detection of carbapenemase-producing Enterobacteriaceae

PubMed Central

Gauthier, Lauraine; Dortet, Laurent; Naas, Thierry

2017-01-01

Background There is an urgent need for accurate and rapid diagnostic tests to identify carbapenemase producing enterobacteria (CPE). Here, we have evaluated the Carbapenem Inactivation Method (CIM) test to detect CPEs from cultured colonies. Methods A total of 256 enterobacterial isolates were used to evaluate the performance of the CIM in comparison to Carba NP test and molecular detection used a reference method. Ninety three well-characterized isolates (including 29 non-CPE and 63 CPEs of worldwide origin) with decreased susceptibility to at least one carbapenem were used to (i) evaluate the efficacy of CIM test and (ii) to compare it to the Carba NP test. We also tested different carbapenems to determine the best substrate for this test. Finally, the CIM test was then evaluated prospectively against 164 isolates referred to the French National Reference Center (NRC) for Antimicrobial Resistance from may 2016 to july 2016. Results Based on the results of this retrospective study, sensitivity and specificity of the CIM and the Carba NP test were 92.1% and 100%, respectively. We demonstrated that the meropenem was the best substrate to perform the CIM test since sensitivity and specificity were 81.1% and 100% using ertapenem disk, and 100% and 65,6% using imipenem disk, and respectively. Taking in account the results of retrospective and prospective studies, CIM and Carba NP tests have similar sensitivity, specificity, positive predictive value and negative predictive values being 96.3%, 98.9%, 99.0% and 98.4% for the CIM test versus 96.9%, 100%, 100% and 100% for the Carba NP test. Conclusions Our results confirm that the CIM test may be a useful tool for the reliable confirmation of carbapenemase-activity in enterobacterial isolates, especially in clinical microbiological laboratories with limited resources, no trained personnel, and no specialized equipment. PMID:28158310

Childhood Maltreatment in South Korea: Retrospective Study

ERIC Educational Resources Information Center

Lee, Yanghee; Kim, Sangwon

2011-01-01

Objective: This study explored the prevalence of childhood maltreatment in South Korea using the retrospective version of ICAST and the associations between perceptions of abuse experienced during childhood and recent interpersonal problems and depression. Methods: 539 young persons, aged 18-24 years, from various universities, work places, and…

Systemic treatment of papular dermatitis: A retrospective study.

PubMed

Moustafa, Farah A; Sandoval, Laura F; Jorizzo, Joseph L; Huang, William W

2015-10-01

Papular dermatitis is an intensely pruritic eruption that is often refractory to conventional therapy. The aim of this study was to evaluate the efficacy of different non-steroidal systemic therapies for long-term control of disease in patients with papular dermatitis. This was a single center, retrospective study involving a chart review of patients with a diagnosis of papular dermatitis who were prescribed systemic therapy between 1 January 2002 and 31 December 2012. Fourteen patients were identified that were treated with a systemic agent. Median duration of treatment was 25 months. Methotrexate was used first line in 12 patients, with control of disease achieved in eight patients with a dose between 2.5 and 10 mg weekly. Azathioprine and mycophenolate mofetil also provided control of disease when used as first-line therapy in the remaining two patients. While azathiopurine was effective in patients who failed methotrexate, gastrointestinal side effects limited its use long term. Low dose weekly methotrexate, as well as, azathioprine and mycophenolate mofetil are long-term treatment options for patients with papular dermatitis refractory to other therapies.

A retrospective evaluation of the Perfecting Patient Care University training program for health care organizations.

PubMed

Morganti, Kristy Gonzalez; Lovejoy, Susan; Beckjord, Ellen Burke; Haviland, Amelia M; Haas, Ann C; Farley, Donna O

2014-01-01

This study evaluated how the Perfecting Patient Care (PPC) University, a quality improvement (QI) training program for health care leaders and clinicians, affected the ability of organizations to improve the health care they provide. This training program teaches improvement methods based on Lean concepts and principles of the Toyota Production System and is offered in several formats. A retrospective evaluation was performed that gathered data on training, other process factors, and outcomes after staff completed the PPC training. A majority of respondents reported gaining QI competencies and cultural achievements from the training. Organizations had high average scores for the success measures of "outcomes improved" and "sustainable monitoring" but lower scores for diffusion of QI efforts. Total training dosage was significantly associated with the measures of QI success. This evaluation provides evidence that organizations gained the PPC competencies and cultural achievements and that training dosage is a driver of QI success.

Pain point system scale (PPSS): a method for postoperative pain estimation in retrospective studies

PubMed Central

Gkotsi, Anastasia; Petsas, Dimosthenis; Sakalis, Vasilios; Fotas, Asterios; Triantafyllidis, Argyrios; Vouros, Ioannis; Saridakis, Evangelos; Salpiggidis, Georgios; Papathanasiou, Athanasios

2012-01-01

Purpose Pain rating scales are widely used for pain assessment. Nevertheless, a new tool is required for pain assessment needs in retrospective studies. Methods The postoperative pain episodes, during the first postoperative day, of three patient groups were analyzed. Each pain episode was assessed by a visual analog scale, numerical rating scale, verbal rating scale, and a new tool – pain point system scale (PPSS) – based on the analgesics administered. The type of analgesic was defined based on the authors’ clinic protocol, patient comorbidities, pain assessment tool scores, and preadministered medications by an artificial neural network system. At each pain episode, each patient was asked to fill the three pain scales. Bartlett’s test and Kaiser–Meyer–Olkin criterion were used to evaluate sample sufficiency. The proper scoring system was defined by varimax rotation. Spearman’s and Pearson’s coefficients assessed PPSS correlation to the known pain scales. Results A total of 262 pain episodes were evaluated in 124 patients. The PPSS scored one point for each dose of paracetamol, three points for each nonsteroidal antiinflammatory drug or codeine, and seven points for each dose of opioids. The correlation between the visual analog scale and PPSS was found to be strong and linear (rho: 0.715; P < 0.001 and Pearson: 0.631; P < 0.001). Conclusion PPSS correlated well with the known pain scale and could be used safely in the evaluation of postoperative pain in retrospective studies. PMID:23152699

Retrospective evaluation of toceranib (Palladia) treatment for canine metastatic appendicular osteosarcoma.

PubMed

Kim, Changseok; Matsuyama, Arata; Mutsaers, Anthony J; Woods, J Paul

2017-10-01

This retrospective study evaluated the outcomes of dogs with macroscopic pulmonary metastasis of appendicular osteosarcoma (OSA) treated with toceranib. Medical records of 20 dogs with macroscopic pulmonary metastasis of OSA that received toceranib were reviewed. The median dose and duration of toceranib administration were 2.52 mg/kg (range: 2.12 to 2.72 mg/kg) and 60 days (range: 17 to 231 days). The median progression free survival (PFS) and overall survival (OS) were 36 days (range: 17 to 231 days) and 90 days (range: 17 to 433 days), respectively. The clinical benefit rate was 10% (2/20; 1 partial response and 1 stable disease). The longest length of initial pulmonary nodules had significant impact on both PFS ( P = 0.01) and OS ( P = 0.02). The prognosis for dogs with metastatic OSA was poor with only 10% of dogs showing clinical benefit from toceranib. These results suggest that toceranib may not improve outcome in dogs with macroscopic pulmonary metastasis of OSA.

Can near real-time monitoring of emergency department diagnoses facilitate early response to sporadic meningococcal infection? - prospective and retrospective evaluations

PubMed Central

2010-01-01

Background Meningococcal infection causes severe, rapidly progressing illness and reporting of cases is mandatory in New South Wales (NSW), Australia. The NSW Department of Health operates near real-time Emergency Department (ED) surveillance that includes capture and statistical analysis of clinical preliminary diagnoses. The system can provide alerts in response to specific diagnoses entered in the ED computer system. This study assessed whether once daily reporting of clinical diagnoses of meningococcal infection using the ED surveillance system provides an opportunity for timelier public health response for this disease. Methods The study involved a prospective and retrospective component. First, reporting of ED diagnoses of meningococcal infection from the ED surveillance system prospectively operated in parallel with conventional surveillance which requires direct telephone reporting of this scheduled medical condition to local public health authorities by hospitals and laboratories when a meningococcal infection diagnosis is made. Follow-up of the ED diagnoses determined whether meningococcal infection was confirmed, and the time difference between ED surveillance report and notification by conventional means. Second, cases of meningococcal infection reported by conventional surveillance during 2004 were retrospectively matched to ED visits to determine the sensitivity and positive predictive value (PPV) of ED surveillance. Results During the prospective evaluation, 31 patients were diagnosed with meningococcal infection in participating EDs. Of these, 12 had confirmed meningococcal disease, resulting in a PPV of 38.7%. All confirmed cases were notified earlier to public health authorities by conventional reporting. Of 149 cases of notified meningococcal disease identified retrospectively, 130 were linked to an ED visit. The sensitivity and PPV of the ED diagnosis for meningococcal infection was 36.2% and 36.7%, respectively. Conclusions Based on prospective

The Collaborative Assessment and Management of Suicidality versus Treatment as Usual: A Retrospective Study with Suicidal Outpatients

ERIC Educational Resources Information Center

Jobes, David A.; Wong, Steven A.; Conrad, Amy K.; Drozd, John F.; Neal-Walden, Tracy

2005-01-01

The Collaborative Assessment and Management of Suicidality (CAMS) is a novel clinical approach used to identify, assess, and manage suicidal outpatients (Jobes & Drozd, 2004). The results of a retrospective study evaluating the impact of CAMS versus treatment as usual (TAU) on suicidal outpatients are presented. Patients in the CAMS treatment…

Is Routine Pathologic Evaluation of Sebaceous Cysts Necessary?: A 15-Year Retrospective Review of a Single Institution.

PubMed

Gargya, Vipul; Lucas, Heather D; Wendel Spiczka, Amy J; Mahabir, Raman Chaos

2017-02-01

A question arose in our practice of whether all cysts considered sebaceous should be sent for pathologic evaluation. To address this controversial topic, we performed a retrospective study of our single institution's histopathology database. A natural language search of the CoPath database across the institution was undertaken using the diagnosis of sebaceous cyst, epidermal cyst, epidermoid cyst, epithelial cyst, infundibular cyst, pilar cyst, trichilemmal cyst, and steatocystoma. A surgical pathologic review of all specimens with one of these preexcision diagnoses was included in the 15-year retrospective study of 1998 to 2013. All slides were confirmed to have undergone histopathologic review, and the preexcision diagnoses were compared with the postexcision diagnoses. Chart review was undertaken in instances of a diagnosis of malignancy. A total of 13,746 samples were identified. Forty-eight specimens had histopathologic diagnosis of malignancy, for an incidence of 0.3% and with the most common malignancy being squamous cell carcinoma. Chart review showed that for all cases, the surgeons reported uncertainty with regard to the diagnosis because of history or physical characteristics, or both. In addition, a comprehensive literature review showed results consistent with our data and illustrated 19 cases during the past 10 years in which most of the findings were squamous cell carcinoma. We propose the recommendation that routine pathologic evaluation of sebaceous cysts is necessary only when clinical suspicion exists.

Evaluating Community Health Advisor (CHA) Core Competencies: The CHA Core Competency Retrospective Pretest/Posttest (CCCRP).

PubMed

Story, Lachel; To, Yen M

2016-05-01

Health care and academic systems are increasingly collaborating with community health advisors (CHAs) to provide culturally relevant health interventions that promote sustained community transformation. Little attention has been placed on CHA training evaluation, including core competency attainment. This study identified common CHA core competencies, generated a theoretically based measure of those competencies, and explored psychometric properties of that measure. A concept synthesis revealed five CHA core competencies (leadership, translation, guidance, advocacy, and caring). The CHA Core Competency Retrospective Pretest/Posttest (CCCRP) resulted from that synthesis, which was administered using multiple approaches to individuals who previously received CHA training (N= 142). Exploratory factor analyses revealed a two-factor structure underlying the posttraining data, and Cronbach's alpha indicated high internal consistency. This study suggested some CHA core competencies might be more interrelated than previously thought, and two major competencies exist rather than five and supported the CCCRP's use to evaluate core competency attainment resulting from training. © The Author(s) 2014.

Utility of retrospective pretest ratings of patient satisfaction with health status.

PubMed

Kreulen, Grace J; Stommel, Manfred; Gutek, Barbara A; Burns, Lawton R; Braden, Carrie Jo

2002-06-01

Outcomes assessment is often difficult to accomplish in evaluation research studies in situations where the gathering of pretest data is impossible or prohibitively expensive. The purpose of this longitudinal study was to investigate the substitutability of retrospective pretest ratings for actual pretest ratings in indexing change in patient satisfaction with health status. The sample consisted of 251 women receiving medical treatment for breast cancer enrolled in the Self-Help Intervention Project (SHIP). ANOVA, ordinary least-squares regression, and pooled time-series regression analysis revealed that retrospective assessments were not significantly different from their prospective counterparts in means and variances and that they differed from current assessments taken at the same time (p<.01). In addition, prospective assessments emerged as a significant independent predictor of corresponding retrospective scores (p<.01), accounting for up to 30% of the recall scores. These findings have implications for inclusion of retrospective pre-post comparisons in outcomes evaluation research. Copyright 2002 Wiley Periodicals, Inc. Res Nurs Health 25:233-241, 2002

Evaluation of three methods for retrospective correction of vignetting on medical microscopy images utilizing two open source software tools.

PubMed

Babaloukas, Georgios; Tentolouris, Nicholas; Liatis, Stavros; Sklavounou, Alexandra; Perrea, Despoina

2011-12-01

Correction of vignetting on images obtained by a digital camera mounted on a microscope is essential before applying image analysis. The aim of this study is to evaluate three methods for retrospective correction of vignetting on medical microscopy images and compare them with a prospective correction method. One digital image from four different tissues was used and a vignetting effect was applied on each of these images. The resulted vignetted image was replicated four times and in each replica a different method for vignetting correction was applied with fiji and gimp software tools. The highest peak signal-to-noise ratio from the comparison of each method to the original image was obtained from the prospective method in all tissues. The morphological filtering method provided the highest peak signal-to-noise ratio value amongst the retrospective methods. The prospective method is suggested as the method of choice for correction of vignetting and if it is not applicable, then the morphological filtering may be suggested as the retrospective alternative method. © 2011 The Authors Journal of Microscopy © 2011 Royal Microscopical Society.

Retrospective Study of Rocky Mountain Spotted Fever in Children.

PubMed

Tull, Rechelle; Ahn, Christine; Daniel, Alyssa; Yosipovitch, Gil; Strowd, Lindsay C

2017-03-01

Rocky Mountain spotted fever (RMSF), a lethal tick-borne illness, is prevalent in the south central United States. Children younger than 10 years old have the greatest risk of fatal outcome from RMSF. The objective of the current study was to review pediatric cases of RMSF seen in the dermatology consult service and to evaluate dermatology's role in the diagnosis and management of this disease. A retrospective review was performed of inpatient dermatology consultations at a tertiary care center in North Carolina from 2001 to 2011. Data collected included patient demographic characteristics, symptoms, pre- and postconsultation diagnoses, diagnostic procedures, length of hospital stay, and outcome. A total of 3,912 consultations were conducted in the dermatology service over 10 years. Six patients with RMSF, ranging in age from 22 months to 10 years (mean 5.1 years), were evaluated during April, May, and June. All preconsultation diagnoses included RMSF in the differential diagnosis. All patients underwent skin biopsies, and a culture was obtained in one case. Fifty percent of patients died within 4 days of hospitalization. Variables associated with mortality from RMSF are delayed diagnosis and initiation of antirickettsial therapy. Physicians should consider RMSF in children presenting with fever and rash during the summer months. Dermatology consultation is useful in evaluating patients with suspicious clinical features of RMSF with skin findings. © 2016 Wiley Periodicals, Inc.

Retrospective Descriptive Study of Cerebral Palsy in Nepal

ERIC Educational Resources Information Center

Thapa, Ritesh

2016-01-01

There is very little data pertaining to cerebral palsy (CP) from Nepal. In this retrospective study it was observed that dyskinetic CP was seen in 29% and the sex ratio of males to females was two in the study population of children with CP. Both of these are much higher than data from developed countries. Hence, further randomized cross-sectional…

Retrospective Benefit-Cost Evaluation of DOE Investment in Photovoltaic Energy Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

O'Connor, Alan C.; Loomis, Ross J.; Braun, Fern M.

2010-08-01

This study is a retrospective analysis of net benefits accruing from DOE's investment in photovoltaic (PV) technology development. The study employed a technology cluster approach. That is, benefits measured for a subset of technologies in a meaningful cluster, or portfolio, of technologies were compared to the total investment in the cluster to provide a lower bound measure of return for the entire cluster.

The pros and cons of intraoperative CT scan in evaluation of deep brain stimulation lead implantation: A retrospective study

PubMed Central

Servello, Domenico; Zekaj, Edvin; Saleh, Christian; Pacchetti, Claudio; Porta, Mauro

2016-01-01

Background: Deep brain stimulation (DBS) is an established therapy for movement disorders, such as Parkinson's disease (PD), dystonia, and tremor. The efficacy of DBS depends on the correct lead positioning. The commonly adopted postoperative radiological evaluation is performed with computed tomography (CT) scan and/or magnetic resonance imaging (MRI). Methods: We conducted a retrospective study on 202 patients who underwent DBS from January 2009 to October 2013. DBS indications were PD, progressive supranuclear palsy, tremor, dystonia, Tourette syndrome, obsessive compulsive disorder, depression, and Huntington's disease. Preoperatively, all patients underwent brain MRI and brain CT scan with the stereotactic frame positioned. The lead location was confirmed intraoperatively with CT. The CT images were subsequently transferred to the Stealth Station Medtronic and merged with the preoperative planning. On the first or second day after, implantation we performed a brain MRI to confirm the correct position of the lead. Results: In 14 patients, leads were in suboptimal position after intraoperative CT scan positioning. The cases with alteration in the Z-axis were corrected immediately under fluoroscopic guidance. In all the 14 patients, an immediate repositioning was done. Conclusions: Based on our data, intraoperative CT scan is fast, safe, and a useful tool in the evaluation of the position of the implanted lead. It also reduces the patient's discomfort derived from the transfer of the patient from the operating room to the radiological department. However, intraoperative CT should not be considered as a substitute for postoperative MRI. PMID:27583182

Issues in Retrospective Conversion for a Small Special Collection: A Case Study.

ERIC Educational Resources Information Center

Hieb, Fern

1997-01-01

Small special collections present unique problems for retrospective conversion of catalogs to machine-readable form. Examines retrospective conversion using the Moravian Music Foundation as a case study. Discusses advantages to automation, options for conversion process, quantifying conversion effort, costs, in-house conversion, national standards…

Use of a 1.0 Tesla open scanner for evaluation of pediatric and congenital heart disease: a retrospective cohort study.

PubMed

Lu, Jimmy C; Nielsen, James C; Morowitz, Layne; Musani, Muzammil; Ghadimi Mahani, Maryam; Agarwal, Prachi P; Ibrahim, El-Sayed H; Dorfman, Adam L

2015-05-25

Open cardiovascular magnetic resonance (CMR) scanners offer the potential for imaging patients with claustrophobia or large body size, but at a lower 1.0 Tesla magnetic field. This study aimed to evaluate the efficacy of open CMR for evaluation of pediatric and congenital heart disease. This retrospective, cross-sectional study included all patients ≤18 years old or with congenital heart disease who underwent CMR on an open 1.0 Tesla scanner at two centers from 2012-2014. Indications for CMR and clinical questions were extracted from the medical record. Studies were qualitatively graded for image quality and diagnostic utility. In a subset of 25 patients, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were compared to size- and diagnosis-matched patients with CMR on a 1.5 Tesla scanner. A total of 65 patients (median 17.3 years old, 60% male) were included. Congenital heart disease was present in 32 (50%), with tetralogy of Fallot and bicuspid aortic valve the most common diagnoses. Open CMR was used due to scheduling/equipment issues in 51 (80%), claustrophobia in 7 (11%), and patient size in 3 (5%); 4 patients with claustrophobia had failed CMR on a different scanner, but completed the study on open CMR without sedation. All patients had good or excellent image quality on black blood, phase contrast, magnetic resonance angiography, and late gadolinium enhancement imaging. There was below average image quality in 3/63 (5%) patients with cine images, and 4/15 (27%) patients with coronary artery imaging. SNR and CNR were decreased in cine and magnetic resonance angiography images compared to 1.5 Tesla. The clinical question was answered adequately in all but 2 patients; 1 patient with a Fontan had artifact from an embolization coil limiting RV volume analysis, and in 1 patient the right coronary artery origin was not well seen. Open 1.0 Tesla scanners can effectively evaluate pediatric and congenital heart disease, including patients with claustrophobia

A retrospective evaluation method for in vitro mammalian genotoxicity tests using cytotoxicity index transformation formulae.

PubMed

Fujita, Yurika; Kasamatsu, Toshio; Ikeda, Naohiro; Nishiyama, Naohiro; Honda, Hiroshi

2016-01-15

Although in vitro chromosomal aberration tests and micronucleus tests have been widely used for genotoxicity evaluation, false-positive results have been reported under strong cytotoxic conditions. To reduce false-positive results, the new Organization for Economic Co-operation and Development (OECD) test guideline (TG) recommends the use of a new cytotoxicity index, relative increase in cell count or relative population doubling (RICC/RPD), instead of the traditionally used index, relative cell count (RCC). Although the use of the RICC/RPD may result in different outcomes and require re-evaluation of tested substances, it is impractical to re-evaluate all existing data. Therefore, we established a method to estimate test results from existing RCC data. First, we developed formulae to estimate RICC/RPD from RCC without cell counts by considering cell doubling time and experiment time. Next, the accuracy of the cytotoxicity index transformation formulae was verified by comparing estimated RICC/RPD and measured RICC/RPD for 3 major chemicals associated with false-positive genotoxicity test results: ethyl acrylate, eugenol and p-nitrophenol. Moreover, 25 compounds with false-positive in vitro chromosomal aberration (CA) test results were re-evaluated to establish a retrospective evaluation method based on derived estimated RICC/RPD values. The estimated RICC/RPD values were in good agreement with the measured RICC/RPD values for every concentration and chemical, and the estimated RICC suggested the possibility that 12 chemicals (48%) with previously judged false-positive results in fact had negative results. Our method enables transformation of RCC data into RICC/RPD values with a high degree of accuracy and will facilitate comprehensive retrospective evaluation of test results. Copyright © 2015 Elsevier B.V. All rights reserved.

Evaluation of a proposed expert system development methodology: Two case studies

NASA Technical Reports Server (NTRS)

Gilstrap, Lewey

1990-01-01

Two expert system development projects were studied to evaluate a proposed Expert Systems Development Methodology (ESDM). The ESDM was developed to provide guidance to managers and technical personnel and serve as a standard in the development of expert systems. It was agreed that the proposed ESDM must be evaluated before it could be adopted; therefore a study was planned for its evaluation. This detailed study is now underway. Before the study began, however, two ongoing projects were selected for a retrospective evaluation. They were the Ranging Equipment Diagnostic Expert System (REDEX) and the Backup Control Mode Analysis and Utility System (BCAUS). Both projects were approximately 1 year into development. Interviews of project personnel were conducted, and the resulting data was used to prepare the retrospective evaluation. Decision models of the two projects were constructed and used to evaluate the completeness and accuracy of key provisions of ESDM. A major conclusion reached from these case studies is that suitability and risk analysis should be required for all AI projects, large and small. Further, the objectives of each stage of development during a project should be selected to reduce the next largest area of risk or uncertainty on the project.

Data Reports for Retrospective Case Study in Killdeer, North Dakota

EPA Pesticide Factsheets

Data from sampling events conducted in Killdeer, North Dakota as part of EPA's Study of the Potential Impacts of Hydraulic Fracturing for Oil and Gas on Drinking Water Resources, retrospective case study

A retrospective study of chronic nasal disease in 75 dogs.

PubMed

Lobetti, R G

2009-12-01

Chronic nasal disease is a common problem in dogs. To determine the aetiology, a retrospective study in 75 dogs with persistent and chronic nasal disease was done. All dogs were evaluated by means of survey nasal radiographs, antegrade and retrograde rhinoscopy, bacterial and fungal cultures, and histopathology. A definitive diagnosis was made in 74/75 cases (98.6%). Nasal neoplasia was the most common diagnosis (46.7%), median age 108 months, followed by lympho-plasmacytic rhinitis (20%), median age 112 months, and fungal rhinitis (10.7%), median age 53.5 months. Other diagnoses included nasal foreign body (5.3%), median age 51 months, and primary bacterial rhinitis (6.7%), median age 116.5 months. Rare aetiologies identified were nasal polyps, granulomatous rhinitis, oro-nasal fistula and naso-pharyngeal stenosis. This study showed that by using a structured combination of survey radiography, rhinoscopy, cultures and histopathology, a diagnosis could be made in dogs with chronic nasal disease.

Data Reports for Retrospective Case Study in Wise County, Texas

EPA Pesticide Factsheets

Data reports from sampling events collected in wise county, texas as part of EPA's Study of the Potential Impacts of Hydraulic Fracturing for Oil and Gas on Drinking Water Resources, retrospective case study.

Brucellosis: a retrospective evaluation of 164 cases.

PubMed

Kazak, Esra; Akalın, Halis; Yılmaz, Emel; Heper, Yasemin; Mıstık, Reşit; Sınırtaş, Melda; Özakın, Cüneyt; Göral, Güher; Helvacı, Safiye

2016-11-01

Brucellosis is a public health problem that is prevalent in several developing countries. The clinical and laboratory characteristics of 164 cases of brucellosis in Bursa, Turkey, were retrospectively evaluated. The ages of the 164 patients ranged from 15-85 years. All of the patients underwent the Rose Bengal test and 163 (99.4%) patients tested positive. 122 (74.4%) patients were diagnosed with acute brucellosis, 31 (18.9%) with subacute brucellosis and 11 (6.7%) with chronic brucellosis. Focal involvement was found in 101 (61.6%) patients. Although patients with focal involvement had a higher white blood cell count (p = 0.002), those without focal involvement had higher aspartate transaminase and alanine transaminase values, and lower platelet values (p = 0.005, 0.007 and 0.039, respectively). Spondylodiscitis was observed on imaging in 58 (66.7%) of the 87 patients who presented with back pain. Among the 118 patients who were examined within the first month of treatment, 79 (66.9%) responded to treatment. The relapse rate was 11.6% among all 164 patients. Brucellosis should be considered as a differential diagnosis among patients who present with fever, and joint or back pain. Focal involvement should be investigated in the presence of leucocytosis, and subacute or chronic forms of brucellosis. To identify cases of spondylodiscitis, radiography should be performed in patients who present with back pain. Copyright: © Singapore Medical Association

Olfaction disorders: retrospective study.

PubMed

Gregorio, Luciano Lobato; Caparroz, Fábio; Nunes, Leonardo Mendes Acatauassú; Neves, Luciano Rodrigues; Macoto, Eduardo Kosugi

2014-01-01

The smell, subjective phenomenon of great importance, is poorly understood and studied in humans. Physicians with more knowledge about smell disorders tend to consider the phenomenon important and to better manage the diagnosis and its treatment. First to describe a sample of patients presenting with main complaint of disturbances of smell. And second, to show our experience on management and treatment of this disease. Retrospective cross-sectional cohort study. Sample description and assessment of treatment response in patients with main complaint of hyposmia or anosmia from January 2005 to October 2011. From 38 patients presented with main complaint of an olfactory disorder, 68.4% of the patients were presented with hyposmia and 31,5% with anosmia, with a mean duration of 30.8 months. The main etiologic diagnoses were idiopathic (31.5%), rhinitis (28.9%) and CRS with polyps (10.5%). Responses to treatment with topical steroids and alpha-lipoic acid were variable, as well as in the literature. Greater importance should be given to disorders of smell in practice of otolaryngologists, since its large differential diagnosis and the fact that could increase morbidity to patients, impacting on their quality of life.

Retrospective evaluation of patients with organizing pneumonia: is cryptogenic organizing pneumonia different from secondary organizing pneumonia?

PubMed

Yılmaz, Saliha; Akıncı Özyürek, Berna; Erdoğan, Yurdanur; Cirit Koçer, Burcu; Demirağ, Funda; Dadalı, Yeliz; Büyükyaylacı Özden, Sertaç

2017-03-01

Organizing pneumonia (OP) is an uncommon clinic opathological situation among lung diseases. If no underlying cause can be detected, it is named as cryptogenic OP (COP). In this study, the etiologic and clinical characteristics of patients diagnosed as OP in our hospital in the last ten years were evaluated retrospectively. It was also aimed to make a comparison between COP and secondary OP patients. One hundred sixty-five patients diagnosed as OP pathologically in the 10 year period from August 2003 to August 2013 were included into that study. Patients' data were evaluated retrospectively from the medical records. One hundred sixty five patients pathologically diagnosed as OP were included. Diagnostic methods were trans-thoracic fine-needle biopsy (TTFNB) in 89 (53.9%) patients, open lung biopsy (lobectomy, wedge resection, segmentectomy) in 52 (31.5%) patients and transbronchial biyopsy (TBB) in 24 (14.5%) patients. One hundred (60.6%) of the patients were defined as COP and 65 (39.4%) as secondary OP. Cough, fatigue and dyspnea were the most common symptoms on admission. We detected OP cases secondary to anthracosis and cyst hydatic besides other well known etiologies. In 61 patients, the main radiologic manifestation was multiple bilateral patchy consolidation typical for OP. In 76 patients focal lesions (solid mass, cavitating mass lesion) and in 6 patients infiltrative opacities were detected radiologically. There is no difference between properties of OP from clinical, laboratory and radiologic finding sin the criptogenic and seconder form of OP. Although it is not asserted, cyst hidatic and anthracosis could be kept in mind for the list of underlying ethiologies for secondary OP.

Comparative evaluation of anchorage loss between self-ligating appliance and Conventional pre-adjusted edgewise appliance using sliding mechanics - A retrospective study.

PubMed

Juneja, Pankaj; Shivaprakash, G; Chopra, S S; Kambalyal, P B

2015-12-01

Although a number of studies have been undertaken to evaluate the friction characteristics of self-ligating brackets, there have been only few studies which have actually evaluated the clinical efficiency of these self-ligating brackets. This study was done to evaluate the clinical efficiency of Passive SLB (Smart Clip) in terms of anchorage loss and total treatment duration by comparing it with a Conventional pre-adjusted edgewise (M.B.T.) bracket system. This was a retrospective study in which the study sample comprised of ten patients treated with Passive SLB (Smart Clip, 0.022″) and ten patients treated with Conventional pre-adjusted edgewise (M.B.T.) bracket system (0.022″) who required therapeutic extraction of U/L first premolars as a part of their orthodontic treatment plan. Pretreatment and post treatment lateral cephalograms were taken to evaluate the amount of anchorage loss. The total time required to complete the treatment was also recorded. Anchorage loss observed with Passive SLB (Smart Clip) sagittally was 1.90 ± 0.68 mm in the maxilla and 1.90 ± 0.43 mm in the mandible and vertically was 0.52 ± 0.53 mm in the maxilla and 0.70 ± 0.69 mm in the mandible. Anchorage loss observed with Conventional pre-adjusted edgewise (M.B.T.) bracket system sagittally was 2.08 ± 0.43 mm in the maxilla and 1.95 ± 0.44 mm in the mandible and vertically was 0.50 ± 0.49 mm in the maxilla and 0.68 ± 0.53 mm in the mandible. The average time taken for the completion of treatment in Passive SLB (Smart Clip) and Conventional pre-adjusted edgewise (M.B.T.) bracket system was 14.0 ± 2.4 and 17.2 ± 2.6 months respectively. There was no statistically significant difference in the quantum of anchor loss between Smart Clip self-ligating bracket system and Conventional pre-adjusted edgewise (M.B.T.) bracket system although Smart Clip self-ligating bracket system is efficient in reducing the overall treatment time.

Curriculum evaluation and revision in a nascent field: the utility of the retrospective pretest--posttest model in a homeland security program of study.

PubMed

Pelfrey, William V; Pelfrey, William V

2009-02-01

Although most academic disciplines evolve at a measured pace, the emerging field of homeland security must, for reasons of safety and security, evolve rapidly. The Department of Homeland Security sponsored the establishment of a graduate educational program for key officials holding homeland security roles. Because homeland security is a nascent field, the establishment of a program curriculum was forced to draw from a variety of disciplines. Curriculum evaluation was complicated by the rapid changes occurring in the emerging discipline, producing response shift bias, and interfering with the pre-post assessments. To compensate for the validity threat associated with response shift bias, a retrospective pretest-posttest evaluative methodology was used. Data indicate the program has evolved in a significant and orderly fashion and these data support the use of this innovative evaluation approach in the development of any discipline.

The role of matched controls in building an evidence base for hospital-avoidance schemes: a retrospective evaluation.

PubMed

Steventon, Adam; Bardsley, Martin; Billings, John; Georghiou, Theo; Lewis, Geraint Hywel

2012-08-01

To test whether two hospital-avoidance interventions altered rates of hospital use: "intermediate care" and "integrated care teams." Linked administrative data for England covering the period 2004 to 2009. This study was commissioned after the interventions had been in place for several years. We developed a method based on retrospective analysis of person-level data comparing health care use of participants with that of prognostically matched controls. Individuals were linked to administrative datasets through a trusted intermediary and a unique patient identifier. Participants who received the intermediate care intervention showed higher rates of unscheduled hospital admission than matched controls, whereas recipients of the integrated care team intervention showed no difference. Both intervention groups showed higher rates of mortality than did their matched controls. These are potentially powerful techniques for assessing impacts on hospital activity. Neither intervention reduced admission rates. Although our analysis of hospital utilization controlled for a wide range of observable characteristics, the difference in mortality rates suggests that some residual confounding is likely. Evaluation is constrained when performed retrospectively, and careful interpretation is needed. © Health Research and Educational Trust.

Evaluation of four designs of short implants placed in atrophic areas with reduced bone height: a three-year, retrospective, clinical and radiographic study.

PubMed

Lopez Torres, J A; Gehrke, S A; Calvo Guirado, J L; Aristazábal, L F R

2017-09-01

The aim of the present study was to evaluate retrospectively the clinical and radiographic behaviour of four commercially-available short implants with different macrodesigns and microdesigns in areas in which the height of the bone was reduced. We took into account the success and survival, peri-implant crestal bone loss, and the level of probing at which the gum bled. Patients were included if they had been given one or more short implants (≤8.5mm long) in the posterior jaws at least three years earlier. Three hundred and ninety-one short implants were placed in 170 subjects, and were divided in four groups based on the brand of implant. The implants were evaluated one, two, and three years after they had been inserted. Short implants had a three-year survival and success rate of 90% in all groups, and bone loss was acceptable after three years with no significant differences between them. These results support the use of short implants as an effective and safe treatment. However, within the limitations of this study, the design of the implant does seem to influence the behaviour of peri-implant bone at the crestal level. Copyright © 2017. Published by Elsevier Ltd.

The heterogeneous management of pediatric ankle traumas: A retrospective descriptive study.

PubMed

Voizard, Philippe; Moore, James; Leduc, Stéphane; Nault, Marie-Lyne

2018-06-01

Frequent misdiagnosis of pediatric ankle traumas leads to inappropriate management, which may result in residual pain, instability, slower return to physical activity, and long-term degenerative changes. The purpose of this study was to evaluate the consistency of diagnosis, management, and the treatment of acute lateral pediatric ankle trauma in a tertiary care pediatric hospital. The hypothesis was that the initial diagnosis is often incorrect, and the treatment varies considerably amongst orthopedic surgeons.We conducted a retrospective study of all cases of ankle sprains and Salter-Harris one (SH1) fractures referred to our orthopedic surgery service between May and August 2014. Exclusion criteria included ankle fractures other than SH1 types, and cases where treatment was initially undertaken elsewhere before referral to our service. Primary outcome was the difference between initial and final diagnosis.Among 3047 cases reviewed, 31 matched our inclusion criteria. Initial diagnosis was 20 SH1 fractures, 8 acute ankle sprains, and 3 uncertain, with a change in diagnosis for 48.5% at follow-up.Accurate diagnosis can be difficult in pediatric ankle trauma, with case management and specific treatments varying considerably. This study reinforces the need to evaluate the safety of a general treatment algorithm for all lateral ankle trauma with normal radiographs.Level of evidence III.

[Cooperation between emergency and forensic medicine - retrospective evaluation of pre-hospital emergency measures].

PubMed

Buschmann, Claas T; Kleber, Christian; Tsokos, Michael; Püschel, Klaus; Hess, Thorsten; Kerner, Thoralf; Stuhr, Markus

2015-06-01

Emergency medical research is subject to special conditions. Emergency patients e.g. are generally considered to be non-capable of giving consent. This results in sparse emergency medical data when compared to clinical observation studies under controlled conditions. After emergency medical treatment, deceased patients are not rarely subject to forensic investigation. The cooperation between emergency and forensic medicine has not only emergency medical training potential in individual cases, but also scientific innovation potential especially with respect to the retrospective evaluation of pre-hospital emergency measures. Such partnerships (like in Berlin at the Charité - Universitätsmedizin Berlin between the Institute of Legal Medicine and the Center for Musculoskeletal Surgery or in Hamburg between the Institute for Legal Medicine at the University Hospital and the Municipal Fire Brigade with the Emergency Medical Service) are yet exceptional in Germany. © Georg Thieme Verlag Stuttgart · New York.

The efficacy and safety of phototherapy in geriatric patients: a retrospective study*

PubMed Central

Bulur, Isil; Erdogan, Hilal Kaya; Aksu, Ayse Esra; Karapınar, Tekden; Saracoglu, Zeynep Nurhan

2018-01-01

Background While phototherapy is a well-established treatment for many dermatoses, data from the literature regarding its use in elderly patients are quite limited. Objective In this study, we aimed to determine the phototherapy indications in geriatric patients and to evaluate the effectiveness and reliability of phototherapy in this group. Methods This study included 95 patients of 65 years of age and older who were treated in our phototherapy unit between 2006 and 2015. The data for this study were collected retrospectively from patient follow-up forms in the phototherapy unit. Results Phototherapy was administered to 28 (29.5%) patients for mycosis fungoides, 25 (26.3%) patients foplaque type psoriasis, 12 (12.6%) patients for palmoplantar psoriasis, 12 (12.6%) patients for generalized pruritus, and 18 (19%) for other dermatoses. Of the patients, 64.2% had received a narrowband UVB (NB-UVB), 21.1% oral psoralen UVA (PUVA), and 14.7% local PUVA treatment. A complete response was achieved in 76.9-85.7% of the mycosis fungoides and in 73.71-100% of the psoriasis vulgaris patients treated with NB-UVB and PUVA, respectively. All the patients with generalized pruritus were treated with NB-UVB, and 80% of these patients achieved significant improvement. The erythema rate was found to be 0.43% per session for NB-UVB treatment and 0.46% per session for PUVA treatment as a side effect. Study limitations The limitations of our study are that it was retrospective and the remission durations of the patients are not known. Conclusion This study showed that phototherapy is effective and reliable in the elderly population with proper dose increases and close follow-up. PMID:29641694

Retrospective Study Evaluating Treatment Decisions and Outcomes of Childhood Uveitis Not Associated with Juvenile Idiopathic Arthritis.

PubMed

Sardar, Elham; Dusser, Perrine; Rousseau, Antoine; Bodaghi, Bahram; Labetoulle, Marc; Koné-Paut, Isabelle

2017-07-01

To evaluate treatment, ocular complications and outcomes of children with pediatric uveitis not associated with juvenile idiopathic arthritis. This was a retrospective chart review of pediatric uveitis in children under 16 years of age, recruited from the pediatric rheumatology department at Bicêtre Hospital from 2005 to 2015. Patients with juvenile idiopathic arthritis-associated and infectious uveitis were excluded. We used the Standardization of Uveitis Nomenclature Working Group to classify uveitis, disease activity, and treatment end points. We enrolled 56 patients and 102 affected eyes. The mean age at diagnosis was 10 ± 3.5 years (range 3-15), and the mean follow-up 4.2 ± 3.3 years (1-15). The main diagnoses were idiopathic (55%), Behçet disease (15%), and sarcoidosis (5%). The main localization was panuveitis in 44 of 102 eyes (43%). Corticosteroid sparing treatment was needed in 62 of 102 eyes (60%). Second-line therapies included methotrexate and azathioprine, and the third-line therapy was a biologic agent, mainly infliximab, in 33 of 102 eyes (32%). Infliximab achieved uveitis inactivity in 14 of 18 eyes (80%), in all etiologies. Severe complications were present in 68 of 102 eyes (67%). The most common were synechiae 33% of eyes, cataract (20%), and macular edema (25%). Of these, 37% were present at diagnosis. Remission was achieved in 22 of 102 eyes (21%). Conventional therapies were insufficient to treat many of the cases of posterior or panuveitis. This study underlines the need for earlier and more aggressive treatment and antitumor necrosis factor-α therapy was rapidly efficient in most cases of refractory uveitis. Copyright © 2017 Elsevier Inc. All rights reserved.

Uncovering the problem-solving process: cued retrospective reporting versus concurrent and retrospective reporting.

PubMed

van Gog, Tamara; Paas, Fred; van Merriënboer, Jeroen J G; Witte, Puk

2005-12-01

This study investigated the amounts of problem-solving process information ("action," "why," "how," and "metacognitive") elicited by means of concurrent, retrospective, and cued retrospective reporting. In a within-participants design, 26 participants completed electrical circuit troubleshooting tasks under different reporting conditions. The method of cued retrospective reporting used the original computer-based task and a superimposed record of the participant's eye fixations and mouse-keyboard operations as a cue for retrospection. Cued retrospective reporting (with the exception of why information) and concurrent reporting (with the exception of metacognitive information) resulted in a higher number of codes on the different types of information than did retrospective reporting.

Brucellosis: a retrospective evaluation of 164 cases

PubMed Central

Kazak, Esra; Akalın, Halis; Yılmaz, Emel; Heper, Yasemin; Mıstık, Reşit; Sınırtaş, Melda; Özakın, Cüneyt; Göral, Güher; Helvacı, Safiye

2016-01-01

INTRODUCTION Brucellosis is a public health problem that is prevalent in several developing countries. METHODS The clinical and laboratory characteristics of 164 cases of brucellosis in Bursa, Turkey, were retrospectively evaluated. RESULTS The ages of the 164 patients ranged from 15–85 years. All of the patients underwent the Rose Bengal test and 163 (99.4%) patients tested positive. 122 (74.4%) patients were diagnosed with acute brucellosis, 31 (18.9%) with subacute brucellosis and 11 (6.7%) with chronic brucellosis. Focal involvement was found in 101 (61.6%) patients. Although patients with focal involvement had a higher white blood cell count (p = 0.002), those without focal involvement had higher aspartate transaminase and alanine transaminase values, and lower platelet values (p = 0.005, 0.007 and 0.039, respectively). Spondylodiscitis was observed on imaging in 58 (66.7%) of the 87 patients who presented with back pain. Among the 118 patients who were examined within the first month of treatment, 79 (66.9%) responded to treatment. The relapse rate was 11.6% among all 164 patients. CONCLUSION Brucellosis should be considered as a differential diagnosis among patients who present with fever, and joint or back pain. Focal involvement should be investigated in the presence of leucocytosis, and subacute or chronic forms of brucellosis. To identify cases of spondylodiscitis, radiography should be performed in patients who present with back pain. PMID:26768063

A retrospective study of nineteen ataxic horses

PubMed Central

Nappert, Germain; Vrins, André; Breton, Luc; Beauregard, Michel

1989-01-01

A retrospective study of 19 ataxic horses admitted to the College of Veterinary Medicine of the University of Montreal during the period of January 1985 to December 1988 is presented. There were 11 cases of cervical vertebral malformation, four of equine degenerative myeloencephalopathy, two of equine protozoal myeloencephalitis, one each of vertebral osteomyelitis and intervertebral disc protrusion. The clinical diagnosis of ataxia in horses requires neurological, radiographic, myelographic, and laboratory examinations. ImagesFigure 1.Figure 2.Figure 3. PMID:17423438

Laser Therapy in the Treatment of Paresthesia: A Retrospective Study of 125 Clinical Cases.

PubMed

de Oliveira, Renata Ferreira; da Silva, Alessandro Costa; Simões, Alyne; Youssef, Michel Nicolau; de Freitas, Patrícia Moreira

2015-08-01

The aim of this retrospective study was to evaluate the effectiveness of laser therapy for acceleration and recovery of nerve sensitivity after orthognathic or minor oral surgeries, by analysis of clinical records of patients treated at the Special Laboratory of Lasers in Dentistry (LELO, School of Dentistry, University of São Paulo), throughout the period 2007-2013. Nerve tissue lesions may occur during various dental and routine surgical procedures, resulting in paresthesia. Laser therapy has been shown to be able to accelerate and enhance the regeneration of the affected nerve tissue; however, there are few studies in the literature that evaluate the effects of treatment with low-power laser on neural changes after orthognathic or minor oral surgeries. A total of 125 clinical records were included, and the data on gender, age, origin of the lesion, nerve, interval between surgery and onset of laser therapy, frequency of laser irradiation (one or two times per week), final evolution, and if there was a need to change the irradiation protocol, were all recorded. These data were related to the recovery of sensitivity in the affected nerve area. Descriptive analyses and modeling for analysis of categorical data (α=5%) were performed. The results from both analyses showed that the recovery of sensitivity was correlated with patient age (p=0.015) and interval between surgery and onset of laser therapy (p=0.002). Within the limits of this retrospective study, it was found that low- power laser therapy with beam emission band in the infrared spectrum (808 nm) can positively affect the recovery of sensitivity after orthognathic or minor oral surgeries.

A comparison of the results of prospective and retrospective cohort studies in the field of digestive surgery.

PubMed

Ukai, Tomohiko; Shikata, Satoru; Nakayama, Takeo; Takemura, Yousuke C

2017-07-01

We compared the results of prospective and retrospective cohort studies in the field of digestive surgery to clarify whether the results of prospective cohort studies were more similar to those of randomized controlled trials (RCTs). We conducted a secondary analysis of the results to compare the results of RCTs with those of cohort studies in meta-analyses of 18 digestive surgical topics. The data from the prospective and retrospective cohort studies were combined. The summary estimates of each design were compared with those of RCTs. We used the Z score to investigate discrepancies. Twenty-nine outcomes of 11 topics were investigated in 289 cohort studies (prospective, n = 69; retrospective, n = 220). These were compared with the outcomes of 123 RCTs. In comparison to retrospective studies, the summary estimates of the prospective cohort studies were more similar to those of the RCTs [19/29 (prospective) vs. 10/29 (retrospective), P = 0.035). Five of the 29 outcomes of prospective studies and 6 of 29 outcomes of retrospective studies (P = 0.99) showed significant discrepancies in comparison to RCTs. In the digestive surgical field, the results of prospective cohort studies tended to be more similar to those of RCTs than retrospective studies; however, there were no significant discrepancies between the two types of cohort study.

Retrospective study evaluating the performance of a first-trimester combined screening for trisomy 21 in an Italian unselected population

PubMed Central

Padula, Francesco; Cignini, Pietro; Giannarelli, Diana; Brizzi, Cristiana; Coco, Claudio; D’Emidio, Laura; Giorgio, Elsa; Giorlandino, Maurizio; Mangiafico, Lucia; Mastrandrea, Marialuisa; Milite, Vincenzo; Mobili, Luisa; Nanni, Cinzia; Raffio, Raffaella; Taramanni, Cinzia; Vigna, Roberto; Mesoraca, Alvaro; Bizzoco, Domenico; Gabrielli, Ivan; Di Giacomo, Gianluca; Barone, Maria Antonietta; Cima, Antonella; Giorlandino, Francesca Romana; Emili, Sabrina; Cupellaro, Marina; Giorlandino, Claudio

2014-01-01

Objectives to assess the performance of a combined first-trimester screening for trisomy 21 in an unselected Italian population referred to a specialized private center for prenatal medicine. Methods a retrospective validation of first-trimester screening algorithms [risk calculation based on maternal age and nuchal translucency (NT) alone, maternal age and serum parameters (free β-hCG and PAPP-A) alone and a combination of both] for fetal aneuploidies evaluated in an unselected Italian population at Artemisia Fetal-Maternal Medical Centre in Rome. All measurements were performed between 11+0 and 13+6 weeks of gestation, between April 2007 and December 2008. Results of 3,610 single fetuses included in the study, we had a complete follow-up on 2,984. Fourteen of 17 cases of trisomy 21 were detected when a cut-off of 1:300 was applied [detection rate (DR) 82.4%, 95% confidence interval (CI) 64.2–100; false-positive rate (FPR) 4.7%, 95% CI 3.9–5.4; false-negative rate (FNR) 17.6%, 95% CI 0–35.8%]. Conclusion in our study population the detection rate for trisomy 21, using the combined risk calculation based on maternal age, fetal NT, maternal PAPP-A and free β-hCG levels, was superior to the application of either parameter alone. The algorithm has been validated for first trimester screening in the Italian population. PMID:26266002

Retrospective Evaluation of Milrinone Pharmacokinetics in Children With Kidney Injury.

PubMed

Gist, Katja M; Mizuno, Tomoyuki; Goldstein, Stuart L; Vinks, Alexander

2015-12-01

Milrinone is an inotropic agent with vasodilating properties used in the treatment of ventricular dysfunction. Milrinone is predominantly eliminated by the kidneys and accumulates in the setting of acute kidney injury (AKI). The purpose of this study was to evaluate milrinone pharmacokinetics in children with AKI with or without continuous renal replacement therapy (CRRT). Retrospective collection of milrinone therapeutic drug monitoring data in patients with AKI, including those requiring CRRT, through chart review from January 2008 to March 2014. Pharmacokinetic (PK) data were analyzed by Bayesian estimation using a pediatric population PK model (MW/Pharm). Clearance estimates were allometrically scaled to body weight. Data on 11 patients were available for analysis. Three patients required CRRT. Milrinone concentrations during continuous infusion varied 30-fold and ranged from 44 to 1343 ng/mL. Of the 33 samples obtained in 11 patients, 24 were outside the target range (72.7%), with 16 (48.5%) above and 8 (24.2%) below. Patients with AKI had significantly lower milrinone clearance (4.72 ± 2.26 L/h per 70 kg) compared with published data in patients without AKI. There was large between-patient variability in milrinone clearance (range: 2.91-13.6 L/h per 70 kg). Clearance in patients on CRRT ranged from 2.8 to 7.19 L/h per 70 kg. A significant correlation between milrinone clearance and estimated creatinine clearance was observed (r = 0.70, P = 0.0097). Allometrically scaled milrinone clearance was lower in the youngest patients (younger than 2 years), suggestive of ongoing renal maturation and existing AKI. Pediatric patients with AKI have significantly lower milrinone clearance compared with published data in patients without AKI. Large variability was noted in milrinone concentrations, and they were frequently outside the target range. The large between-patient variability in milrinone concentrations suggests that dosing regimens should be individualized in

[Diabetic retinopathy complications--12-year retrospective study].

PubMed

Ignat, Florica; Davidescu, Livia

2002-01-01

It is analyzed, on a retrospective study on 12 years, the incidence of diabetus melitus cases, hospitalized in the Ophthalmologic Clinic from Craiova with special mention to the frequency of the diabetic retinopathy, of it's complications and in an accordance to other general diseases, especially cardiovascular's, which contributes to the aggravation of the diabetic ocular in juries evolution. The study underlines the high incidence of the new founded cases with diabetus melitus in complicated diabetes retinopathy stage; the high frequency of ocular complications is explained, according to our statistic facts and through an insufficient treatment, sometimes incorrect and many other cases total neglected by the patients.

Retrospective evaluation of xylitol ingestion in dogs: 192 cases (2007-2012).

PubMed

DuHadway, Meghan R; Sharp, Claire R; Meyers, Katherine E; Koenigshof, Amy M

2015-01-01

To summarize the signalment, clinical signs, prevalence of decreased blood glucose concentration (BG), prevalence of increased liver values, treatment, and outcome in dogs known to have ingested xylitol. Retrospective study from December 2007 to February 2012 SETTING: Three university teaching hospitals. One hundred ninety-two client-owned dogs with known or suspected xylitol ingestion. None. The median ingested xylitol dose was 0.32 g/kg (range 0.03-3.64 g/kg). Clinical signs were present in 39 (20%) dogs on presentation to the veterinary teaching hospitals. The most common clinical sign was vomiting (n = 25), followed by lethargy (12). The median duration of clinical signs prior to presentation was 93 minutes (range 0-5,040 minutes). Dogs that developed clinical signs ingested a significantly higher dose of xylitol than those that were asymptomatic. Thirty dogs became hypoglycemic (BG ≤ 3.3 mmol/L [60 mg/dL]) at some time point during their hospitalization. When evaluating all dogs, there was a significant difference between the initial and lowest BGs. Thirty dogs had increased alanine aminotransferase activity or total serum bilirubin concentration. Dogs with increases in alanine aminotransferase activity or total serum bilirubin concentration had a significantly lower nadir BG. All dogs survived to discharge and 158 were known to be alive at 28 days. The rest were lost to follow up. The prognosis for dogs evaluated by a veterinarian that ingest lower doses of xylitol and do not develop liver failure is excellent. Dogs ingesting xylitol should be hospitalized and monitored for variations in BG, because BG drops in most dogs following presentation. Additional studies are needed in dogs ingesting higher doses of xylitol before correlations between dose and the development of clinical signs or liver failure can be established. Treatment and prognosis for these dogs warrants further investigation. © Veterinary Emergency and Critical Care Society 2015.

Indonesia Cohort of IO HAT Study to Evaluate Diabetes Management, Control, and Complications in Retrospective and Prospective Periods Among Insulin-Treated Patients with Type 1 and Type 2 Diabetes.

PubMed

Rudijanto, Achmad; Saraswati, Made R; Yunir, Em; Kumala, Poppy; Puteri, Happy Hs; Mandang, Veny Vv

2018-01-01

hypoglycemia is a major adverse event of insulin therapy for diabetes mellitus patients. The study was conducted to evaluate the incidence of hypoglycemia among insulin treated patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) in the Indonesian cohort. this Indonesian cohort study consisted of retrospective and prospective evaluation of hypoglycemic episodes, using International Operations Hypoglycemia Assessment Tool (IO HAT) in 374 patients with diabetes (T1DM; n=17 or T2DM; n=357). The patients of ≥18 years of age and treated with insulin for >12 months were selected for this study (ClinicalTrials.gov number: NCT02306681). a total of 374 patients were enrolled in this study and completed SAQ1. All patients with T1DM (17 [100%]), and 347 (97.2%) patients with T2DM completed SAQ2. Almost all the patients in the 4-week prospective period reported at least one hypoglycemic event (T1DM 100%, T2DM 99.4%) and the incidence rate of any hypoglycemia was 67.5 events per patient-year (PPY) and 25.7 events PPY for T1DM and T2DM patients, respectively. Among patients with T1DM and T2DM, 5.9% and 36.4%, respectively, did not know what hypoglycemia was at baseline, also high proportion of patients had impaired hypoglycemic awareness in the study (82.4% and 62.7%, respectively). overall, high proportion of patients reported hypoglycemic events in the prospective period indicating under reporting during the retrospective period due to recall bias. Therefore, there is a need for patient education program to improve the awareness of hypoglycemia in diabetes patient in Indonesia.

Retrospective clinical evaluation of ceramic onlays placed by dental students.

PubMed

Archibald, Jennifer J; Santos, Gildo Coelho; Moraes Coelho Santos, Maria Jacinta

2017-09-16

Indirect restorations with partial or complete occlusal surface coverage have been recommended to restore teeth with weakened walls in order to prevent cusp fracture. The success of these restorations when performed by dental students is unknown. The purpose of this retrospective study was to evaluate the clinical performance of adhesively bonded ceramic onlay restorations placed by third- and fourth-year dental students. Sixty-five ceramic onlays were placed in patients between 2009 and 2015. The onlays were laboratory or chairside fabricated with a computer-aided design and computer-aided manufacturing (CAD-CAM) system, using either IPS e.max Press or IPS e.max CAD. An adhesive technique and luting composite resin agent were used to cement the restorations. Thirty-seven onlays were evaluated clinically using the modified United States Public Health Service (USPHS) criteria. Data were statistically analyzed using the Cox proportional hazards model to compare tooth type and failures and the Fisher exact and McNemar tests to compare the USPHS criteria for significant differences (α=.05). Survival probability was calculated using the Kaplan-Meier algorithm. Five onlays were considered to be failures and needed replacement. According to the Kaplan-Meier analysis, the estimated survival rate was 96.3% after 2 years and 91.5% at 4 years. All 5 of the failures occurred on molars (13.5%) and none on premolars (P=.025). A statistically significant difference was found for marginal discoloration between onlays placed within 0 to 3 years and 3 to 6 years (P<.05) but no differences between any other criteria. Ceramic onlays placed by dental students demonstrated acceptable long-term clinical performance. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Risk factors associated with early implant failure: A 5-year retrospective clinical study.

PubMed

Olmedo-Gaya, Maris Victoria; Manzano-Moreno, Francisco J; Cañaveral-Cavero, Esther; de Dios Luna-del Castillo, Juan; Vallecillo-Capilla, Manuel

2016-02-01

The replacement of lost teeth with dental implants is a widespread treatment whose associated problems are also frequently encountered. Nevertheless, the factors associated with early implant failure have not been well documented. Further analyses of the factors influencing osseointegration establishment are required to maximize the predictability of the procedure and minimize implant failures. The purpose of this retrospective clinical study was to explore the association between possible risk factors and early implant failure. This retrospective clinical study evaluated 142 participants who received 276 external connection BTI implants between 2007 and 2011. Participant variables (age, sex, systemic disease, tobacco use, alcohol consumption, bruxism, and degree of periodontal disease), implant variables (type of edentulism, localization, area, diameter, length, and bone quality), intervention variables (expansion mechanisms, sinus augmentation techniques, bone regeneration, and implant insertion), and postoperative variables (presence of pain/inflammation at 1 week postsurgery) were studied. A multilevel logistic regression model (mixed effects-type model) was used to determine the influence of variables on early implant failure. Early implant failure was significantly associated with the male sex (P=.001), severe periodontal disease (P=.005), short implants (P=.001), expansion technique (P=.002), and postoperative pain/inflammation at 1 week postsurgery (P<.001). Early dental implant failure is more frequent in men and in individuals with severe periodontal disease, short implants, pain/inflammation at 1 week postsurgery, or bone expansion treatment. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)

PubMed Central

2011-01-01

Background Median sternotomy infection and bony nonunion are two commonly described complications which occur in 0.4 - 5.1% of cardiac procedures. Although relatively infrequent, these complications can lead to significant morbidity and mortality. The aim of this retrospective study is to evaluate the initial experience of a transverse plate fixation system following wound complications associated with sternal dehiscence with or without infection following cardiac surgery. Methods A retrospective chart review of 40 consecutive patients who required sternal wound reconstruction post sternotomy was performed. Soft tissue debridement with removal of all compromised tissue was performed. Sternal debridement was carried using ronguers to healthy bleeding bone. All patients underwent sternal fixation using three rib plates combined with a single manubrial plate (Titanium Sternal Fixation System®, Synthes). Incisions were closed in a layered fashion with the pectoral muscles being advanced to the midline. Data were expressed as mean ± SD, Median (range) or number (%). Statistical analyses were made by using Excel 2003 for Windows (Microsoft, Redmond, WA, USA). Results There were 40 consecutive patients, 31 males and 9 females. Twenty two patients (55%) were diagnosed with sternal dehiscence alone and 18 patients (45%) with associated wound discharge. Thirty eight patients went on to heal their wounds. Two patients developed recurrent wound infection and required VAC therapy. Both were immunocompromised. Median post-op ICU stay was one day with the median hospital stay of 18 days after plating. Conclusion Sternal plating appears to be an effective option for the treatment of sternal wound dehiscence associated with sternal instability. Long-term follow-up and further larger studies are needed to address the indications, benefits and complications of sternal plating. PMID:21529357

Trade Policy and Health: Adding Retrospective Studies to the Research Agenda

PubMed Central

Blouin, Chantal

2017-01-01

Prospective studies of the potential health consequences of trade and investment treaties, such as the Trans-Pacific Partnership, are critical. These studies can make visible to trade policy-makers the potential negative impacts associated to such treaties and can influence the outcomes of such negotiations. However, few researchers have examined retrospectively the consequences of trade agreements. With more than 400 trade agreements and more than 2000 investment treaties currently in force, researchers have a large corpus of agreements to analyse in order to assess not only their potential impacts on health system and population health, but also their actual impacts. This comment suggests some research questions that would benefit from retrospective inquiry. PMID:28812809

Diagnostic workup for fever of unknown origin: a multicenter collaborative retrospective study.

PubMed

Naito, Toshio; Mizooka, Masafumi; Mitsumoto, Fujiko; Kanazawa, Kenji; Torikai, Keito; Ohno, Shiro; Morita, Hiroyuki; Ukimura, Akira; Mishima, Nobuhiko; Otsuka, Fumio; Ohyama, Yoshio; Nara, Noriko; Murakami, Kazunari; Mashiba, Kouichi; Akazawa, Kenichiro; Yamamoto, Koji; Senda, Shoichi; Yamanouchi, Masashi; Tazuma, Susumu; Hayashi, Jun

2013-12-20

Fever of unknown origin (FUO) can be caused by many diseases, and varies depending on region and time period. Research on FUO in Japan has been limited to single medical institution or region, and no nationwide study has been conducted. We identified diseases that should be considered and useful diagnostic testing in patients with FUO. A nationwide retrospective study. 17 hospitals affiliated with the Japanese Society of Hospital General Medicine. This study included patients ≥18 years diagnosed with 'classical fever of unknown origin' (axillary temperature ≥38°C at least twice over a ≥3-week period without elucidation of a cause at three outpatient visits or during 3 days of hospitalisation) between January and December 2011. A total of 121 patients with FUO were enrolled. The median age was 59 years (range 19-94 years). Causative diseases were infectious disease in 28 patients (23.1%), non-infectious inflammatory disease in 37 (30.6%), malignancy in 13 (10.7%), other in 15 (12.4%) and unknown in 28 (23.1%). The median interval from fever onset to evaluation at each hospital was 28 days. The longest time required for diagnosis involved a case of familial Mediterranean fever. Tests performed included blood cultures in 86.8%, serum procalcitonin in 43.8% and positron emission tomography in 29.8% of patients. With the widespread use of CT, FUO due to deep-seated abscess or solid tumour is decreasing markedly. Owing to the influence of the ageing population, polymyalgia rheumatica was the most frequent cause (9 patients). Four patients had FUO associated with HIV/AIDS, an important cause of FUO in Japan. In a relatively small number of cases, cause remained unclear. This may have been due to bias inherent in a retrospective study. This study identified diseases that should be considered in the differential diagnosis of FUO.

Clinical study of children with cryofibrinogenemia: a retrospective study from a single center.

PubMed

Chou, Hsiao-Feng; Wu, Yu-Hung; Ho, Che-Sheng; Kao, Yu-Hsuan

2018-04-24

This study aimed to evaluate the demographic, clinical features, laboratory data, pathology and other survey in pediatric patients with cryofibrinogenemia. A 12-year retrospective chart review identified eight pediatric patients at Mackay Memorial Hospital, Taipei, Taiwan. The female-to-male ratio was 3:1. The mean age at symptom onset and of diagnosis was 10.3 ± 4.6 years and 12.3 ± 4 years, respectively. One child (12.5%) had primary cryofibrinogenemia. The common symptoms were purpura, arthralgia, and muscle weakness (100%). On laboratory examination, cryofibrinogen was positive in all patients. All patients had increased anti-thrombin III while 87.5% and 62.5% had abnormal protein S and protein C, respectively. All eight also complained of neurologic symptoms. One had vertebral artery narrowing, two showed increased T2-weighted signal intensity on the thalamus or white matter, and one had acute hemorrhagic encephalomyelitis on brain magnetic resonance imaging. This study reports on the presentations of cryofibrinogenemia, which is rare in children. Most cases are associated with autoimmune disease and have severe and complex presentations. Central nervous system involvement is common.

Cement burns: retrospective study of 18 cases and review of the literature.

PubMed

Poupon, M; Caye, N; Duteille, F; Pannier, M

2005-11-01

Cement is increasingly used in the construction industry, but the occurrence of cement burns is rarely reported. This retrospective study concerns patients treated for cement burns in our unit between 1997 and 2002. Eighteen patients 18-64 years of age, treated previously in our unit for cement burns, were interviewed by telephone for evaluation. The mean time since treatment was 39 months. Burns were predominantly seen on the lower limbs, and a third occurred during an accident on the job. All deep burns were excised, and 16 patients received grafts. Mean hospital stay was 10 days, and mean sick leave 2 months. Our study indicated that all patients were poorly informed about cement-related risks. Surgical treatment of full-thickness cement burns at diagnosis enables rapid healing with a minimum of sequelae and reduces the high socioeconomic costs resulting from these lesions. This study indicates once again the need to improve preventive measures; which are very often inadequate because of lack of awareness of risks.

Oral paracoccidioidomycosis: a retrospective study of 62 Brazilian patients.

PubMed

Bicalho, R N; Santo, M F; de Aguiar, M C; Santos, V R

2001-01-01

The purpose of this study was to evaluate retrospectively the profile of patients with oral paracoccidioidomycosis referred to two Dental Schools in Belo Horizonte (MG, Brazil) between 1955 and 1998. Despite the importance of the oral manifestations of this disease, few papers in the English literature have provided epidemiological data. The medical records of 62 patients presenting oral paracoccidioidomycosis were reviewed in detail. Patient age, gender, race, occupation, site of lesion and type of clinical manifestation of the disease were tabulated. There was a predominance of male patients (97%), with a male:female ratio of 30:1. The mean age was 40 years. Most of the patients were farm workers (53%). Some patients presented multiple oral lesions (19 cases, 30%). The fungal lesions were found principally in the alveolar process and gingiva, but were also seen on the palate, lip and buccal mucosa. All patients had chronic proliferative mulberry-like ulcerated oral lesions and the diagnosis was confirmed histologically. The clinical records did not contain notes about pulmonary involvement by the lesions. The purpose of this study was to describe the epidemiological profile of a specific population with the diagnosis of oral paracoccidioidomycosis. The major goal is to establish a scientific basis for initiating educational programs for prevention and early diagnosis of oral paracoccidioidomycosis.

Usefulness of vessel-sealing devices for peripartum hysterectomy: a retrospective cohort study.

PubMed

Rossetti, Diego; Vitale, Salvatore Giovanni; Bogani, Giorgio; Rapisarda, Agnese Maria Chiara; Gulino, Ferdinando Antonio; Frigerio, Luigi

2015-09-01

To evaluate the feasibility to perform peripartum hysterectomy (PH) with the introduction of LigaSure™ vessels-sealing device (LVSD) and how it influenced the surgical outcomes. We retrospectively evaluated procedures and outcome of women undergoing PH during the period between January 2001 and October 2013. Perioperative surgical results of patients undergoing PH using LVSD were compared to patients undergoing PH without LVSD. Forty-nine subjects had PH during the study period. Twenty (41%) hysterectomies were performed for placenta accreta, 8 (16%) for placenta previa, 21 (43%) for atony. Twenty-three subjects had PH using LVSD and 26 subjects had hysterectomy without the use of this device. We observe significant differences in estimated blood loss (p = 0.001), massive blood transfusions (>10 units RBC) (p = 0.025), operative time (p = 0.06). No difference in term of hospital stay and complications were observed (p = 0.78 and p = 0.35). One patient for each group had intraoperative complication (p = 0.9). The use of LVSD during PH does not increase operative complications, blood loss, and operative time in comparison to standard procedure.

Retrospective Study of Obesity in Children with Down Syndrome.

PubMed

Basil, Janet S; Santoro, Stephanie L; Martin, Lisa J; Healy, Katherine Wusik; Chini, Barbara A; Saal, Howard M

2016-06-01

To assess whether children with Down syndrome in the US are at an increased risk for obesity, we determined the obesity prevalence and analyzed obesity development throughout childhood in a cohort of children with Down syndrome. In addition, we analyzed a comorbidity that is associated with Down syndrome and obesity, obstructive sleep apnea syndrome (OSAS). This study was a retrospective chart review that evaluated 303 children ages 2 through 18 years with a diagnosis of Down syndrome. All children were patients at Cincinnati Children's Hospital Medical Center with multiple height and weight measurements. To determine obesity burden, the rate of obesity was compared with a local control cohort using contingency tables. Change in obesity rate through time was determined with mixed models. Association of obesity with OSAS was determined with contingency tables. We evaluated 303 individuals, 47.8% of whom were obese (body mass index ≥95th percentile for age and sex). This was significantly higher than the general pediatric population, which had a 12.1% obesity rate (P < .0001). Body mass index z-scores did not change markedly over time (P = .40). The majority of children with Down syndrome also had OSAS (74.0% of the 177 children who had polysomnography studies). However, OSAS risk was elevated in obese children (risk ratio = 2.4, P = .0015). Our results indicate that children with Down syndrome are at a substantial risk for obesity and OSAS. These findings support the need for more aggressive weight management in early childhood and throughout the lifespan. Copyright © 2016 Elsevier Inc. All rights reserved.

Retrospective Population Cohort Study on Hip Fracture Risk Associated with Zolpidem Medication

PubMed Central

Lin, Fang-Yu; Chen, Pei-Chun; Liao, Chun Hui; Hsieh, Yow-Wen; Sung, Fung-Chang

2014-01-01

Study Objective: Few studies have evaluated the hip fracture risk for zolpidem users. We assessed the risk for subjects taking zolpidem. Design: Population-based retrospective cohort study using claims data of a universal insurance system. Participants: We identified 6,978 patients newly prescribed for zolpidem in 2000-2001 age 18 y and older, and 27,848 nonusers frequency matched with sex, age, and date visiting a clinic. Measurements and Results: Both cohorts were followed up to the end of 2008 to measure the hip fracture incidence and risk, which considered factors such as sex, age, occupation, days of drug use, and osteoporosis status. The zolpidem users had a 2.23-fold higher hip fracture incidence than nonusers (3.10 versus 1.39 per 1,000 person-y). The risk increased with age for both cohorts. The elderly users had a 21-fold higher incidence than the younger users, or twofold higher than the elderly nonusers. Among 33 patients (20.4%) with hip fracture occurring during presumed medication days, which was accountable for an incidence of 1,083.0 per 1,000 person-y. Those taking the medicine for 8 days or longer had a moderately higher fracture rate than those taking it for less days (6.02 versus 4.48 per 100 person-times) with a ratio of 1.34 (95% confidence interval 0.42-4.56). Subjects with blue collar occupations were at a higher fracture risk. Conclusion: The hip fracture risk of zolpidem users is higher than that of nonusers. Fracture prevention awareness should be disseminated to the users. Citation: Lin FY; Chen PC; Liao CH; Hsieh YW; Sung FC. Retrospective population cohort study on hip fracture risk associated with zolpidem medication. SLEEP 2014;37(4):673-679. PMID:24899758

Control of Cattle Ticks and Tick-Borne Diseases by Acaricide in Southern Province of Zambia: A Retrospective Evaluation of Animal Health Measures According to Current One Health Concepts.

PubMed

Laing, Gabrielle; Aragrande, Maurizio; Canali, Massimo; Savic, Sara; De Meneghi, Daniele

2018-01-01

One health thinking for health interventions is increasingly being used to capture previously unseen stakeholders and impacts across people, animals, and the environment. The Network for One Health Evaluation (NEOH) proposes a systems-based framework to quantitatively assess integration and highlight the added value (theory of change) that this approach will bring to a project. This case study will retrospectively evaluate the pioneering use of a One Health (OH) approach during an international collaboration (satellite project to tackle production losses due to tick-borne disease in cattle in Southern Zambia in late 1980s). The objective of the evaluation is twofold: retrospective evaluation the OH-ness of the satellite project and identification of costs and benefits. Data for evaluation was recovered from publications, project documents, and witness interviews. A mixed qualitative and quantitative evaluation was undertaken. In this case study, a transdisciplinary approach allowed for the identification of a serious public health risk arising from the unexpected reuse of chemical containers by the local public against advice. Should this pioneering project not have been completed then it is assumed this behavior could have had a large impact on public wellbeing and ultimately reduced regional productivity and compromised welfare. From the economic evaluation, the costs of implementing this OH approach, helping to avoid harm, were small in comparison to overall project costs. The overall OH Index was 0.34. The satellite project demonstrated good OH operations by managing to incorporate the input across multiple dimensions but was slightly weaker on OH infrastructures (OH Ratio = 1.20). These quantitative results can be used in the initial validation and benchmarking of this novel framework. Limitations of the evaluation were mainly a lack of data due to the length of time since project completion and a lack of formal monitoring of program impact. In future

Role of bronchoscopy in evaluation of cases with sputum smear negative pulmonary tuberculosis, interstitial lung disease and lung malignancy: A retrospective study of 712 cases.

PubMed

Kumar, Raj; Gupta, Nitesh

2015-01-01

The introduction of flexible bronchoscope has revolutionized the field of pulmonary medicine and is a standard instrument used for diagnostic purpose. A retrospective analysis of the clinico-radiological profile, indication, biopsy procedure and complications, for patients undergoing bronchoscopy at one of the respiratory unit at a tertiary care center in India. Retrospective analysis of 712 bronchoscopies was done in regard to demographic profile, clinical and radiological presentation and diagnostic indication. The results were analyzed on basis of bronchoscopy inspection and histopathological specimen obtained from transbronchial (TBLB), endobronchial biopsy (EBLB) and cytology specimen by transbronchial needle aspiration (TBNA). Furthermore, diagnostic yield of each biopsy procedure and their combination was evaluated. Of 712 patients undergoing bronchoscopy, the pathological diagnosis was achieved in 384 (53.93%). Of 384 diagnosed cases, the clinic-radio-pathological diagnosis of pulmonary tuberculosis in 88 (22.19%), interstitial lung disease (ILDs) in 226 (58.85%), and lung cancer in 70 (18.22%) cases. Of 116 sputum smear negative tuberculosis patients, 88 (75.86%) were diagnosed to be pulmonary tuberculosis; the contribution of BAL being 71.59%. Of 226 ILDs, sarcoidosis was most common 148/226 (65.48%). Among 70 lung cancer diagnosed cases, squamous cell carcinoma was most common (54.28%). The results from current study reemphasizes on the diagnostic utility as well as safety of the bronchoscopy procedure. Copyright © 2015 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Adverse Outcomes after Major Surgery in Patients with Pressure Ulcer: A Nationwide Population-Based Retrospective Cohort Study

PubMed Central

Chou, Chia-Lun; Lee, Woan-Ruoh; Yeh, Chun-Chieh; Shih, Chun-Chuan

2015-01-01

Background Postoperative adverse outcomes in patients with pressure ulcer are not completely understood. This study evaluated the association between preoperative pressure ulcer and adverse events after major surgeries. Methods Using reimbursement claims from Taiwan’s National Health Insurance Research Database, we conducted a nationwide retrospective cohort study of 17391 patients with preoperative pressure ulcer receiving major surgery in 2008-2010. With a propensity score matching procedure, 17391 surgical patients without pressure ulcer were selected for comparison. Eight major surgical postoperative complications and 30-day postoperative mortality were evaluated among patients with pressure ulcer of varying severity. Results Patients with preoperative pressure ulcer had significantly higher risk than controls for postoperative adverse outcomes, including septicemia, pneumonia, stroke, urinary tract infection, and acute renal failure. Surgical patients with pressure ulcer had approximately 1.83-fold risk (95% confidence interval 1.54-2.18) of 30-day postoperative mortality compared with control group. The most significant postoperative mortality was found in those with serious pressure ulcer, such as pressure ulcer with local infection, cellulitis, wound or treatment by change dressing, hospitalized care, debridement or antibiotics. Prolonged hospital or intensive care unit stay and increased medical expenditures were also associated with preoperative pressure ulcer. Conclusion This nationwide propensity score-matched retrospective cohort study showed increased postoperative complications and mortality in patients with preoperative pressure ulcer. Our findings suggest the urgency of preventing and managing preoperative pressure ulcer by a multidisciplinary medical team for this specific population. PMID:26000606

Women's Reported Health Behaviours before and during Pregnancy: A Retrospective Study

ERIC Educational Resources Information Center

Smedley, Jenna; Jancey, Jonine M.; Dhaliwal, Satvinder; Zhao, Yun; Monteiro, Sarojini M. D. R.; Howat, Peter

2014-01-01

Objective: This study aimed to determine women's reported health behaviours (physical activity, diet, weight management) before and during pregnancy, and to identify sources of health information. Design: Retrospective study incorporating quantitative (a self-completed survey) and qualitative (one-on-one interviews) methods. Methodology:…

The ClASsification for Psoriatic ARthritis (CASPAR) criteria--a retrospective feasibility, sensitivity, and specificity study.

PubMed

Tillett, William; Costa, Luisa; Jadon, Deepak; Wallis, Dinny; Cavill, Charlotte; McHugh, Jessica; Korendowych, Eleanor; McHugh, Neil

2012-01-01

To evaluate the sensitivity, specificity, and feasibility of the ClASsification criteria for Psoriatic ARthritis (CASPAR) to retrospectively classify an existing research cohort. In total, 480 patient records were reviewed from the Royal National Hospital for Rheumatic Diseases Psoriatic Arthritis (PsA) cohort and for 100 consecutive controls with inflammatory arthritis from a general rheumatology clinic. The CASPAR score was modified for retrospective use; both "inflammation" and "current psoriasis" were recorded as present if they had ever been confirmed in the rheumatology clinic. Sensitivity and specificity of the CASPAR criteria were compared with expert clinical diagnosis. A total of 480 database records were identified. Nine sets of records had been lost or destroyed. The diagnoses had changed in 15 cases, which were transferred to the control arm, leaving 456 patients with an expert diagnosis of PsA. Of 115 controls, 96 had rheumatoid arthritis, 5 osteoarthritis, 3 reactive arthritis, 3 seronegative arthritis, 3 undifferentiated arthralgia, 2 ankylosing spondylitis, 1 spondyloarthritis, and 2 systemic sclerosis. Sensitivity (99.7%) and specificity (99.1%) were both high and equivalent to previous reports. Sensitivity remained high even after inclusion of 7 PsA patients with insufficient data to complete the CASPAR assessment (sensitivity 98.2%, specificity 99.1%). The criteria were found to be easy and practical to apply to case records. Our study demonstrates that the feasibility, specificity, and sensitivity of the CASPAR are maintained when adapted for retrospective use to classify an established research cohort.

Retrospective Study of the Costs of EPA Regulations: A Report of Four Case Studies (2014)

EPA Pesticide Factsheets

Report discusses the factors that may account for differences between projected and actual regulatory costs and presents the findings of four case studies that attempt to assess compliance cost retrospectively.

Suvorexant is associated with a low incidence of delirium in critically ill patients: a retrospective cohort study.

PubMed

Masuyama, Tomoyuki; Sanui, Masamitsu; Yoshida, Naoto; Iizuka, Yusuke; Ogi, Kunio; Yagihashi, Satoko; Nagatomo, Kanae; Sasabuchi, Yusuke; Lefor, Alan K

2018-02-08

Benzodiazepine use is a risk factor for the development of delirium in adult intensive care unit (ICU) patients. Suvorexant is an alternative to benzodiazepines to induce sleep, but the incidence of delirium in critically ill patients is unknown. We undertook this retrospective study to investigate the incidence of delirium in patients who receive suvorexant in the ICU. This retrospective cohort study was conducted in a closed 12-bed ICU at a tertiary teaching hospital. Patients admitted to the ICU for 72 h or longer between January and June 2015 were evaluated for delirium using the Confusion Assessment Method for the Intensive Care Unit tool. We evaluated the incidence of delirium in patients who received suvorexant and those who did not. To adjust for confounding factors, multivariable logistic regression analysis was conducted. Study subjects included 118 patients, with a median age of 72 years and a median Acute Physiology and Chronic Health Evaluation II score of 18 points. Eighty-two patients (69.5%) were admitted after cardiovascular surgery. In the suvorexant group, there were fewer post-cardiovascular surgical patients and more medical patients. The duration of mechanical ventilation during ICU stay was longer in the suvorexant group, and sedatives and sleep inducers other than suvorexant were used more frequently in the suvorexant group. The incidence of delirium was 43.8% in the suvorexant group and 58.8% in the non-suvorexant group (P = 0.149). After adjustment for risk factors using multivariable logistic regression analysis, suvorexant was associated with a lower incidence of delirium (odds ratio = 0.23, 95% confidence interval: 0.07-0.73; P = 0.012). Suvorexant was associated with decreased odds of transitioning to delirium in critically ill patients. The use of suvorexant may lower the incidence of delirium in ICU patients. Future prospective studies are warranted. © 2018 Japanese Psychogeriatric Society.

Tinea capitis: a retrospective epidemiological comparative study.

PubMed

Chokoeva, A A; Zisova, L; Sotiriou, E; Miteva-Katrandzhieva, T

2017-03-01

Currently, a wide spectrum of retrospective studies regarding the incidence of TC among children and adults are available in the world literature, but none of them are comparative, aiming to distinguish etiological diversity depending on the different geographic areas. This study aimed to investigate the epidemiology of TC in Plovdiv, Bulgaria and Thessaloniki, and Greece, and to compare the results and predominant etiological agents using retrospective comparative analysis for an 11-year time period. The subjects included were selected from archives of the Mycological Laboratory of the University Dermatologic Clinic, University Hospital "St. George" Plovdiv, Bulgaria, and the Mycological Laboratory of the First Dermatology Department of Aristotle University Thessaloniki, Greece, by retrospective analysis of data from an 11-year time period (2004-2014). A total count of 374 children aged 0-18, with confirmed diagnosis of TC via direct mycological examination and culture were included (128 children from Plovdiv, Bulgaria, and 246 children from Thessaloniki, Greece). Samples were plated on Sabouraud agar, followed by species identification of the isolated colonies. Our results demonstrate that the incidence of TC in the region of Bulgaria and Thessaloniki for the investigated period was lower than for the previously reported period. In Plovdiv, Bulgaria, it was 1.20 ± 0.09 % (n = 172 from a total count of 14,278 cases of mycoses), as the disease accounts for 23.10 ± 1.79 % of all mycological infections among the pediatric population and 0.36 ± 0.05 % (n = 49 from a total count of 13,724) among the adults patients in Plovdiv, Bulgaria. The incidence of the disease during the period 2004-2014 in Thessaloniki was 2.49 ± 0.15 % (n = 253 cases of TC from a total count of 10,168 mycoses), as it accounts for approximately 27.06 ± 1.47 % of mycological infections among the pediatric population in Thessaloniki, Greece, and 0.08 ± 0.03�

Comparative evaluation of anchorage loss between self-ligating appliance and Conventional pre-adjusted edgewise appliance using sliding mechanics – A retrospective study

PubMed Central

Juneja, Pankaj; Shivaprakash, G.; Chopra, S.S.; Kambalyal, P.B.

2015-01-01

Background Although a number of studies have been undertaken to evaluate the friction characteristics of self-ligating brackets, there have been only few studies which have actually evaluated the clinical efficiency of these self-ligating brackets. This study was done to evaluate the clinical efficiency of Passive SLB (Smart Clip) in terms of anchorage loss and total treatment duration by comparing it with a Conventional pre-adjusted edgewise (M.B.T.) bracket system. Methods This was a retrospective study in which the study sample comprised of ten patients treated with Passive SLB (Smart Clip, 0.022″) and ten patients treated with Conventional pre-adjusted edgewise (M.B.T.) bracket system (0.022″) who required therapeutic extraction of U/L first premolars as a part of their orthodontic treatment plan. Pretreatment and post treatment lateral cephalograms were taken to evaluate the amount of anchorage loss. The total time required to complete the treatment was also recorded. Results Anchorage loss observed with Passive SLB (Smart Clip) sagittally was 1.90 ± 0.68 mm in the maxilla and 1.90 ± 0.43 mm in the mandible and vertically was 0.52 ± 0.53 mm in the maxilla and 0.70 ± 0.69 mm in the mandible. Anchorage loss observed with Conventional pre-adjusted edgewise (M.B.T.) bracket system sagittally was 2.08 ± 0.43 mm in the maxilla and 1.95 ± 0.44 mm in the mandible and vertically was 0.50 ± 0.49 mm in the maxilla and 0.68 ± 0.53 mm in the mandible. The average time taken for the completion of treatment in Passive SLB (Smart Clip) and Conventional pre-adjusted edgewise (M.B.T.) bracket system was 14.0 ± 2.4 and 17.2 ± 2.6 months respectively. Conclusion There was no statistically significant difference in the quantum of anchor loss between Smart Clip self-ligating bracket system and Conventional pre-adjusted edgewise (M.B.T.) bracket system although Smart Clip self-ligating bracket system is efficient in reducing the overall

Valproate for agitation in critically ill patients: A retrospective study.

PubMed

Gagnon, David J; Fontaine, Gabriel V; Smith, Kathryn E; Riker, Richard R; Miller, Russell R; Lerwick, Patricia A; Lucas, F L; Dziodzio, John T; Sihler, Kristen C; Fraser, Gilles L

2017-02-01

The purpose was to describe the use of valproate therapy for agitation in critically ill patients, examine its safety, and describe its relationship with agitation and delirium. This retrospective cohort study evaluated critically ill adults treated with valproate for agitation from December 2012 through February 2015. Information on valproate prescribing practices and safety was collected. Incidence of agitation, delirium, and concomitant psychoactive medication use was compared between valproate day 1 and valproate day 3. Concomitant psychoactive medication use was analyzed using mixed models. Fifty-three patients were evaluated. The median day of valproate therapy initiation was ICU day 7, and it was continued for a median of 7 days. The median maintenance dose was 1500 mg/d (23 mg/kg/d). The incidence of agitation (96% vs 61%, P < .0001) and delirium (68% vs 49%, P = .012) significantly decreased by valproate day 3. Treatment with opioids (77% vs 65%, P = .02) and dexmedetomidine (47% vs 24%, P = .004) also decreased. In mixed models analyses, valproate therapy was associated with reduced fentanyl equivalents (-185 μg/d, P = .0003) and lorazepam equivalents (-2.1 mg/d, P = .0004). Hyperammonemia (19%) and thrombocytopenia (13%) were the most commonly observed adverse effects. Valproate therapy was associated with a reduction in agitation, delirium, and concomitant psychoactive medication use within 48 hours of initiation. Copyright © 2016 Elsevier Inc. All rights reserved.

A Retrospective View of Selective Admission of Physical Therapist Assistants.

ERIC Educational Resources Information Center

Pape, C. Dale; Casey, John P.

1986-01-01

This study was an attempt to evaluate how well a specific selection formula for admission to a physical therapist assistant program worked. It compared the relative selective admission score with the clinical and academic success of those students who completed the course of study; this necessitated a retrospective analysis. (Author/CT)

Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

PubMed

Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

2014-12-01

Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

Retrospective multicenter evaluation of patients diagnosed with mucosal melanoma: a study of Anatolian Society of Medical Oncology.

PubMed

Ercelep, Ozlem; Topcu, Turkan Ozturk; Bayoglu, Ibrahim Vedat; Ekinci, Ahmet Siyar; Koca, Sinan; Kavgaci, Halil; Ozcelik, Melike; Alacacioglu, Ahmet; Uzunoglu, Sernaz; Bozkurt, Oktay; Ulas, Arife; Aksoy, Asude; Taskoylu, Burcu Yapar; Gumussay, Ozge; Yaman, Sebnem; Uysal, Mukremin; Aydin, Dincer; Gumus, Mahmut

2016-09-01

Mucosal melanoma (MM) is a rare type of cancer that differs significantly from cutaneous melanoma. In this study, we aimed to evaluate clinical and demographical characteristics, prognoses and factors influencing survival, treatment alternatives, and features of different subtypes of the patients. The patients were followed up with and treated in different centers due to their diagnoses of MM. We retrospectively analyzed data of 107 patients who were diagnosed with MM in 14 different institutions in Turkey. The mean age of the patients was 64.5 years. Of the patients, 47 % were female and 53 % were male. The median overall survival (OS) was 17 months, and the mean follow-up duration was 27 months. The 2-year survival rate was 42 %, and the 5-year survival rate was 23 %. The best survival rate appeared in those patients with MM in the head-neck region (median survival rate was 27 months, P = 0.034). The most common anatomical site was the head-neck region. In a univariate analysis, variables including age ≥65 years, the anatomical site of the primary lesion other than head and neck region, the metastatic stage of the disease, high levels of lactate dehydrogenase (LDH), and an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of ≥1 were found to be associated with poor survival (P < 0.05). However, in a multivariate analysis, only advanced stage disease (HR = 2.70; 95 % CI, 1.64-4.45; P = 0.000) and high LDH levels (HR = 2.31; 95 % CI, 1.40-3.80; P = 0.001) were determined to be adverse prognostic variables. Primary MM presents a more aggressive behavior and offers a poorer prognosis compared to cutaneous melanoma. Because the disease is rarely seen, is heterogeneous, and lacks randomized studies, issues concerning optimal treatment approaches and management and clinical characteristics of the disease have not been clarified yet.

Manual exchange transfusion for severe imported falciparum malaria: a retrospective study.

PubMed

Lin, Jinfeng; Huang, Xiaoying; Qin, Gang; Zhang, Suyan; Sun, Weiwei; Wang, Yadong; Ren, Ke; Xu, Junxian; Han, Xudong

2018-01-16

This study was designed to evaluate the efficacy of exchange transfusion in patients with severe imported falciparum malaria. Twelve patients who met the diagnostic criteria for severe malaria were treated with exchange transfusion 14 times according to a conventional anti-malarial treatment. This study evaluated the efficacy of exchange transfusion for severe imported falciparum malaria. Clinical data of severe imported falciparum malaria patients admitted to the intensive care unit (ICU) of Nantong Third People's Hospital from January 2007 to December 2016 were investigated in this retrospective study. Patients were divided into the intervention group, which received exchange transfusion, and the control group. This study assessed parasite clearance and outcomes of the two groups, and levels of erythrocytes, haemoglobin, platelets, coagulation, liver function, lactate, C-reactive protein, and procalcitonin, before and after exchange transfusion in the intervention group. There was no significant difference in the severity of admitted patients. Exchange transfusion was successfully applied 14 times in the intervention group. Differences in the levels of erythrocytes, haemoglobin and platelets did not reach statistical significance. Exchange transfusion improved coagulation, liver function, lactic acid, C-reactive protein, and procalcitonin. No differences were observed in parasite clearance, ICU and hospital length of stay, in-hospital mortality, and costs of hospitalization between the two groups. Exchange transfusion as adjunctive therapy for severe malaria was observed to be safe in this setting. Exchange transfusion can improve liver function and coagulation and reduce inflammation, but it failed to improve parasite clearance and the outcomes of severe imported falciparum malaria in this case series.

Space Adaptation Back Pain: A Retrospective Study

NASA Technical Reports Server (NTRS)

Kerstman, E. L.; Scheuring, R. A.; Barnes, M. G.; DeKorse, T. B.; Saile, L. G.

2008-01-01

Back pain is frequently reported by astronauts during the early phase of space flight as they adapt to the microgravity environment. However, the epidemiology of space adaptation back pain has not been well defined. The purpose of this retrospective study was to develop a case definition of space adaptation back pain, determine the incidence of space adaptation back pain, and determine the effectiveness of available treatments. Medical records from the Mercury, Apollo, Apollo-Soyuz Test Project (ASTP), Skylab, Mir, International Space Station (ISS), and Shuttle programs were reviewed. All episodes of in-flight back pain that met the criteria for space adaptation back pain were recorded. Pain characteristics, including intensity, location, and duration of the pain were noted. The effectiveness of specific treatments also was recorded. The incidence of space adaptation back pain among astronauts was determined to be 53% (384/722). Most of the affected astronauts reported mild pain (85%). Moderate pain was reported by 11% of the affected astronauts and severe pain was reported by only 4% of the affected astronauts. The most effective treatments were fetal positioning (91% effective) and the use of analgesic medications (85% effective). This retrospective study aids in the development of a case definition of space adaptation back pain and examines the epidemiology of space adaptation back pain. Space adaptation back pain is usually mild and self-limited. However, there is a risk of functional impairment and mission impact in cases of moderate or severe pain that do not respond to currently available treatments. Therefore, the development of preventive measures and more effective treatments should be pursued.

A Retrospective Cohort Study on Patients with Hidradenitis Suppurativa.

PubMed

Seyed Jafari, S Morteza; Knüsel, Evelyne; Cazzaniga, Simone; Hunger, Robert E

2018-05-14

Hidradenitis suppurativa (HS) is one of the most distressing conditions observed in dermatology and has a substantial negative effect on the quality of life of affected persons. The aim of this study was to evaluate different treatment strategies in patients with HS. In a retrospective cohort, all patients with HS (July 2015 to March 2017) were reviewed. Collected data consisted of patients' demographics, clinical characteristics, psychosocial situation, and previous and current treatments. In addition, therapy response to the most recent prescribed treatments was assessed. 102 patients (38 females, 64 males; median age 37.5 years) were included in this study. 68.4% of patients had BMI ≥25, and 76.5% of patients were current smokers. Hurley stages I, II, and III were detected in 13.5, 53.1, and 33.3% of patients, respectively. The most commonly administered treatments were surgery (67.6%), nonantibiotic topical therapies (72.5%), antibiotic topical therapies (55.9%), systemic antibiotics (88.2%), and biologics in 11.8% of the patients. 84.6% of the patients showed a response (27.5 and 47.1% partial and complete response, respectively) to the treatments. HS as a chronic, recurrent inflammatory skin disease is associated with smoking and obesity. Application of systemic antibiotics is the most frequent treatment strategy for this disease. However, surgical intervention seems to be the most effective treatment strategy. © 2018 S. Karger AG, Basel.

Evaluation of dystonia in children and adolescents treated with atomoxetine within the Truven MarketScan database: a retrospective cohort study.

PubMed

Meyers, Kristin J; Upadhyaya, Himanshu P; Goodloe, Robert; Kryzhanovskaya, Ludmila A; Liles-Burden, Marie A; Kellier-Steele, Nicole A; Mancini, Michele

2018-05-01

Atomoxetine is a non-stimulant drug indicated for the treatment of attention-deficit/hyperactivity disorder in children aged ≥6 years, adolescents, and adults. In this retrospective cohort study, the incidence and risk of dystonia in children and adolescents treated with atomoxetine was compared to a propensity score-matched cohort of stimulant users. Data between 1 January 2006 and 31 December 2014 from patients aged 6-17 years in the Truven Health Analytics MarketScan database were used to generate two cohorts of patients: (1) atomoxetine users and (2) stimulant (methylphenidates or amphetamines) users. A Cox proportional hazards regression model was used to compare incidence of dystonia across propensity score-matched cohorts. Of the 70,657 atomoxetine users, 70,655 users were propensity score-matched to a stimulant user. In the atomoxetine- and stimulant-treated cohorts, the crude incidence rates of dystonia were 54.9 (95% CI: 27.1-82.7) and 77.9 (95% CI: 49.1-106.8) per 100,000 person-years, respectively. The hazard ratio for occurrence of dystonia with atomoxetine use relative to stimulant use was 0.68 (95% CI: 0.36 - 1.28; P = 0.23). In this large retrospective cohort study, there was no significant difference in incidence or risk of dystonia among patients treated with atomoxetine compared to stimulants.

Retrospective evaluation of a national guideline to prevent neonatal hypoglycemia.

PubMed

Rasmussen, Annett Helleskov; Wehberg, Sonja; Fenger-Groen, Jesper; Christesen, Henrik Thybo

2017-10-01

Hypoglycemia is common in neonates and may cause adverse neurological outcomes. Guidelines should aim to prevent repeated hypoglycemic episodes in risk groups, but they are not usually stratified according to the severity of hypoglycemia risk, which may lead to inappropriate and redundant interventions. We evaluated the effect of a national prevention guideline stratified according to mild, moderate, and severe risks of hypoglycemia. From national registers, a population cohort of 22,725 neonates was identified retrospectively before and after implementation of a national guideline. Of these, 1900 had World Health Organization International Classification of Diseases 10 discharge diagnoses of hypoglycemia. Diagnoses indicating hypoglycemia risk [small/large for gestational age (SGA/LGA), asphyxia, prematurity, maternal insulin-treated diabetes mellitus] were recorded. Neonatal ward files were evaluated to validate hypoglycemia diagnoses. Adjusted odds ratios (aORs) were calculated, adjusting for sex, parity, SGA, LGA, preterm birth, and asphyxia, where relevant. Primiparity and male sex were associated independently with hypoglycemia diagnosis [aORs, 1.29 (1.17-1.42) and 1.14 (1.03-1.26), respectively]. Overall incidence of hypoglycemia at discharge decreased from 9.4% to 5.5% after guideline implementation [aOR change , 0.57 (0.50-0.64)]. Overall incidence of validated hypoglycemia decreased from 2.1% to 1.2% [aOR 0.59 (0.46-0.77), p<0.001]. By risk group, the hypoglycemia incidence decreased from 30.5% to 18.6% [aOR 0.52 (0.36-0.75)] among SGA neonates, from 25.8% to 16.4% [aOR 0.57 (0.42-0.76)] among preterm infants, and from 27.4% to 16.6% [aOR 0.63 (0.34-0.83)] among those with asphyxia. LGA neonates showed a decreased incidence in obstetric wards only. No significant change was observed for the diabetes group. Stratification of hypoglycemia risk in a hypoglycemia prevention guideline was followed by decreased estimated hypoglycemia incidence, but no causative

Parenting Environment and Scholastic Achievement during Adolescence: A Retrospective Study.

ERIC Educational Resources Information Center

Taris, Toon W.; Bok, Inge A.

1996-01-01

This study examined the effects of perceived parenting style (overly protective versus a warm and loving environment) on the scholastic achievement of 986 Dutch adults age 18-30 years. Retrospective and longitudinal data suggested that respondents with overprotective parents drop out more frequently and have a lower level of educational attainment…

Retrospective study on the characteristics and treatment of late-onset vitiligo.

PubMed

Kong, Yan Ling; Ching, Vanessa Hui Ling; Chuah, Sai Yee; Thng, Tien Guan

2017-01-01

Late-onset vitiligo, defined as being aged 50 years and above at the point of clinical onset, remains poorly characterized till now. This study aims to describe the clinical characteristics and treatment response of patients with late-onset vitiligo. We retrospectively reviewed the case records of all patients diagnosed with late-onset vitiligo, from January 1, 2010 to December 31, 2014. Information obtained included patient demographics, characteristics of vitiligo and treatment responses. Of the 3128 patients diagnosed with vitiligo over the 5-year period, 461 (14.7%) had late-onset disease. The study had more females (n = 260, 56.4%) than males, with an average onset age of 59.4 ± 7.4 years. Majority of patients were Chinese (n = 308, 66.8%) and 45 (9.8%) patients had an associated autoimmune disease. Focal vitiligo, defined as the localized presence of depigmented patches, was most common (n = 209, 45.3%). Treatment response was evaluated in 359 patients, of which 216 received monotherapy (topical creams: n = 210, 97.2%; phototherapy: n = 6, 2.8%) and 143 received both modalities. Fifty six (15.6%) patients received oral steroids. Patients who were treated with both topical creams and phototherapy yielded better clinical responses compared to those on monotherapy (P < 0.001) with 56.6% (n = 81) of them achieving good epidermal repigmentation, defined as >50% return of pigmentation compared to baseline (vs. n = 66, 30.6% in the monotherapy group). The choice of phototherapy (targeted, narrowband ultraviolet B or psoralen + ultraviolet A) did not significantly affect clinical response (P = 0.774). This study is limited by its retrospective nature, the nonstandardized documentation resulting in the inability to determine disease progression and associated metabolic comorbidities and also by the gradual loss to follow-up of patients. Late-onset vitiligo is not uncommon and tends to be of the focal vitiligo subtype. Nonsegmented vitiligo is more prevalent than

Uncovering the Problem-Solving Process: Cued Retrospective Reporting Versus Concurrent and Retrospective Reporting

ERIC Educational Resources Information Center

van Gog, Tamara; Paas, Fred; Merrienboer, Jeroen J. G.; Witte, Puk

2005-01-01

This study investigated the amounts of problem-solving process information ("action," "why," "how," and "metacognitive") elicited by means of concurrent, retrospective, and cued retrospective reporting. In a within-participants design, 26 participants completed electrical circuit troubleshooting tasks under different reporting conditions. The…

Thrombocytosis: a retrospective study of 165 dogs.

PubMed

Neel, Jennifer A; Snyder, Laura; Grindem, Carol B

2012-06-01

Thrombocytosis has been associated with various conditions, including inflammation, neoplasia, iron deficiency, splenectomy, and drug administration. The aim of this study was to characterize diseases and conditions associated with thrombocytosis in dogs. In this retrospective study, dogs with thrombocytosis (platelet count > 600 × 10(3) /μL) and complete medical records during a 1-year period were included, and breed, sex, age, CBC results, alkaline phosphatase and gamma-glutamyltransferase activities in some dogs, administration of glucocorticoids or vincristine, and primary diagnosis were evaluated. Thrombocytosis was found in 240 of 5342 dogs (4.6%), and 165 (3.1%) met inclusion criteria. Thrombocytosis was secondary in all dogs, and underlying diseases and conditions (n,%) were neoplasia (56, 33.9%), inflammation (55, 33.3%), miscellaneous disorders (26, 15.8%), neoplasia plus a second disease (13, 7.9%), endocrine diseases (8, 4.8%), and multiple diseases (7, 4.2%). In dogs with neoplasia, carcinomas (24) and round cell neoplasms (20), especially lymphoma and mast cell tumor, were the most frequent tumors. Inflammatory disorders consisted of immune-mediated disorders (11), neurologic diseases (8), infectious diseases (6), allergic disease (5), orthopedic diseases (4), gastrointestinal diseases (4), and miscellaneous conditions (17). Of the 165 dogs, 73 (44.2%) had received glucocorticoids (55) or vincristine (18) Marked (850-969 × 10(3) platelets/μL) or extreme ( ≥ 970 × 10(3) platelets/μL) thrombocytosis occurred in 24 (14.5%) dogs; 12 (50.0%) had neoplasia. Thromboembolism occurred in 13 (7.9%) dogs. Thrombocytosis in dogs occurred most frequently secondary to neoplastic and inflammatory diseases and was commonly associated with glucocorticoid and vincristine administration. Thromboembolic complications occurred in a small number of patients. Marked or extreme thrombocytosis was more likely to occur with neoplasia than with other conditions. © 2012

Validity of retrospective disease activity assessment in systemic lupus erythematosus.

PubMed

Arce-Salinas, A; Cardiel, M H; Guzmán, J; Alcocer-Varela, J

1996-05-01

To evaluate the validity of retrospective disease activity assessment derived from clinical charts. We prospectively evaluated 37 patients with systemic lupus erythematosus (SLE) in 90 visits using the SLE Disease Activity Index (SLEDAI), the Mexican SLEDAI (Mex-SLEDAI), and the Lupus Activity Criteria Count (LACC) indices. Routine clinical observations were written by rheumatologists blind to index scores. These notes were reviewed 2 years later to obtain retrospective index scores and their validity was assessed using prospective scores as the standard. Statistical analysis was by Spearman's rank correlation coefficient (rs), Wilcoxon matched pairs test, kappa statistic, and intraclass correlation coefficient (ri). We calculated the sensitivity and specificity of retrospective indices to detect active disease. Median retrospective scores were lower in all indices: SLEDAI (4 VS 2, p =0.004, RS = 0.68, ri = 0.30); Mex-SLEDAI (2 vs 1, p < 0.0003, rs = 0.79, ri = 0.31); and LACC (1 vs 1, p = 0.007, rs = 0.65, ri = 0.21). Used to detect active SLE, the retrospective SLEDAI had a sensitivity of 0.68 and a specificity of 0.86; corresponding values for the Mex-SLEDAI were 0.72 and 0.91, and for the LACC, 0.77 and 0.76. Retrospective disease activity indices tended to provide lower scores than prospective evaluations. They often missed patients with mildly active disease, but when positive they were good predictors of disease activity.

Gilding the Outcome by Tarnishing the Past: Inflationary Biases in Retrospective Pretests

ERIC Educational Resources Information Center

Taylor, Paul J.; Russ-Eft, Darlene F.; Taylor, Hazel

2009-01-01

We tested for inflationary bias introduced through retrospective pretests by analyzing traditional pretest, retrospective pretest, and posttest evaluation data collected on a first-line supervisory leadership training program, involving 196 supervisors and their subordinates, across 17 organizational settings. Retrospective pretest ratings by both…

Retrospective cohort study of anti-tumor necrosis factor agent use in a veteran population

PubMed Central

Madkour, Nermeen; Kazerooni, Rashid

2014-01-01

Introduction. Anti-tumor necrosis factor (TNF) agents are effective for several immunologic conditions (rheumatoid arthritis (RA), Crohn’s disease (CD), and psoriasis). The purpose of this study was to evaluate the efficacy and safety of anti-TNF agents via chart review. Methods. Single-site, retrospective cohort study that evaluated the efficacy and safety of anti-TNF agents in veterans initiated between 2010 and 2011. Primary aim evaluated response at 12 months post-index date. Secondary aims evaluated initial response prior to 12 months post-index date and infection events. Results. A majority of patients were prescribed anti-TNF agents for CD (27%) and RA (24%). Patients were initiated on etanercept (41%), adalimumab (40%), and infliximab (18%) between 2010 and 2011. No differences in patient demographics were reported. Response rates were high overall. Sixty-five percent of etanercept patients, 82% of adalimumab patients, and 59% of infliximab patients were either partial or full responders, respectively. Approximately 16%, 11%, and 12% of etanercept, adalimumab, and infliximab were non-responders, respectively. Infections between the groups were non-significant. Etanercept and adalimumab patients had higher but non-significant odds of being a responder relative to infliximab. Conclusions. Most patients initiated with anti-TNF agent were responders at 12 months follow-up for all indications in a veteran population. PMID:24883246

Risk of anaphylaxis in patients with large local reactions to hymenoptera stings: a retrospective and prospective study.

PubMed

Pucci, Stefano; D'Alò, Simona; De Pasquale, Tiziana; Illuminati, Ilenia; Makri, Elena; Incorvaia, Cristoforo

2015-01-01

In the few studies available, the risk of developing systemic reactions (SR) to hymenoptera stings in patients with previous large local reactions (LLRs) to stings ranges from 0 to 7 %. We evaluated both retrospectively and prospectively the risk of SRs in patients with LLRs to stings. An overall number of 477 patients, 396 with an SR as the first manifestation of allergy and 81 with a history of only LLRs after hymenoptera stings, were included in the study. All patients had clinical history and allergy testing (skin tests and/or specific IgE) indicative of allergy to venom of only one kind of Hymenoptera. Of the 81 patient with LLRs, 53 were followed-up for 3 years by annual control visits, while the 396 patients with SR were evaluated retrospectively. Among the 396 patients with an SR, only 17 (4.2 %) had had a previous LLR as debut of allergy, after an history of normal local reactions to Hymenoptera stings. All the 81 patients with a history of only LLRs had previously had at least two LLRs, with an overall number of 238 stings and no SR. Among the 53 patients who were prospectively evaluated we found that 31 of them (58.3 %) were restung by the same type of insect, with an overall number of 59 stings, presenting only LLRs and no SR. Our findings confirm that patients with repeated LLRs to stings had no risk of SR, while a single LLR does not exclude such risk. This has to be considered in the management of patients with LLRs.

Diagnostic workup for fever of unknown origin: a multicenter collaborative retrospective study

PubMed Central

Naito, Toshio; Mizooka, Masafumi; Mitsumoto, Fujiko; Kanazawa, Kenji; Torikai, Keito; Ohno, Shiro; Morita, Hiroyuki; Ukimura, Akira; Mishima, Nobuhiko; Otsuka, Fumio; Ohyama, Yoshio; Nara, Noriko; Murakami, Kazunari; Mashiba, Kouichi; Akazawa, Kenichiro; Yamamoto, Koji; Senda, Shoichi; Yamanouchi, Masashi; Tazuma, Susumu; Hayashi, Jun

2013-01-01

Objective Fever of unknown origin (FUO) can be caused by many diseases, and varies depending on region and time period. Research on FUO in Japan has been limited to single medical institution or region, and no nationwide study has been conducted. We identified diseases that should be considered and useful diagnostic testing in patients with FUO. Design A nationwide retrospective study. Setting 17 hospitals affiliated with the Japanese Society of Hospital General Medicine. Participants This study included patients ≥18 years diagnosed with ‘classical fever of unknown origin’ (axillary temperature ≥38°C at least twice over a ≥3-week period without elucidation of a cause at three outpatient visits or during 3 days of hospitalisation) between January and December 2011. Results A total of 121 patients with FUO were enrolled. The median age was 59 years (range 19–94 years). Causative diseases were infectious disease in 28 patients (23.1%), non-infectious inflammatory disease in 37 (30.6%), malignancy in 13 (10.7%), other in 15 (12.4%) and unknown in 28 (23.1%). The median interval from fever onset to evaluation at each hospital was 28 days. The longest time required for diagnosis involved a case of familial Mediterranean fever. Tests performed included blood cultures in 86.8%, serum procalcitonin in 43.8% and positron emission tomography in 29.8% of patients. Conclusions With the widespread use of CT, FUO due to deep-seated abscess or solid tumour is decreasing markedly. Owing to the influence of the ageing population, polymyalgia rheumatica was the most frequent cause (9 patients). Four patients had FUO associated with HIV/AIDS, an important cause of FUO in Japan. In a relatively small number of cases, cause remained unclear. This may have been due to bias inherent in a retrospective study. This study identified diseases that should be considered in the differential diagnosis of FUO. PMID:24362014

Understanding data requirements of retrospective studies.

PubMed

Shenvi, Edna C; Meeker, Daniella; Boxwala, Aziz A

2015-01-01

Usage of data from electronic health records (EHRs) in clinical research is increasing, but there is little empirical knowledge of the data needed to support multiple types of research these sources support. This study seeks to characterize the types and patterns of data usage from EHRs for clinical research. We analyzed the data requirements of over 100 retrospective studies by mapping the selection criteria and study variables to data elements of two standard data dictionaries, one from the healthcare domain and the other from the clinical research domain. We also contacted study authors to validate our results. The majority of variables mapped to one or to both of the two dictionaries. Studies used an average of 4.46 (range 1-12) data element types in the selection criteria and 6.44 (range 1-15) in the study variables. The most frequently used items (e.g., procedure, condition, medication) are often available in coded form in EHRs. Study criteria were frequently complex, with 49 of 104 studies involving relationships between data elements and 22 of the studies using aggregate operations for data variables. Author responses supported these findings. The high proportion of mapped data elements demonstrates the significant potential for clinical data warehousing to facilitate clinical research. Unmapped data elements illustrate the difficulty in developing a complete data dictionary. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Evaluating markers for the early detection of cancer: overview of study designs and methods.

PubMed

Baker, Stuart G; Kramer, Barnett S; McIntosh, Martin; Patterson, Blossom H; Shyr, Yu; Skates, Steven

2006-01-01

The field of cancer biomarker development has been evolving rapidly. New developments both in the biologic and statistical realms are providing increasing opportunities for evaluation of markers for both early detection and diagnosis of cancer. To review the major conceptual and methodological issues in cancer biomarker evaluation, with an emphasis on recent developments in statistical methods together with practical recommendations. We organized this review by type of study: preliminary performance, retrospective performance, prospective performance and cancer screening evaluation. For each type of study, we discuss methodologic issues, provide examples and discuss strengths and limitations. Preliminary performance studies are useful for quickly winnowing down the number of candidate markers; however their results may not apply to the ultimate target population, asymptomatic subjects. If stored specimens from cohort studies with clinical cancer endpoints are available, retrospective studies provide a quick and valid way to evaluate performance of the markers or changes in the markers prior to the onset of clinical symptoms. Prospective studies have a restricted role because they require large sample sizes, and, if the endpoint is cancer on biopsy, there may be bias due to overdiagnosis. Cancer screening studies require very large sample sizes and long follow-up, but are necessary for evaluating the marker as a trigger of early intervention.

The effect of deep shoulder infections on patient outcomes after arthroscopic rotator cuff repair: a retrospective comparative study.

PubMed

Atesok, Kivanc; MacDonald, Peter; Leiter, Jeff; McRae, Sheila; Singh, Mandip; Stranges, Greg; Old, Jason

2017-01-01

The purpose of this study was to evaluate the effects of deep shoulder infections after RCR on patient outcomes. A retrospective chart review was conducted involving all patients with deep shoulder infections after arthroscopic RCR (study group). Another group of patients who were matched with the study group by age, gender and rotator cuff tear size, and did not develop deep shoulder infections after arthroscopic RCR were randomly identified (control group). The two groups were compared in terms of time to start physiotherapy, shoulder function, and delay in return to work. There were 10 patients in each group. The mean time to start physiotherapy after surgery was 145.3 (SD=158.8) days for the study group and 40.0 (SD=13.7) days for the control group (p=.051). The average forward elevation of the operated shoulder was 133 (SD=33.4) degrees for the study group, and 172 (SD=12.0) degrees for the control group (p=0.003). The average time to return to work at preoperative level was 5.6 months for the study group and 3 months for the control group. Deep shoulder infections after RCR significantly impedes time to start physiotherapy, shoulder function, and patients' ability to return to work. III b [retrospective comparative (case-control) study].

Automated classification of radiology reports to facilitate retrospective study in radiology.

PubMed

Zhou, Yihua; Amundson, Per K; Yu, Fang; Kessler, Marcus M; Benzinger, Tammie L S; Wippold, Franz J

2014-12-01

Retrospective research is an import tool in radiology. Identifying imaging examinations appropriate for a given research question from the unstructured radiology reports is extremely useful, but labor-intensive. Using the machine learning text-mining methods implemented in LingPipe [1], we evaluated the performance of the dynamic language model (DLM) and the Naïve Bayesian (NB) classifiers in classifying radiology reports to facilitate identification of radiological examinations for research projects. The training dataset consisted of 14,325 sentences from 11,432 radiology reports randomly selected from a database of 5,104,594 reports in all disciplines of radiology. The training sentences were categorized manually into six categories (Positive, Differential, Post Treatment, Negative, Normal, and History). A 10-fold cross-validation [2] was used to evaluate the performance of the models, which were tested in classification of radiology reports for cases of sellar or suprasellar masses and colloid cysts. The average accuracies for the DLM and NB classifiers were 88.5% with 95% confidence interval (CI) of 1.9% and 85.9% with 95% CI of 2.0%, respectively. The DLM performed slightly better and was used to classify 1,397 radiology reports containing the keywords "sellar or suprasellar mass", or "colloid cyst". The DLM model produced an accuracy of 88.2% with 95% CI of 2.1% for 959 reports that contain "sellar or suprasellar mass" and an accuracy of 86.3% with 95% CI of 2.5% for 437 reports of "colloid cyst". We conclude that automated classification of radiology reports using machine learning techniques can effectively facilitate the identification of cases suitable for retrospective research.

Diagnostic evaluation and management of patients with rectus sheath hematoma. A retrospective study.

PubMed

Salemis, Nikolaos S; Gourgiotis, Stavros; Karalis, Georgios

2010-01-01

Rectus sheath hematoma (RSH) is an uncommon cause of acute abdominal pain. It may mimic a wide variety of intraabdominal disorders thus frequently leading to delay in treatment, increased morbidity or even in an unnecessary surgery. This is a retrospective study of 10 patients with RSH who were treated in our department over a five-year period. There were 6 (60%) men and 4 (40%) women ranging in age from 38 to 86 years, with a mean age of 57.1 years. The most common clinical presentation was a palpable abdominal mass associated with abdominal pain. Computed tomography (CT) established the diagnosis in 100% of the cases. 4 patients had type I hematoma, 3 had type II hematoma and 3 had type III hematoma. Anticoagulation therapy was the most common predisposing factor. Conservative treatment was effective in 90% of the cases and in all cases of spontaneous RSHs in patients under anticoagulation therapy. One patient, who developed a very severe RSH following an abdominal injection of low-molecular-weight heparin (LMWH), underwent surgery. All patients with type III hematoma required blood transfusion. RSH should be considered in the differential diagnosis of the elderly patients under anticoagulation therapy presenting with acute abdominal pain and a palpable mass. CT is the diagnostic modality of choice. Conservative treatment is feasible in most cases. Early diagnosis is mandatory in order to avoid morbidity or unnecessary surgery. In order to prevent a traumatic RSH, trocar insertion under direct vision during laparoscopic surgery and careful attention in the abdominal administration of LMWH are essential. Copyright (c) 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Tolerance and Efficacy of Sodium Oxybate in Childhood Narcolepsy with Cataplexy: A Retrospective Study

PubMed Central

Lecendreux, Michel; Poli, Francesca; Oudiette, Delphine; Benazzouz, Fatima; Donjacour, Claire E.H.M; Franceschini, Christian; Finotti, Elena; Pizza, Fabio; Bruni, Oliviero; Plazzi, Giuseppe

2012-01-01

Narcolepsy with cataplexy is a sleep disorder characterized by excessive daytime sleepiness, irresistible sleep episodes, and sudden loss of muscle tone (cataplexy) mostly triggered by emotions. Narcolepsy with cataplexy is a disabling lifelong disorder frequently arising during childhood. Pediatric narcolepsy often results in severe learning and social impairment. Improving awareness about this condition increases early diagnosis and may allow patients to rapidly access adequate treatments, including pharmacotherapy and/or non-medication-based approaches. Even though children currently undergo pharmacotherapy, data about safety and efficacy in the pediatric population are scarce. Lacking international guidelines as well as drugs registered for childhood narcolepsy with cataplexy, physicians have no other alternative but to prescribe in an off-label manner medications identical to those recommended for adults. We retrospectively evaluated 27 children ranging from 6 to 16 years old, suffering from narcolepsy with cataplexy, who had been treated with off-label sodium oxybate and had been followed in a clinical setting. Throughout a semi-structured interview, we documented the good efficacy and tolerability of sodium oxybate in the majority of the patients. This study constitutes a preliminary step towards a further randomized controlled trial in childhood narcolepsy with cataplexy. Citation: Lecendreux M; Poli F; Oudiette D; Benazzouz F; Donjacour CEHM; Franceschini C; Finotti E; Pizza F; Bruni O; Plazzi G. Tolerance and efficacy of sodium oxybate in childhood narcolepsy with cataplexy: a retrospective study. SLEEP 2012;35(5):709-711. PMID:22547897

Equine keratomycosis in Switzerland: a retrospective evaluation of 35 horses (January 2000-August 2011).

PubMed

Voelter-Ratson, K; Pot, S A; Florin, M; Spiess, B M

2013-09-01

Keratomycosis is a severe disease in horses. Geographical differences in fungi causing keratomycosis and susceptibility of the organisms to antifungal drugs exist but few previous publications on this disease originate from Europe. To retrospectively compare the clinical data of 36 eyes with keratomycosis, diagnosed in 35 horses between January 2000 and August 2011 at the Vetsuisse Faculty of Switzerland. Case history, season, prior treatment, clinical appearance, surgical and medical treatment, treatment duration, and globe survival were evaluated. Retrospective case series. Medical records of horses with a definitive cytological or histological diagnosis of keratomycosis were reviewed. Thirty-one of 36 eyes (86.1%) presented with ulcerative keratitis, 2/36 (5.55%) had diffuse corneal infiltration, 2/36 (5.55%) had superficial punctate keratitis and 1/36 (2.8%) had a fluorescein-negative fungal plaque. Two of 6 fungal cultures produced Aspergillus spp. Thirty eyes received medical and surgical treatment, while 3 eyes were treated medically only. In 3 horses the globe was removed at the time of first presentation. Sex, age, prior treatment with antimicrobials or steroids, or type of surgical approach did not significantly influence the outcome. Twenty-three of 36 eyes (63.9%) were at least partially visual, 11/36 eyes (30.5%) were enucleated and 2 horses (2/36 eyes, 5.6%) were subjected to euthanasia. Treatment protocols were compared in the 31 eyes with ulcerative keratitis. In this group, 3/31 globes were immediately enucleated, 16/31 eyes were treated topically with voriconazole or voriconazole/fluconazole and 12/31 with other antifungal drug combinations. The different medication protocols did not significantly affect the outcome. There were no significant differences in outcome between different medical treatment protocols or types of surgical approach. Future studies in central Europe should focus on the identification of fungal pathogens, susceptibility

Anorexia nervosa versus bulimia nervosa: differences based on retrospective correlates in a case-control study.

PubMed

Machado, Bárbara C; Gonçalves, Sónia F; Martins, Carla; Brandão, Isabel; Roma-Torres, António; Hoek, Hans W; Machado, Paulo P

2016-06-01

This study is the result of two Portuguese case-control studies that examined the replication of retrospective correlates and preceding life events in anorexia nervosa (AN) and bulimia nervosa (BN) development. This study aims to identify retrospective correlates that distinguish AN and BN METHOD: A case-control design was used to compare a group of women who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N = 98) and BN (N = 79) with healthy controls (N = 86) and with other psychiatric disorders (N = 68). Each control group was matched with AN patients regarding age and parental social categories. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview. Compared to AN, women with BN reported significantly higher rates of paternal high expectations, excessive family importance placed on fitness/keeping in shape, and negative consequences due to adolescent overweight and adolescent objective overweight. Overweight during adolescence emerged as the most relevant retrospective correlate in the distinction between BN and AN participants. Family expectations and the importance placed on keeping in shape were also significant retrospective correlates in the BN group.

Affective Antecedents of the Perceived Effectiveness of Antidrug Advertisements: An Analysis of Adolescents’ Momentary and Retrospective Evaluations

PubMed Central

Vohs, Kathleen D.; Luciana, Monica; Cuthbert, Bruce N.; MacDonald, Angus W.

2013-01-01

Perceived message effectiveness is often used as a diagnostic tool to determine whether a health message is likely to be successful or needs modification before use in an intervention. Yet, published research on the antecedents of perceived effectiveness is scarce and, consequently, little is known about why a message is perceived to be effective or ineffective. The present study’s aim was to identify and test the affective antecedents of perceived effectiveness of antidrug television messages in a sample of 190 adolescents in the 15–19 year age range. Factor-analytical tests of retrospective message evaluation items suggested two dimensions of perceived effectiveness, one that contained items such as convincingness whereas the other contained pleasantness items. Using retrospective data as well as real time valence and arousal ratings, we found that arousal underlies perceived convincingness and valence underlies perceived pleasantness. The results indicated activation of appetitive and defensive motivational systems, which suggests a clear motivational component to the concept of perceived message effectiveness. PMID:21499729

Achieving recovery in patients with schizophrenia through psychosocial interventions: A retrospective study.

PubMed

Buonocore, Mariachiara; Bosia, Marta; Baraldi, Maria A; Bechi, Margherita; Spangaro, Marco; Cocchi, Federica; Bianchi, Laura; Guglielmino, Carmelo; Mastromatteo, Antonella R; Cavallaro, Roberto

2018-01-01

Recovery, or functional remission, represents the ultimate treatment goal in schizophrenia. Despite its importance, a standardized definition of remission is still lacking, thus reported rates significantly vary across studies. Moreover, the effects of rehabilitative interventions on recovery have not been thoroughly investigated. This study aimed to evaluate recovery in a sample of patients with chronic schizophrenia engaged in rehabilitation programs and to explore contributing factors, with a focus on sociocognitive rehabilitative interventions. Data from 104 patients with schizophrenia treated either with a standard rehabilitation program, including cognitive remediation (n = 46), or the latter plus a specific sociocognitive intervention (n = 58), and assessed for psychopathology, cognition, social cognition, and Quality of Life Scale, were retrospectively analyzed for this study. Recovery, evaluated with the Quality of Life Scale, was achieved by 56.76% of patients in our sample. While no effects were observed for clinical, cognitive, or sociocognitive variables, participation in the sociocognitive rehabilitative interventions was positively associated with recovery. Our results indicate that high rates of recovery can be achieved in patients treated with psychosocial interventions and suggest that rehabilitative programs targeting social cognition may further facilitate the process of recovery. If confirmed, these results may have relevant implications for daily clinical practice and service provision, allowing clinicians to develop and optimize specific rehabilitation programs in order to promote recovery. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

Incidence of autoimmune bullous diseases in Serbia: a 20-year retrospective study.

PubMed

Milinković, Mirjana V; Janković, Slavenka; Medenica, Ljiljana; Nikolić, Miloš; Reljić, Vesna; Popadić, Svetlana; Janković, Janko

2016-10-01

While most previous surveys on the clinico-epidemiological features of autoimmune bullous diseases (AIBDs) have predominantly focused on a single disease entity or just one disease group, there have been only few studies examining the incidence of various AIBDs. In the present study, we set out to determine the spectrum of AIBDs, to estimate the incidence of the most common AIBDs, and to examine their temporal trends in Central Serbia over a period of 20 years. We retrospectively recruited 1,161 new AIBD cases diagnosed in Central Serbia during the period from January 1991 to December 2010. The diagnosis was based on strict clinical, histological, and immunohistological evaluation. The incidence rates were: 4.35 per million population/year (pmp/year) for pemphigus, 4.47 pmp/year for pemphigoid, 1.42 pmp/year for dermatitis herpetiformis (DH), 0.25 pmp/year for linear IgA disease, and 0.08 pmp/year for epidermolysis bullosa acquisita. In the period observed, age-adjusted incidence rates significantly increased for pemphigus and particularly for pemphigoid, whereas they decreased, albeit not significantly, for DH. For the first time, our study evaluates the incidence rates of the entire spectrum of AIBDs in Serbia, and examines their temporal trends over a 20-year period. To the best of our knowledge, our finding of similar incidence rates for pemphigus and pemphigoid has previously not been reported. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

[Rehospitalization and early discharge in neonatology: retrospective evaluation].

PubMed

Giroux, J D; Finel, E; Sizun, J; Guillois, B; Alix, D; de Parscau, L

1993-03-01

This retrospective study compared discharge summary data in neonates discharged from the Brest Teaching Hospital Neonatology Unit between May 1, 1980 and April 30, 1981 (Period I) or between May 1, 1990 and April 30, 1991 (Period II). Birth weight, gestational age, duration of hospitalization, corrected age at discharge and rehospitalization rate were compared. Among infants with intrauterine growth retardation (IUGR) with or without prematurity, weight at discharge was 2,500 g or less in none of Period I patients (n = 144) versus 67.8% of Period II patients (n = 87). Four Period II infants weighted 2,000 g or less at discharge (1,850, 1,930, 1,960, and 2,000 g). Among premature infants without growth retardation, weight at discharge was 2,500 g or less in 2.2% of Period I infants versus 52.5% of Period II infants (p < 0.0001). Period II infants were not rehospitalized more often or earlier than Period I infants. Early discharge reduces the duration of separation of the child from his or her parents without increasing the rehospitalization rate.

Effects of pulmonary rehabilitation in bronchiectasis: A retrospective study.

PubMed

Ong, H K; Lee, A L; Hill, C J; Holland, A E; Denehy, L

2011-01-01

There is limited information about the benefits of pulmonary rehabilitation (PR) in patients with bronchiectasis. This study aimed to evaluate the effects of an out-patient PR program in patients with a primary diagnosis of bronchiectasis and to compare them with a matched COPD group who completed the same PR program. A retrospective review was conducted of patients with bronchiectasis or COPD who completed 6 to 8 weeks of PR at two tertiary institutions. The outcome measures were the 6-minute walk distance (6MWD) and Chronic Respiratory Disease Questionnaire (CRQ). Ninety-five patients with bronchiectasis completed the PR (48 male; FEV(1) 63 [24] % predicted; age 67 [10] years). Significant improvements in 6MWD (mean change 53.4 m, 95% CI 45.0 to 61.7) and CRQ total score (mean change 14.0 units, 95% CI 11.3 to 16.7) were observed immediately following PR. In patients with complete follow-up (n = 37), these improvements remained significantly higher than baseline at 12 months (20.5 m, 95% CI 1.4 to 39.5 for 6MWD; 12.1 points, 95% CI 5.7 to 18.4 for CRQ total score). The time trend and changes in the 6MWD and CRQ scores were not significantly different between the bronchiectasis and the COPD groups (all p > 0.05). This study supports the inclusion of patients with bronchiectasis in existing PR programs. Further prospective RCTs are warranted to substantiate these findings.

Retrospective evaluation of current-based impedance compensation defibrillation in out-of-hospital cardiac arrest.

PubMed

Chen, Bihua; Yin, Changlin; Ristagno, Giuseppe; Quan, Weilun; Tan, Qing; Freeman, Gary; Li, Yongqin

2013-05-01

Transthoracic impedance (TTI) is a principal parameter that influences the intracardiac current flow and defibrillation outcome. In this study, we retrospectively evaluated the performance of current-based impedance compensation defibrillation in out-of-hospital cardiac arrest (OHCA) patients. ECG recordings, along with TTI measurements were collected from multiple emergency medical services (EMSs) in the USA. All the EMSs in this study used automated external defibrillators (AEDs) which employing rectilinear biphasic (RLB) waveform. The distribution and change of TTI between successive shocks, the influence of preceding shock results on the subsequent shock outcome, and the performance of current-based impedance compensation defibrillation was evaluated. A total of 1166 shocks from 594 OHCA victims were examined in this study. The average TTI for the 1st shock was 134.8 Ω and a significant decrease in TTI was observed for the 2nd (p<0.001) and 3rd (p=0.033) sequential escalating shock. But TTI did not change after the 3rd shock. A higher success rate was observed for shocks with preceding defibrillation success. The success rate remained unchanged over the whole spectrum of TTI. The average TTI was relatively higher in this OHCA population treated with RLB defibrillation as compared with previously reported data. TTI was significantly decreased after 1st and 2nd successive escalating shock but kept constant after the 3rd shock. Preceding shock success was a better predictor of subsequent defibrillation outcome other than TTI. Current-based impedance compensation defibrillation resulted in equivalent success rate for high impedance patients when compared with those of low impedance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Diffuse malignant peritoneal mesothelioma: Evaluation of systemic chemotherapy with comprehensive treatment through the RENAPE Database: Multi-Institutional Retrospective Study.

PubMed

Kepenekian, V; Elias, D; Passot, G; Mery, E; Goere, D; Delroeux, D; Quenet, F; Ferron, G; Pezet, D; Guilloit, J M; Meeus, P; Pocard, M; Bereder, J M; Abboud, K; Arvieux, C; Brigand, C; Marchal, F; Classe, J M; Lorimier, G; De Chaisemartin, C; Guyon, F; Mariani, P; Ortega-Deballon, P; Isaac, S; Maurice, C; Gilly, F N; Glehen, O

2016-09-01

Diffuse malignant peritoneal mesothelioma (DMPM) is a severe disease with mainly locoregional evolution. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is the reported treatment with the longest survival. The aim of this study was to evaluate the impact of perioperative systemic chemotherapy strategies on survival and postoperative outcomes in patients with DMPM treated with curative intent with CRS-HIPEC, using a multi-institutional database: the French RENAPE network. From 1991 to 2014, 126 DMPM patients underwent CRS-HIPEC at 20 tertiary centres. The population was divided into four groups according to perioperative treatment: only neoadjuvant chemotherapy (NA), only adjuvant chemotherapy (ADJ), perioperative chemotherapy (PO) and no chemotherapy before or after CRS-HIPEC (NoC). All groups (NA: n = 42; ADJ: n = 16; PO: n = 16; NoC: n = 48) were comparable regarding clinicopathological data and main DMPM prognostic factors. After a median follow-up of 61 months, the 5-year overall survival (OS) was 40%, 67%, 62% and 56% in NA, ADJ, PO and NoC groups, respectively (P = 0.049). Major complications occurred for 41%, 45%, 35% and 41% of patients from NA, ADJ, PO and NoC groups, respectively (P = 0.299). In multivariate analysis, NA was independently associated with worse OS (hazard ratio, 2.30; 95% confidence interval, 1.07-4.94; P = 0.033). This retrospective study suggests that adjuvant chemotherapy may delay recurrence and improve survival and that NA may impact negatively the survival for patients with DMPM who underwent CRS-HIPEC with curative intent. Upfront CRS and HIPEC should be considered when achievable, waiting for stronger level of scientific evidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluating response shift in training evaluation: comparing the retrospective pretest with an adapted measurement invariance approach in a classroom management training program.

PubMed

Piwowar, Valentina; Thiel, Felicitas

2014-10-01

Response shift (RS) can threaten the internal validity of pre-post designs. As RS may indicate a redefinition of the target construct, its occurrence in training evaluation is rather likely. The most common approach to deal with RS is to implement a retrospective pretest (then-test) instead of the traditional pre-test. In health psychology, an adapted measurement invariance approach (MIad) was developed as an alternative technique to study RS. Results produced by identifying RS with the two approaches were rarely studied simultaneously or within an experimental framework. To study RS in two different treatment conditions and compare results produced by both techniques in identifying various types of RS. We further studied validity aspects of the then-test. We evaluated RS by applying the then-test procedure (TP) and the measurement invariance apporach MIad within an experimental design: Participants either attended a short-term or a long-term classroom management training program. Participants were 146 student teachers in their first year of master's study. Pre (before training), post, and then self-ratings (after training) on classroom management knowledge were administered. Results indicated that the two approaches do not yield the same results. The MIad identified more and also group-specific RS as opposed to the findings of the TP, which found less and only little evidence for group-specific RS. Further research is needed to study the usability and validity of the respective approaches. In particular, the usability of the then-test seems to be challenged. © The Author(s) 2014.

Third-Line Chemotherapy for Metastatic Urothelial Cancer: A Retrospective Observational Study

PubMed Central

Di Lorenzo, Giuseppe; Buonerba, Carlo; Bellelli, Teresa; Romano, Concetta; Montanaro, Vittorino; Ferro, Matteo; Benincasa, Alfonso; Ribera, Dario; Lucarelli, Giuseppe; De Cobelli, Ottavio; Sonpavde, Guru; De Placido, Sabino

2015-01-01

Abstract The prognosis of locally advanced (T3/T4 or N1) and metastatic disease urothelial carcinoma is poor. In this retrospective study, we reviewed data about patients receiving third-line chemotherapy for metastatic disease, in view of the lack of data in this setting. We retrospectively analyzed medical records of patients with a pathologic diagnosis of urothelial carcinoma treated with systemic chemotherapy for metastatic disease at 4 participating Institutions between January, 2010, and January, 2015. Cox proportional hazards regression was used to evaluate the association of the chemotherapy agent used versus others with overall survival, adjusted for 5 externally validated prognostic factors in advanced urothelial carcinoma. Of 182 patients that received first-line chemotherapy/adjuvant chemotherapy as defined above, 116 patients (63.73%) received second-line salvage treatment. Fifty-two patients were finally included in this analysis, whereas 9 were excluded due to missing data. Third-line chemotherapy was based on cyclophosphamide, platinum, vinflunine, taxanes, and gemcitabine in 16, 12, 11, 10, and 3 patients, respectively. Median PFS (progression-free survival) and OS (overall survival) of the population were 13 (10–17) and 31 (28–36) weeks. Single-agent cyclophosphamide was associated with a PFS of 18 (13–22) and an OS of 38 (33–41) weeks, whereas platinum-based combinations were associated with a PFS of 5 weeks and an OS of 8 weeks. Multivariate analysis showed improved survival in patients treated with cyclophosphamide (hazard ratio (HR) = 0.42; 95% CI: 0.20–0.89; P = 0.025) and a worse survival in those treated with platinum-based regimens (HR: 4.37; 95% CI = 1.95–9.77; P < 0.01). We observed a significantly longer overall survival in patients receiving single-agent cyclophosphamide, with few grade 3 to 4 toxicities. Further studies should assess the efficacy of metronomic single-agent cyclophosphamide in advanced lines

Prospective versus Retrospective Approaches to the Study of Intergenerational Social Mobility

ERIC Educational Resources Information Center

Song, Xi; Mare, Robert D.

2015-01-01

Most intergenerational social mobility studies are based upon retrospective data, in which samples of individuals report socioeconomic information about their parents, an approach that provides representative data for offspring but not the parental generation. When available, prospective data on intergenerational mobility, which are based on a…

Cutaneous reactive histiocytosis in dogs: a retrospective evaluation of 32 cases.

PubMed

Palmeiro, Brian S; Morris, Daniel O; Goldschmidt, Michael H; Mauldin, Elizabeth A

2007-10-01

Thirty-two cases of canine cutaneous histiocytosis were retrospectively evaluated. Median age at onset was 4 years. Lesions included nodules and plaques affecting the head/face, trunk and limbs, and erythema, swelling and depigmentation of the nasal planum/nares. Systemic involvement was not ruled out in all cases. All dogs had complete resolution of dermatological lesions after initial treatment (median 45 days). Initial treatment included prednisone +/- antibiotics (12 of 32 dogs), prednisone and tetracycline/niacinamide (four of 32), prednisone and azathioprine (three of 32), tetracycline/niacinamide +/- vitamin E/essential fatty acids (six of 32), antibiotics +/- antihistamines (three of 32), cyclosporine and ketoconazole (one of 32), topical therapy (two of 32), and no treatment (one of 32). Seventeen dogs received maintenance therapy which consisted of tetracycline/niacinamide +/- vitamin E/essential fatty acids (12 of 17), cyclosporine/ketoconazole (two to three times a week) (two of 17), azathioprine daily (one of 17), prednisone/azathioprine (two times a week) (one of 17), and prednisone daily (one of 17). Median follow up was 25 months. Nine dogs had a recurrence of cutaneous histiocytosis (median days to recurrence 130 days), with seven of nine having more than one recurrence. At study completion, six dogs were deceased (no lesions at the time of death) and 26 of 32 were alive with no lesions. Ten of 26 dogs were on maintenance treatment (eight tetracycline/niacinamide, one azathioprine, one vitamin E). Previous dermatological disease and season had no detectable influence on recurrence. Recurrence was significantly more likely in dogs with nasal planum/nares lesions than dogs without these lesions. Tetracycline/niacinamide was an effective treatment option for dogs in this study population.

Effectiveness of Omalizumab in Severe Allergic Asthma: A Retrospective UK Real-World Study

PubMed Central

2013-01-01

Objective. The aim of this study was to evaluate the “real world” effects of the monoclonal antibody omalizumab (OMB) when used to treat severe persistent allergic asthma in UK clinical practice. Methods. A 10-center retrospective observational study was carried out to compare oral corticosteroid (OCS) use and exacerbation frequency in 12 months pre- versus post-OMB initiation in 136 patients aged ≥12 years with severe persistent allergic asthma. All patients received ≥1 dose of OMB. Patients who had received OMB in a clinical trial were excluded. Data were obtained from hospital and if necessary general practitioners’ (GPs’) records on OCS use, lung function, hospital resource use, and routinely used quality of life (QoL) measures at baseline (pre-OMB), 16 weeks, and up to 12 months post-OMB initiation. Results. Mean total quantity of OCS prescribed per year decreased by 34% between the 12 months pre- and post-OMB initiation. During the 12 months post-OMB initiation, 87 patients (64%) stopped/reduced OCS use by 20% or more and 66 (49%) stopped OCS completely. Mean percent predicted forced expiratory volume in one second (FEV1) increased from 66.0% at baseline to 75.2% at week 16 of OMB therapy. The number of asthma exacerbations decreased by 53% during the 12 months post-initiation. Accident and emergency visits reduced by 70% and hospitalizations by 61% in the 12 months post-OMB initiation. Conclusion. This retrospective analysis showed a reduction in exacerbations and improved QoL as per previous studies with OMB. However, the total reduction in annual steroid burden and improved lung function in this severely ill group of patients taking regular or frequent OCS is greater than that seen in previous trials. PMID:23574000

Retrospective study on the performance of porcelain laminate veneers delivered by undergraduate dental students.

PubMed

Murphy, E; Ziada, H M; Allen, P F

2005-03-01

The aim of this study was to retrospectively evaluate the clinical performance of porcelain laminate veneer restorations delivered by undergraduate students at the Department of Restorative Dentistry, University Dental School and Hospital Cork and to analyze the factors that influence their prognosis and their effect on periodontal health. Patients who had veneers fitted over a period of 5 yrs. were recalled for evaluation. The recall protocol took the form of a questionnaire and a full clinical examination of the teeth involved and contra lateral control teeth. In all, 29 patients with 62 porcelain veneers were examined, only 2 of which were in the mandible. 77% of patients had veneers fitted due to discolouration, 13% in order to alter the shape or size of teeth and 10% due to palatal erosion. On the date of recall 89% of veneers had never debonded or fractured, 6% had to be rebonded since the date of insertion and 5% presented with a fracture. From this study it appears that porcelain laminate veneers are successful in the treatment of discoloured and irregular configured anterior teeth. It shows that undergraduate students can deliver satisfactory veneer restorations.

Hemifacial spasm associated with type 1 Chiari malformation: a retrospective study of 13 cases.

PubMed

Li, Ning; Zhao, Wei-Guo; Pu, Chun-Hua; Yang, Wen-Lei

2017-04-01

Hemifacial spasm (HFS) associated with type 1 Chiari malformation is particularly uncommon and is limited to isolated case report. The aims of this study were to report the clinical correlates of patients who had simultaneously HFS and type 1 Chiari malformation and to present the outcome of these patients treated with microvascular decompression (MVD) surgery. We retrospectively evaluated 13 patients who had simultaneously HFS and type 1 Chiari malformation among 675 HFS patients. Clinical features and radiological findings were collected from each patient and analyzed. All these 13 patients were surgically treated with MVD through retro-mastoid microsurgical approach, and postoperative outcomes were evaluated. A review of literature about this association was also provided. In this study, the frequency of type 1 Chiari malformation in HFS patients was 1.9 %. The clinical profile of this series of patients did not differ from typical form of primary HFS. MVD achieved satisfactory results in 11 patients (85 %) in short- and long-term follow-up. There was no mortality or severe complication occurred postoperatively. Although rare, clinician should be aware of the association of HFS and type 1 Chiari malformation and consider MVD as an effective surgical management.

Multidimensional esthetic evaluation of patients with a cleft lip and palate wearing a maxillary partial removable dental prosthesis: A 5-year retrospective study.

PubMed

Yu, Dedong; Xing, Guofang; Nie, Ping; Zhang, Xiuyin; Steve Shen, Guofang

2016-04-01

No published quantitative or qualitative studies are available of the 2-dimensional (2D) and 3D esthetic evaluation of patients with a cleft lip and palate (CLP) wearing a maxillary partial removable dental prosthesis (MPRDP). The purpose of this retrospective clinical study was to qualitatively and quantitatively evaluate the facial esthetic improvements of patients with CLP wearing an MPRDP for 5 years by using 2D cephalometric and 3D photogrammetry methods. Six patients, 2 men and 4 women, with CLP deformity were recruited and treated with an MPRDP by the same dentist over 5 years. Results of the clinical examination were recorded before and after wearing the MPRDP. Sella-nasion-A (SNA) point, the U1-SN, 0-meridian to SN, nasolabial angle, and maxillary incisor exposure were measured by 2D cephalometric analysis before and after wearing the MPRDP. 3D photographs were captured by 3dMD software. Geomagic Spark Studio software was also used to measure the patients' improved upper lip projection after the MPRDP was worn. The paired sample t test was used to compare the participants (α=.05). U1-SN (P<.05) and 0-meridian to SN (P<.01) had significant deviation statistically. After patients underwent clinical examination, SNA and nasiolabial angles were found to have improved, although no statistical significance was observed. A maxillary partial removable dental prosthesis (MPRDP) can advance the upper lip forward, restoring the subnasal and upper lip projection. Patients' nasiolabial angles with MPRDPs were decreased, which led to a more harmonious facial contour. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

A retrospective study of root canal therapy in non-vital primary molars.

PubMed

Stallaert, K M; Sigal, M J; Titley, K C; Andrews, P B

2016-12-01

This study was performed to assess the clinical and radiographic success rates of a formocresol and zinc oxide eugenol (ZOE) primary molar root canal therapy (RCT) technique. The effects of this treatment on the permanent successors and on exfoliation times were also investigated. Study design: the retrospective study included 161 patients with 211 primary molars treated by RCT by a single operator in a private paediatric dental office in the Toronto area. Data were coded and entered into a Microsoft Excel database and analysis undertaken using SPSS software. Predominantly non-parametric tests were used to evaluate statistical differences (p < 0.05). A clinical success rate of 90% (190/211) and a radiographic success rate of 77.3% (136/176) were obtained. Following RCT in a primary molar, enamel defects were found in 6.8% (7/103) of premolars, all of which occurred in first premolars, and in patients treated at a mean age of 54.1 months (p < 0.005). Treated molars exfoliated on average 7.6 months sooner than contralateral teeth (p < 0.005). This formocresol and ZOE RCT is a viable treatment for necrotic primary molars and yielded very high clinical and acceptable radiographic success rates.

Disc displacement without reduction: a retrospective study of a clinical diagnostic sign.

PubMed

Giraudeau, Anne; Jeany, Marion; Ehrmann, Elodie; Déjou, Jacques; Ouni, Imed; Orthlieb, Jean-Daniel

2017-03-01

The purpose of this retrospective study is to evaluate a clinical diagnostic sign for disc displacement without reduction (DDWR), the absence of additional condylar translation during opening compared with protrusion. Thirty-eight electronic axiographic and magnetic resonance imaging (MRI) examinations of the TMJ were analyzed in order to compare the opening/protrusion ratio of condylar translation between non-painful DDWR and non-DDWR. According to the Mann-Whitney U test, the opening/protrusion ratio in non-painful DDWR differs significantly from non-DDWR (p < 0.0001). Among non-painful DDWR, there is no additional condylar translation during opening in comparison with protrusion, and this is probably also the case for DDWR without limited opening, which is a subtype that has not been validated by the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Comparative condylar palpation can analyze this sign, and therefore, further comparative investigations between MRI and clinical examination are needed to validate the corresponding clinical test.

Follow-up methods for retrospective cohort studies in New Zealand.

PubMed

Fawcett, Jackie; Garrett, Nick; Bates, Michael N

2002-01-01

To define a general methodology for maximising the success of follow-up processes for retrospective cohort studies in New Zealand, and to illustrate an approach to developing country-specific follow-up methodologies. We recently conducted a cohort study of mortality and cancer incidence in New Zealand professional fire fighters. A number of methods were used to trace vital status, including matching with records of the New Zealand Health Information Service (NZHIS), pension records of Work and Income New Zealand (WINZ), and electronic electoral rolls. Non-electronic methods included use of paper electoral rolls and the records of the Registrar of Births Deaths and Marriages. 95% of the theoretical person-years of follow-up of the cohort were traced using these methods. In terms of numbers of cohort members traced to end of follow-up, the most useful tracing methods were fire fighter employment records, the NZHIS, WINZ, and the electronic electoral rolls. The follow-up process used for the cohort study was highly successful. On the basis of this experience, we propose a generic, but flexible, model for follow-up of retrospective cohort studies in New Zealand. Similar models could be constructed for other countries. Successful follow-up of cohort studies is possible in New Zealand using established methods. This should encourage the use of cohort studies for the investigation of epidemiological issues. Similar models for follow-up processes could be constructed for other countries.

Obstetric bleeding among women with inherited bleeding disorders: a retrospective study.

PubMed

Hawke, L; Grabell, J; Sim, W; Thibeault, L; Muir, E; Hopman, W; Smith, G; James, P

2016-11-01

Women with inherited bleeding disorders are at increased risk for bleeding complications during pregnancy and the postpartum period, particularly postpartum haemorrhage (PPH). This retrospective study evaluates pregnancy management through the Inherited Bleeding Disorders Clinic of Southeastern Ontario, the clinical factors associated with pregnancy-related abnormal bleeding and assesses tranexamic acid use in the postpartum treatment of bleeding disorder patients. A chart review of 62 pregnancies, from 33 women, evaluated patient characteristics (age, haemostatic factor levels) and delivery conditions (mode of delivery, postpartum treatment) in relation to abnormal postpartum bleeding. This cohort revealed increased risk of immediate PPH with increased age at delivery (mean age: 30.1 years with PPH, 26.5 years without PPH, P < 0.013), and birth by vaginal delivery (P < 0.042). Low von Willebrand factor (VWF) antigen or factor VIII (FVIII) in the third trimester was not associated with an increased risk of PPH; however, low VWF:RCo was associated with increased immediate PPH despite treatment with continuous factor infusion (P < 0.042). Women treated with tranexamic acid postpartum had less severe bleeding in the 6-week postpartum (P < 0.049) with no thrombotic complications. This study contributes to the growing body of work aimed at optimizing management of bleeding disorder patients through pregnancy and the postpartum period, showing patients are at a higher risk of PPH as they age. Risk factors such as low third trimester VWF:RCo have been identified. Treatment with tranexamic acid in the postpartum period is associated with a reduced incidence of abnormal postpartum bleeding. © 2016 John Wiley & Sons Ltd.

There is no age limit for methadone: a retrospective cohort study

PubMed Central

2011-01-01

Background Data from the US indicates that methadone-maintained populations are aging, with an increase of patients aged 50 or older. Data from European methadone populations is sparse. This retrospective cohort study sought to evaluate the age trends and related developments in the methadone population of Basel-City, Switzerland. Methods The study included methadone patients between April 1, 1995 and March 31, 2003. Anonymized data was taken from the methadone register of Basel-City. For analysis of age distributions, patient samples were split into four age categories from '20-29 years' to '50 years and over'. Cross-sectional comparisons were performed using patient samples of 1996 and 2003. Results Analysis showed a significant increase in older patients between 1996 and 2003 (p < 0.001). During that period, the percentage of patients aged 50 and over rose almost tenfold, while the proportion of patients aged under 30 dropped significantly from 52.8% to 12.3%. The average methadone dose (p < 0.001) and the 1-year retention rate (p < 0.001) also increased significantly. Conclusions Findings point to clear trends in aging of methadone patients in Basel-City which are comparable, although less pronounced, to developments among US methadone populations. Many unanswered questions on medical, psychosocial and health economic consequences remain as the needs of older patients have not yet been evaluated extensively. However, older methadone patients, just as any other patients, should be accorded treatment appropriate to their medical condition and needs. Particular attention should be paid to adequate solutions for persons in need of care. PMID:21592331

Clinical Outcome Following Radiofrequency Denervation for Refractory Sacroiliac Joint Dysfunction Using the Simplicity III Probe: A 12-Month Retrospective Evaluation.

PubMed

Hegarty, Dominic

2016-01-01

Sacroiliac joint syndrome (SIJ) is diagnosed in 10% to 25% of cases of lower back pain. The response to traditional radiofrequency (RF) denervation of the SIJ has being inconsistent. The Simplicity III RF probe (Neruotherm. Inc.) offers a novel treatment option. To evaluate the long-term clinical outcome (12 months) refractory SIJ syndrome in terms of pain intensity and functional improvement. A 50% reduction in intensity pain intensity (VAS) at 12 months was deemed clinically significant. A 12-month retrospective observational evaluation all of adults treated with RF for refractory SIJ. Chronic pain management center. The medical records of all adults treated with this technique was retrospectively reviewed. The primary outcome was pain intensity scores (VAS) over a 12 months period; Secondary outcomes included Roland-Morris Functional scores (RMF), Brief Pain Inventory (BPI), general health assessment (Sf12), and patient satisfaction scores (GPI), which were recorded pre and post denervation. Pain Intensity improved by 4.7 points compared to pre-treatment representing a 61% reduction in pain at 12 months (n=11, P < 0.001). Significant improvements in (a) RMF (P < 0.01, W2 = 0.63 (large effect size); (b) BPI (P < 0.001, W2 = 0.72 (strong effect size); and (c) Sf12 (P < 0.01) were noted. Overall patients were satisfied with the outcome (GPI = 77.7%). The retrospective in nature of the study and the small sample size are limitations. As it was our policy to monitor the progress of the individuals since the introduction of this technique a reliable method of recording the baseline and outcome variables at each point of contact was in place. Access to a complete set of variables in all individuals over a 12-month period was therefore possible, which we feel contributes to the quality of the dataset. By creating a consistent radiofrequency lesion between the sacral foramen and the SIJ will reliably capture the innervation to the SIJ with significant long-term clinical

Acupuncture for treatment of hospital-induced constipation in children: a retrospective case series study.

PubMed

Anders, Eric Falk; Findeisen, Annette; Nowak, Andreas; Rüdiger, Mario; Usichenko, Taras Ivanovich

2012-12-01

Acupuncture is a promising option in the treatment of functional bowel disorders. The aim of this study was to evaluate the feasibility and acceptance of acupuncture for the treatment of hospital-induced constipation (HIC) in children. Bilateral stimulation of acupuncture point LI11 was applied in 10 children with HIC using fixed indwelling acupuncture needles (0.9 mm long) before considering starting conventional local constipation therapy with laxative suppositories. The clinical records were studied retrospectively for feasibility, acceptance and effectiveness of acupuncture. Acupuncture was feasible in all children and application of the indwelling needles was tolerated without fear. Side effects were not observed. After a median of 3 days of HIC, all children defaecated within 2 h after LI11 stimulation. No patient required conventional local constipation therapy. Acupuncture for the treatment of HIC is feasible and acceptable. Its effect should be verified in a randomised controlled trial.

Maxillofacial Injuries in Children: A 10 year Retrospective Study.

PubMed

Kambalimath, H V; Agarwal, S M; Kambalimath, Deepashri H; Singh, Mamta; Jain, Neha; Michael, P

2013-06-01

Fractures of facial bones in children are relatively uncommon although both children and adults are subjected to similar types of injuries. This study aims to evaluate the epidemiology of facial bone fractures among children under 14 years, their management and outcome. This retrospective study included maxillofacial injuries treated in 112 children under 14 years admitted due to maxillofacial injuries during the period from 2001 to 2011. Of them ten (8.93 %) were below 5 years, 44 (39.29 %) between 6 and 10 years and 58 (51.78 %) between 11 and 14 years of age. Male to female ratio was 1.8:1. Fall from a height was the most common etiology. The most common jaw involved in the fracture was the mandible. Conservative management was done in 83.04 % of cases and open reduction and internal fixation was performed in 16.96 % of cases. Five (4.46 %) cases accounted for post-operative wound infection. Fracture of the mandible is the most common maxillofacial injury in children, most often caused by fall from a height. The osteogenic potential of the mandible in children leads to conservative management of these fractures. Opportunities for prevention of maxillofacial trauma should be taken into consideration by parents and care takers.

A Retrospective Study of DARE: Substantive Effects not Detected in Undergraduates.

ERIC Educational Resources Information Center

Thombs, Dennis L.

2000-01-01

This retrospective study examined long-term effects of Drug Abuse Resistance Education (DARE) by assessing substance use among undergraduates. Results from a multiple discriminant analysis found that after accounting for effects of age, there were no substantial group differences in substance use. These findings add to a growing literature that…

Dental implants in medically complex patients-a retrospective study.

PubMed

Manor, Yifat; Simon, Roy; Haim, Doron; Garfunkel, Adi; Moses, Ofer

2017-03-01

Dental implant insertion for oral rehabilitation is a worldwide procedure for healthy and medically compromised patients. The impact of systemic disease risks on the outcome of implant therapy is unclear, since there are few if any published randomized controlled trials (RCTs). The objective of this study is to investigate the rate of complications and failures following dental implantation in medically compromised patients in order to elucidate risk factors and prevent them. A retrospective cohort study was conducted from patient files treated with dental implantation between the years 2008-2014. The study group consisted of medically complex patients while the control group consisted of healthy patients. Preoperative, intraoperative, and post operative clinical details were retrieved from patients' files. The survival rate and the success rate of the dental implants were evaluated clinically and radiographically. A total of 204 patients (1003 dental implants) were included in the research, in the study group, 93 patients with 528 dental implants and in the control group, 111 patients with 475 dental implants. No significant differences were found between the groups regarding implant failures or complications. The failure rate of dental implants among the patients was 11.8 % in the study group and 16.2 % in the control group (P = 0.04). It was found that patients with a higher number of implants (mean 6.8) had failures compared with patients with a lower number of implants (mean 4.2) regardless of their health status (P < 0.01). We found a similar rate of failure and complications of dental implantation in medically complex patients and in healthy patients. Medically complex patients can undergo dental implantation. There are similar rates of complications and failures of dental implants in medically complex patients and in healthy patients.

Computed tomographic features of apical infection of equine maxillary cheek teeth: a retrospective study of 49 horses.

PubMed

Bühler, M; Fürst, A; Lewis, F I; Kummer, M; Ohlerth, S

2014-07-01

Computed tomographic (CT) studies evaluating the relevance of individual CT features of apical infection in maxillary cheek teeth are lacking. To study the prevalence and relationship of single CT features in horses with and without clinical evidence of apical infection in maxillary cheek teeth. Retrospective case-control study. Multislice CT scans of the head of 49 horses were evaluated retrospectively. Changes of the infundibulum, pulp, root, lamina dura, periodontal space and alveolar bone in maxillary cheek teeth were recorded. Single CT changes were much more prevalent in the 28 horses with clinical signs. However, infundibular changes and a nondetectable lamina dura were also common in the 21 horses without clinical evidence of apical infection. Computed tomographic abnormalities of the pulp, root, periapical bone and periodontal space and the presence of a tooth fracture were significantly related. Infundibular changes were not associated with other CT signs of apical infection. Although nondetectable lamina dura was the most frequent CT change in all teeth in both studied groups, it was most commonly a solitary feature in otherwise normal teeth. Apical infections, defined as ≥3 CT changes, occurred mainly in the 108/208, 109/209 and 110/210 (Triadan numbers) and were found only in horses with clinical evidence of apical infection, except in one horse without clinical signs that had one affected root. Combined CT changes of the pulp, root, lamina dura, periapical bone and periodontal space and the presence of a tooth fracture appear to be reliable features to diagnose apical infection in maxillary cheek teeth. As a solitary feature, a nondetectable lamina dura should be interpreted cautiously and may even be considered normal due to its minor thickness and/or too low resolution of the imaging modality. © 2013 EVJ Ltd.

Oral cobalamin supplementation in cats with hypocobalaminaemia: a retrospective study.

PubMed

Toresson, Linda; Steiner, Joerg M; Olmedal, Gunilla; Larsen, MajBritt; Suchodolski, Jan S; Spillmann, Thomas

2017-12-01

Objectives The objective of the study was to evaluate whether oral cobalamin supplementation can restore normocobal-aminaemia in cats with hypocobalaminaemia and clinical signs of gastrointestinal disease. Methods This was a retrospective study based on a computerised database search for client-owned cats treated at Evidensia Specialist Animal Hospital, Helsingborg, Sweden, during the period December 2013 to August 2016. Inclusion criteria were cats with clinical signs of chronic enteropathy, an initial serum cobalamin concentration ⩽250 pmol/l (reference interval 214-738 pmol/l) and oral treatment with cobalamin tablets. Results Twenty-five cats met the inclusion criteria. The cats were treated with 0.25 mg cyanocobalamin tablets once daily. Serum cobalamin concentration was rechecked 27-94 days after continuous oral cobalamin supplementation. All cats had serum cobalamin concentrations above the reference interval after oral cobalamin supplementation. Median (range) serum cobalamin concentration was 128 pmol/l (111-250 pmol/l) prior to treatment and 2701 pmol/l (738-16,359 pmol/l) after supplementation. This difference was statistically significant ( P <0.0001). Conclusions and relevance Our results suggest that oral cobalamin supplementation is effective in increasing serum cobalamin to supranormal concentrations in cats with hypocobalaminaemia. Thus, oral cobalamin supplementation is a promising alternative to parenteral administration. Prospective comparative studies in cats being treated with parenteral vs oral cobalamin supplementation in a larger number of patients are warranted before oral supplementation can be recommended for routine use.

Retrospective voting and party support at elections: credit and blame for government and opposition

PubMed Central

Plescia, Carolina; Kritzinger, Sylvia

2017-01-01

ABSTRACT Retrospective voting is arguably one of the most important mechanisms of representative democracy, and whether or not the public holds the government accountable for its policy performance has been extensively studied. In this paper, we test whether retrospective voting extends to parties in the opposition, that is whether and how parties’ past performance evaluations affect their vote, regardless of whether they were in government or in opposition. Taking advantage of a rich set of questions embedded in a representative German national elections panel, we update our knowledge on the retrospective voting mechanism by modeling retrospective voting at the party level. The findings indicate that the incumbent status is not the only criterion for retrospective voting, ultimately suggesting that both government and opposition parties can expect credit and blame for their conduct and this should provide some impetus for responsive performance of all parties. PMID:28515772

A half century retrospective study of homicide-suicide in Geneva--Switzerland: 1956-2005.

PubMed

Shiferaw, Kebede; Burkhardt, Sandra; Lardi, Christelle; Mangin, Patrice; La Harpe, Romano

2010-02-01

This study provides a retrospective review from the forensic files of the University Centre of Legal Medicine in Western Switzerland in Geneva, from January 1956 to December 2005. The studied homicide-suicide cases cover a period of half a century (50 years). As a rule, all police-ordered forensic examinations of violent death cases in the Canton of Geneva are conducted by the University Centre of Legal Medicine. All of the data necessary for an exhaustive retrospective study are thus readily available. During the period covered in this work, 228 homicides were perpetrated in Geneva. In 23 cases, the homicide was followed by the suicide of the aggressor. The 34 victims of these homicides (18 women, 1 man and 15 children) had either an intimate or filial relationship with the perpetrator. Most of the suicidal perpetrators were men that killed their spouses or intimate partners, with children as additional victims in some cases. Shooting was the most common means to kill, followed by stabbing. The majority of the victims and perpetrators were Swiss nationals. This retrospective study shows that in the last 50 years, homicide-suicide cases in the Canton of Geneva have been a rare and an episodic phenomena with a very variable frequency from 1 year to another. Copyright 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Breast abscess, an early indicator for diabetes mellitus in non-lactating women: a retrospective study from rural India.

PubMed

Verghese, Basil George; Ravikanth, R

2012-05-01

Breast abscess is commonly seen in lactating and non-lactating women. Diabetes mellitus (DM) frequently predisposes to soft tissue infections and has many different presentations. But DM presenting in the form of breast abscess is yet to be studied, and we believe our study is the first to explore this connection. We collected 30 cases of breast abscess in women who presented to our hospital from May 2010 to June 2011 retrospectively. They were classified into lactating and non-lactating women, and their glycemic status was evaluated, together with length of hospital stay, management, recurrence, and follow-up status after 6 months. We found that of the 30 patients in our study, 20% had high blood sugar levels. And 37.5% of the non-lactating women were diagnosed newly with DM. This study shows that DM can present as breast abscess in non-lactating women. Therefore, non-lactating women with a breast abscess should be evaluated for DM.

Gastric dilatation volvulus: a retrospective study of 203 dogs with ventral midline gastropexy.

PubMed

Ullmann, B; Seehaus, N; Hungerbühler, S; Meyer-Lindenberg, A

2016-01-01

To evaluate the recurrence rate of gastric dilatation volvulus and the incidence of complications in subsequent coeliotomies following ventral midline gastropexy. The medical records of dogs treated for gastric dilatation volvulus by ventral midline gastropexy were retrospectively reviewed. Owners were contacted and invited to complete a questionnaire and to return to the clinic for ultrasonographic and radiographic follow-up. The questionnaire was completed by 203 owners 2 to 123 months postoperatively, 24 of whom attended the follow-up examination. Of the 203 dogs, 13 (6 · 4%) underwent subsequent ventral midline coeliotomy and none developed complications related to the gastropexy site. In 23 of the 24 re-evaluated dogs, the stomach was closely associated with the abdominal on radiography and/or ultrasound. The recurrence rate for clinical signs of gastric dilatation or gastric dilatation volvulus after ventral midline gastropexy was 6 · 4%. This study shows that the recurrence of gastric dilatation volvulus after ventral midline gastropexy is low and adhesion of the stomach to the abdominal wall is persistent in almost all dogs that were re-examined. The gastropexy site did not appear to interfere with subsequent coeliotomy. © 2015 British Small Animal Veterinary Association.

Retrospective evaluation of recurrent secondary septic peritonitis in dogs (2000-2011): 41 cases.

PubMed

Barfield, Dominic M; Tivers, Michael S; Holahan, Matthew; Welch, Kristin; House, Arthur; Adamantos, Sophie E

2016-01-01

To describe the clinical characteristics of recurrent septic peritonitis in dogs. Multicenter retrospective observational study. Client-owned dogs with recurrent septic peritonitis. Three university emergency and referral hospitals. None. Medical records from 3 veterinary university teaching hospitals were reviewed and data were collected using a standardized data collection sheet for all cases of septic peritonitis during the study period (2000-2011). Forty one dogs met the inclusion criteria for recurrent peritonitis. All dogs underwent relaparotomy. The original cause of septic peritonitis in these cases included previous surgery for gastrointestinal foreign body removal (n = 26), gastrointestinal neoplasia (n = 3), gastric or duodenal ulceration (n = 3), biliary tract leakage (n = 2), and single instance for each of the following: penetrating foreign body, hernia strangulation, intussusception, mesenteric volvulus, infection of the laparotomy incision, prostatic abscess, and trauma. Eighteen animals survived to discharge. There was no difference detected between survivors and nonsurvivors with recurrent peritonitis in terms of inciting cause, serum albumin concentration, surgical management, or provision of appropriate initial antimicrobials. The survival rate for dogs having recurrent peritonitis was 43.9% (18/41 dogs). This retrospective study did not identify any significant prognostic indicators for dogs with recurrent peritonitis and that the mortality rate for dogs having more than one surgery for septic peritonitis is similar to that reported for a single surgery for septic peritonitis. ©Veterinary Emergency and Critical Care Society 2015.

Re-evaluation of link between interpregnancy interval and adverse birth outcomes: retrospective cohort study matching two intervals per mother

PubMed Central

Pereira, Gavin; Jacoby, Peter; de Klerk, Nicholas; Stanley, Fiona J

2014-01-01

Objective To re-evaluate the causal effect of interpregnancy interval on adverse birth outcomes, on the basis that previous studies relying on between mother comparisons may have inadequately adjusted for confounding by maternal risk factors. Design Retrospective cohort study using conditional logistic regression (matching two intervals per mother so each mother acts as her own control) to model the incidence of adverse birth outcomes as a function of interpregnancy interval; additional unconditional logistic regression with adjustment for confounders enabled comparison with the unmatched design of previous studies. Setting Perth, Western Australia, 1980-2010. Participants 40 441 mothers who each delivered three liveborn singleton neonates. Main outcome measures Preterm birth (<37 weeks), small for gestational age birth (<10th centile of birth weight by sex and gestational age), and low birth weight (<2500 g). Results Within mother analysis of interpregnancy intervals indicated a much weaker effect of short intervals on the odds of preterm birth and low birth weight compared with estimates generated using a traditional between mother analysis. The traditional unmatched design estimated an adjusted odds ratio for an interpregnancy interval of 0-5 months (relative to the reference category of 18-23 months) of 1.41 (95% confidence interval 1.31 to 1.51) for preterm birth, 1.26 (1.15 to 1.37) for low birth weight, and 0.98 (0.92 to 1.06) for small for gestational age birth. In comparison, the matched design showed a much weaker effect of short interpregnancy interval on preterm birth (odds ratio 1.07, 0.86 to 1.34) and low birth weight (1.03, 0.79 to 1.34), and the effect for small for gestational age birth remained small (1.08, 0.87 to 1.34). Both the unmatched and matched models estimated a high odds of small for gestational age birth and low birth weight for long interpregnancy intervals (longer than 59 months), but the estimated effect of long interpregnancy

Diffusion-Weighted Magnetic Resonance Imaging of Cholesteatoma Using PROPELLER at 1.5T: A Single-Centre Retrospective Study.

PubMed

Clarke, Sharon E; Mistry, Dipan; AlThubaiti, Talal; Khan, M Naeem; Morris, David; Bance, Manohar

2017-05-01

The purpose of this study was to evaluate the sensitivity, specificity, and positive and negative predictive values of the diffusion-weighted periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique in the detection of cholesteatoma at our institution with surgical confirmation in all cases. A retrospective review of 21 consecutive patients who underwent diffusion-weighted PROPELLER magnetic resonance imaging (MRI) on a 1.5T MRI scanner prior to primary or revision/second-look surgery for suspected cholesteatoma from 2009-2012 was performed. Diffusion-weighted PROPELLER had a sensitivity of 75%, specificity of 60%, positive predictive value of 86%, and negative predictive value of 43%. In the 15 patients for whom the presence or absence of cholesteatoma was correctly predicted, there were 2 cases where the reported locations of diffusion restriction did not correspond to the location of the cholesteatoma observed at surgery. On the basis of our retrospective study, we conclude that diffusion-weighted PROPELLER MRI is not sufficiently accurate to replace second look surgery at our institution. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Laparoscopic Repair for Perforated Peptic Ulcer: A Retrospective Study.

PubMed

Vărcuş, Flore; Beuran, Mircea; Lica, Ioan; Turculet, Claudiu; Cotarlet, Adrian Valentin; Georgescu, Stefan; Vintila, Dan; Sabău, Dan; Sabau, Alexandru; Ciuce, Constantin; Bintintan, Vasile; Georgescu, Eugen; Popescu, Razvan; Tarta, Cristi; Surlin, Valeriu

2017-04-01

The incidence of patients presenting with perforated peptic ulcers (PPU) has decreased during the last decades. At the same time, a laparoscopic approach to this condition has been adopted by increased number of surgeons. The aim of this study was to evaluate the early postoperative results of the laparoscopic treatment of perforated peptic ulcer performed in eight Romanian surgical centers with extensive experience in laparoscopic surgery. Between 2009 and 2013, 297 patients with perforated peptic ulcer were operated in the eight centers participating in this retrospective study. The patients' charts were reviewed for demographics, surgical procedure, complications and short-term outcomes. Boey score of 0 was found in 122 patients (41.1%), Boey 1 in 169 (56.9%), Boey 3 in 6 (2.0%). For 145 (48.8%) patients, primary suture repair was performed, in 146 (49.2%) primary suture repair with omentopexy. There were 6 (2.0%) conversions to open surgery. The operative time was between 25 and 120 min, with a mean of 68 min. Two (0.7%) deaths were noted. Mean hospital stay was 5.5 days, ranges 3-25 days. Postoperative complications included: 7 (2.4%) superficial surgical site infections, 5 (1.6%) cardiovascular, 3 (1.0%) pulmonary, 2 (0.7%) duodenal leakages, 3 (1.0%) deep space infections and 1 (0.3%) upper digestive hemorrhage. This study shows that the laparoscopic approach for PPU is feasible; the procedure is safe, with no increased risk of duodenal fistulae or residual intraperitoneal abscesses. We now consider the laparoscopic approach for PPU as the "gold standard" in patients with Boey score 0 or 1.

Clinical Outcomes after Keraring Implantation for Keratoconus Management in Patients Older Than 40 Years: A Retrospective, Interventional, Cohort Study.

PubMed

Gatzioufas, Zisis; Khine, Aye; Elalfy, Mohamed; Guber, Ivo; McLintock, Cameron; Sabatino, Francesco; Hamada, Samer; Lake, Damian

2018-06-01

Intracorneal ring segment implantation is an effective and safe method of visual improvement in patients with keratoconus. The aim of our study was to evaluate the long-term clinical outcomes after Keraring implantation for keratoconus in patients older than 40 years. Eleven eyes from 11 patients with keratoconus who underwent femtosecond laser-assisted Keraring implantation for keratoconus were included in this retrospective study. The uncorrected visual acuity (UCVA), corrected visual acuity, keratometric readings, central corneal thickness and thinnest corneal pachymetry were evaluated preoperatively and 6 months after the Keraring implantation. UCVA, BCVA and keratometric readings improved at 6 months postoperatively. Our data showed significant keratometric amelioration and visual improvement after Keraring implantation for keratoconus in patients older than 40 years at 6 months postoperatively.

Treatment of rabbit cheyletiellosis with selamectin or ivermectin: a retrospective case study.

PubMed

Mellgren, Marianne; Bergvall, Kerstin

2008-01-02

A retrospective study of rabbits treated against cheyletiellosis was performed to evaluate the efficacy and safety of selamectin or ivermectin in clinical practice. Medical records from 53 rabbits with microscopically confirmed Cheyletiella infestation were collected from two small animal clinics. The rabbits were divided into three groups, based on treatment protocols. Group 1 included 11 rabbits treated with ivermectin injections at 200-476 microg kg-1 subcutaneously 2-3 times, with a mean interval of 11 days. In Group 2, 27 rabbits were treated with a combination of subcutaneous ivermectin injections (range 618-2185 microgkg-1) and oral ivermectin (range 616-2732 microgkg-1) administered by the owners, 3-6 times at 10 days interval. The last group (Group 3) included 15 rabbits treated with selamectin spot-on applications of 6.2-20,0 mgkg-1, 1-3 times with an interval of 2-4 weeks. Follow-up time was 4 months-4.5 years. Rabbits in remission were 9/11 (81,8%), 14/27 (51,9%) and 12/15 (80,8%) in groups 1, 2 and 3, respectively. All treatment protocols seemed to be sufficiently effective and safe for practice use. Though very high doses were used in Group 2 (ivermectin injections followed by oral administration), the protocol seemed less efficacious compared to ivermectin injections (Group 1) and selamectin spot on (Group 3), respectively, although not statistically significant. Controlled prospective studies including larger groups are needed to further evaluate efficacy of the treatment protocols.

Stroke in Duchenne Muscular Dystrophy: A Retrospective Longitudinal Study in 54 Patients.

PubMed

Winterholler, Martin; Holländer, Christian; Kerling, Frank; Weber, Irina; Dittrich, Sven; Türk, Matthias; Schröder, Rolf

2016-08-01

Duchenne muscular dystrophy (DMD) is the most frequent skeletal muscle myopathy. Nearly all patients develop cardiomyopathy in their second decade of life. The purpose of this study was to evaluate the frequency, cause, and outcome of stroke in a German cohort of patients with DMD. Retrospective analysis of medical records of 54 DMD patients, who lived in a regional facility for handicapped people (Wichernhaus Altdorf, Germany) between 1963 and 2013. Fifty-four DMD patients were followed up for 7.4 years on average. Mean age at admission and discharge from the long-term care facility or death were 11.4 and 18.8 years, respectively. Covering a total observation period of 400 patient-years, we identified 4 DMD patients with juvenile arterial ischemic strokes. Off-label systemic thrombolysis in 2 patients resulted in a nearly complete regression of stroke-related symptoms, but 1 patient died of septic pneumonia and cardiac failure 24 days after thrombolysis therapy. In the other 2 patients, who had their ischemic strokes in 1994 and 1998, severe infarction-related symptoms persisted, and 1 patient died 13 days later. DMD-associated cardiomyopathy without evidence of atrial fibrillation was the only risk factor for ischemic stroke in all patients. This study indicates an increased risk for ischemic strokes in DMD patients. Regular cardiological assessment of all DMD patients is mandatory to evaluate the individual risk profile for cardioembolic events and to adapt therapeutic strategies. © 2016 American Heart Association, Inc.

Tuberculin skin test conversion among health sciences students: A retrospective cohort study

PubMed Central

Pérez-Lu, José E.; Cárcamo, Cesar P.; García, Patricia J.; Bussalleu, Alejandro; Bernabé-Ortiz, Antonio

2014-01-01

SUMMARY Previous studies have reported that health sciences students are at greater risk for tuberculosis infection, especially in developing countries. The objective of this study was to estimate the prevalence, incidence, and factors associated with latent tuberculosis infection among Health Sciences students in Peru. Students enrolled at private university (in Lima – Peru) are tested annually for tuberculosis infection by tuberculin skin test. Data on tuberculin skin test results between 2002 and 2009 was used in this retrospective cohort study, a total of 4842 students were included. Tuberculin skin test conversion was defined as the change of tuberculin skin test from negative (<10 mm) to positive (≥10 mm) after 48 –72 h of inoculation. Baseline tuberculin skin test positivity was 1.0% (95%CI: 0.6%–1.3%), whereas tuberculin skin test conversion incidence was 12.4 per 100 person-years (95%CI: 11.8–13.0). This study showed that students from clinical careers in close contact with patients had an increased risk of tuberculosis infection in the internship, especially Medicine, Dentistry, Medical Technology and Nursing. Administrative, environmental and personal protection measures should be implemented and evaluated periodically in order to reduce the risk of exposure. PMID:23116653

Early discharge after total thyroidectomy: a retrospective feasibility study.

PubMed

Tartaglia, F; Giuliani, A; Sorrenti, S; Tromba, L; Carbotta, S; Maturo, A; Carbotta, G; De Anna, L; Merola, R; Livadoti, G; Pelle, F; Ulisse, S

2016-01-01

The continued hospitalization after total thyroidectomy is often due to the onset of hypocalcemic complications more than 24 hours after surgery. So it would be important to predict which patients will not develop the hypocalcemic complication to discharge them early. This was the aim of our study. Our retrospective study was conducted on 327 consecutive thyroidectomized patients, operated on for benign and malignant diseases. We evaluated the values of preoperative serum calcium levels (Cal0) and of the first postoperative day (Cal1) and two new variables were calculated (dCal and dCaln). The same thing was made on a subgroup of 111 patients in whom also parathiroyd hormone (PTH) values were detected. Statistical analysis was performed with the goal of determining if we could establish a safe criterion for discharge at 24 hours after surgery and if there is a correlation between suitability for discharge and diagnosis. As to discharge, the predictive power of the discriminant function applied was significant both on the total of patients and in the subgroup of 111 patients, but it was clinically unacceptable because it would expose us to a 21% to 27% error rate. It is not possible to identify a threshold, below which to consider patients surely dischargeable. The diagnosis does not appear correlated with the suitability for discharge. On the basis of serum calcium and PTH levels in the first postoperative day, it is impossible to predict which patients can be discharged 24 hours after surgery without incurring in hypocalcemic complications.

Evaluation of decontamination process of heart valve and artery tissues in European Homograft Bank (EHB): a retrospective study of 1,055 cases.

PubMed

Fan, Ye-Dong; Van Hoeck, Beatrice; Holovska, Vanda; Jashari, Ramadan

2012-06-01

To evaluate the efficiency of decontamination practice in European Homograft Bank (EHB), the data of the cardiovascular tissues received during recent 2 years were retrospectively analysed in this study. After initial assessment, the tissues were incubated in a 3-antibiotics' cocktail at 4°C for 20-48 h. The states of contamination were evaluated before and after incubation with the focus on the differences in donor type, tissue type, germ type and incubation time. Amongst 1,055 eligible tissues, 77.2% were hearts and 22.8% were arteries. 82.2% of the tissues were retrieved from the multi-organ donors (MOD), 15.4% from the recipients of heart transplantation (RHT) and 2.4% from the non-heart beating donors (NHBD). The initial contamination rate was 27.4% with a significantly higher incidence in arteries. The RHT tissues had the lowest contamination rate comparing to that of MOD and NHBD. Staphylococcus species was the major source of contamination. After antibiotic incubation, 76.8% of the contaminated tissues were disinfected, which was significantly higher for the hearts than the arteries. The RHT tissues had the highest decontamination rate than that of MOD and NHBD tissues. Propionibacterium acnes was detected in 48.1% of the remaining contaminated cases. The average incubation time of the Propionibacterium-positive tissues was significantly shorter than that of decontaminated tissues. In conclusion, the current decontamination protocol of EHB is sufficient for most of the initially contaminated bacteria, whereas it is inadequate for Propionibacterium acnes. This may be related to the slow-growing nature of this bacterium and thereby the relative shorter antibiotic incubation time.

A 10-year retrospective study of teaching nursing diagnosis to baccalaureate students in Italy.

PubMed

Palese, Alvisa; De Silvestre, Daniele; Valoppi, Graziella; Tomietto, Marco

2009-01-01

The aim of this 10-year retrospective study was to evaluate the impact of teaching nursing process to students at different levels of baccalaureate education, using the North American Nursing Diagnosis Association International (NANDA-I) Taxonomy. Nursing care plans written between 1996 and 2006 by 3,784 students who had completed a baccalaureate course in nursing process at a university in northern Italy were evaluated. At least three of the four steps of the nursing process were included in the evaluation: assessing, planning, intervening, and evaluating. An average of 6.3 (range 0-31; +/-3.9; median 6) problems were identified in each care plan. Of these, 5.1 (range 0-29; +/-3.06; median 5) were related to nursing diagnoses concerning either an actual problem or the risk of developing a problem; the remaining 1.2 (range 0-20; +/-1.9; median 0) diagnoses were concerned either with collaborative problems or with potential complications. The students demonstrated significant improvement in accurately identifying 75 diagnostic titles from the NANDA-I Taxonomy as they progressed through their first, second, and third years of baccalaureate study. These findings suggest that the ability to use the NANDA-I Taxonomy accurately is acquired over time. Thus, the theory and practice of using nursing process should be introduced in a formal course during the first year of baccalaureate nursing education and should be reinforced throughout the remaining courses. Students can then progressively improve their knowledge, critical thinking abilities, and use of the NANDA-I Taxonomy during their second and third years of study. Teaching strategies to reinforce students' learning are recommended.

Retrospective evaluation of pediatric cranio-spinal axis irradiation plans with the Hi-ART tomotherapy system.

PubMed

Penagaricano, José A; Yan, Yulong; Corry, Peter; Moros, Eduardo; Ratanatharathorn, Vaneerat

2007-08-01

Helical tomotherapy (HT) can be used for the delivery of cranio-spinal axis irradiation (CSAI) without the need for beam matching of conventional linac-based external beam irradiation. The aim of this study is to retrospectively evaluate HT plans used for treatment in nine patients treated with CSAI. Helical tomotherapy cranio-spinal axis irradiation (HT-CSAI) plans were created for each patient. Average length along the cranio-spinal axis of the PTV was 65.6 cm with a range between 53 and 74 cm. Treatment planning optimization and plan evaluation parameters were obtained from the HT planning station for each of the nine patients. PTV coverage by the 95% isodose surface ranged between 98.0 to 100.0% for all nine patients. The clinically acceptable dose variation within the PTV or tolerance range was between 0.7 and 2.5% for all nine patients. Doses to the organs at risk were clinically acceptable. An increasing length along the longitudinal axis of the PTV did not consistently increase the beam-on time indicating that using a larger jaw width had a greater impact on treatment time. With a larger jaw width it is possible to substantially reduce the normalized beam-on treatment time without compromising plan quality and sparing of organs at risk. By using a larger jaw width or lower modulation factor or both, normalized beam-on times were decreased by up to 61% as compared to the other evaluated treatment plans. From the nine cases reported in this study the minimum beam-on time was achieved with a jaw width of 5.0 cm, pitch of 0.287 and a modulation factor of 2.0. Large and long cylindrical volumes can be effectively treated with helical tomotherapy with both clinically acceptable dose distribution and beam-on time.

Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study

PubMed Central

Lazarovici, Julien; Dartigues, Peggy; Brice, Pauline; Obéric, Lucie; Gaillard, Isabelle; Hunault-Berger, Mathilde; Broussais-Guillaumot, Florence; Gyan, Emmanuel; Bologna, Serge; Nicolas-Virelizier, Emmanuelle; Touati, Mohamed; Casasnovas, Olivier; Delarue, Richard; Orsini-Piocelle, Frédérique; Stamatoullas, Aspasia; Gabarre, Jean; Fornecker, Luc-Matthieu; Gastinne, Thomas; Peyrade, Fréderic; Roland, Virginie; Bachy, Emmanuel; André, Marc; Mounier, Nicolas; Fermé, Christophe

2015-01-01

Nodular lymphocyte predominant Hodgkin lymphoma represents a distinct entity from classical Hodgkin lymphoma. We conducted a retrospective study to investigate the management of patients with nodular lymphocyte predominant Hodgkin lymphoma. Clinical characteristics, treatment and outcome of adult patients with nodular lymphocyte predominant Hodgkin lymphoma were collected in Lymphoma Study Association centers. Progression-free survival (PFS) and overall survival (OS) were analyzed, and the competing risks formulation of a Cox regression model was used to control the effect of risk factors on relapse or death as competing events. Among 314 evaluable patients, 82.5% had early stage nodular lymphocyte predominant Hodgkin lymphoma. Initial management consisted in watchful waiting (36.3%), radiotherapy (20.1%), rituximab (8.9%), chemotherapy or immuno-chemotherapy (21.7%), combined modality treatment (12.7%), or radiotherapy plus rituximab (0.3%). With a median follow-up of 55.8 months, the 10-year PFS and OS estimates were 44.2% and 94.9%, respectively. The 4-year PFS estimates were 79.6% after radiotherapy, 77.0% after rituximab alone, 78.8% after chemotherapy or immuno-chemotherapy, and 93.9% after combined modality treatment. For the whole population, early treatment with chemotherapy or radiotherapy, but not rituximab alone (Hazard ratio 0.695 [0.320–1.512], P=0.3593) significantly reduced the risk of progression compared to watchful waiting (HR 0.388 [0.234–0.643], P=0.0002). Early treatment appears more beneficial compared to watchful waiting in terms of progression-free survival, but has no impact on overall survival. Radiotherapy in selected early stage nodular lymphocyte predominant Hodgkin lymphoma, and combined modality treatment, chemotherapy or immuno-chemotherapy for other patients, are the main options to treat adult patients with a curative intent. PMID:26430172

Implementation of a Cardiogenic Shock Team and Clinical Outcomes (INOVA-SHOCK Registry): Observational and Retrospective Study.

PubMed

Tehrani, Behnam; Truesdell, Alexander; Singh, Ramesh; Murphy, Charles; Saulino, Patricia

2018-06-28

The development and implementation of a Cardiogenic Shock initiative focused on increased disease awareness, early multidisciplinary team activation, rapid initiation of mechanical circulatory support, and hemodynamic-guided management and improvement of outcomes in cardiogenic shock. The objectives of this study are (1) to collect retrospective clinical outcomes for acute decompensated heart failure cardiogenic shock and acute myocardial infarction cardiogenic shock, and compare current versus historical survival rates and clinical outcomes; (2) to evaluate Inova Heart and Vascular Institute site specific outcomes before and after initiation of the Cardiogenic Shock team on January 1, 2017; (3) to compare outcomes related to early implementation of mechanical circulatory support and hemodynamic-guided management versus historical controls; (4) to assess survival to discharge rate in patients receiving intervention from the designated shock team and (5) create a clinical archive of Cardiogenic Shock patient characteristics for future analysis and the support of translational research studies. This is an observational, retrospective, single center study. Retrospective and prospective data will be collected in patients treated at the Inova Heart and Vascular Institute with documented cardiogenic shock as a result of acute decompensated heart failure or acute myocardial infarction. This registry will include data from patients prior to and after the initiation of the multidisciplinary Cardiogenic Shock team on January 1, 2017. Clinical outcomes associated with early multidisciplinary team intervention will be analyzed. In the study group, all patients evaluated for documented cardiogenic shock (acute decompensated heart failure cardiogenic shock, acute myocardial infarction cardiogenic shock) treated at the Inova Heart and Vascular Institute by the Cardiogenic Shock team will be included. An additional historical Inova Heart and Vascular Institute control group will

Second Mesiobuccal Canal Treatment in a Predoctoral Dental Clinic: A Retrospective Clinical Study.

PubMed

Coelho, Marcelo Santos; Parker, Jeffrey M; Tawil, Peter Z

2016-06-01

The aim of this retrospective clinical study was to evaluate the location and treatment of second canals in mesiobuccal roots (MB2) of first and second maxillary molars in a predoctoral endodontic clinic by the graduating classes of 2008 to 2015. These results were compared to similar clinical studies. Included in the study were 368 root canal treatments performed by 310 third- and fourth-year dental students at one U.S. dental school. All cases were done under faculty supervision, and the students were instructed to use dental loupe magnification. Students' evaluation sheets were used to deteremine the total MB2 canals treated in first and second maxillary molars. The results showed that, overall, 72.55% of the teeth had an MB2 canal treated. The frequency was higher in first molars (75.91%) than in second molars (56.92%) (p<0.05). Third-year students were able to detect 39 MB2 canals in 57 maxillary molars (68.42%), while fourth-year students detected 228 MB2 canals in 311 teeth (73.31%) (p>0.05). Under proper supervision by experienced endodontists, these dental students were capable of treating MB2 canals in maxillary molars. The frequency of MB2 canals located and treated by dental students with the assistance of experienced professionals was higher in first than in second molars. No significant difference was found between third- and fourth-year students. The incidence of MB2 canals located and treated in this study was found to be similar to that in other clinical studies.

The Evaluation of the Effectiveness of Austrians Disease Management Program in Patients with Type 2 Diabetes Mellitus - A Population-Based Retrospective Cohort Study.

PubMed

Riedl, Regina; Robausch, Martin; Berghold, Andrea

2016-01-01

To evaluate the effectiveness of the Austrian Disease Management Program (DMP) 'Therapie aktiv-Diabetes im Griff' for patients with type 2 diabetes mellitus concerning patient-relevant outcomes (mortality, myocardial infarction and stroke) and costs. Based on routine health insurance data, we conducted a population-based retrospective cohort study using a propensity score (PS) matched control group design. The DMP-group consists of participants enrolled in the program during 2008 and 2009 (n = 7181). Out of 208.532 patients with no participation in the DMP up to 2013, PS-matched controls were selected with a matching ratio 1:3. In the PS-model, patient's characteristics, form of antidiabetic drug therapy, several prescriptions, the number of hospital admissions and days, main discharge diagnoses and costs at baseline were included. Over a follow-up period of four years, we observed a significantly lower mortality rate in the DMP-group (9.4%) in comparison with the control group (15.9%, p<0.001). The cumulative number of hospital days and mean annual hospital costs were lower for DMP-participants resulting in significantly lower mean annual total costs, amounting to € 8226.80 per patient in the DMP-group and € 9231.10 in the control group respectively (p<0.001). The evaluation shows a survival benefit and an average reduction of costs for participants in the DMP compared with the control-group. Despite we took great effort to ensure comparable groups, we cannot entirely rule out an influence by residual and unmeasured confounding due to the observational study design and the use of routine data. However, the results indicate that the disease management program implemented in Austria improves quality of care for patients with type 2 diabetes mellitus.

Management of ASCUS findings in Papanicolaou smears. A retrospective study.

PubMed

Iavazzo, C; Boutas, I; Grigoriadis, C; Vrachnis, N; Salakos, N

2012-01-01

Atypical squamous cells of undetermined significance (ASCUS) are a cervical cytologic finding category suggestive but not definitive of squamous intraepithelial lesions. ASCUS remains an incompletely described entity and accounts for even 5%-10% of reported Papanicolaou (Pap) smears. The management of women with such cytologic findings remains controversial. The aim of this study was to evaluate the cytology laboratory findings with regards to ASCUS diagnosis, using cervical Pap smears, and colposcopic biopsies, as well as their management. This is a retrospective study of patients with ASCUS Pap smears taken during the period January 2010 - December 2010 in the Second Department of Obstetrics and Gynecology, Aretaieion Hospital. During the study period, 657 Pap smears were examined at the Aretaieion Hospital; moreover, seven patients, whose Pap smears were cytologically diagnosed with ASCUS, were referred from other clinics, providing a total of 42 cases with a descriptive diagnosis of ASCUS for review. Of the 42 cases, eight were not studied because they were either lost in follow-up or they did not have available data. The remaining 34/42 patients were evaluated by colposcopic examination and directed biopsies where necessary. The ratio of ASCUS to low-grade squamous intraepithelial lesion (LGSIL), high-grade squamous cell intraepithelial lesion (HGSIL) or squamous cell carcinoma (SCC) was 5/34, 1/34, and 0/34, respectively. In the 34 ASCUS cases evaluated by colposcopy, the age distribution varied from 22 to 54 years. Eight of 34 cases did not have a child, 7/34 were primigravida, 18/34 were secondi-gravida, and 1/34 had four children. Four out of 34 cases were postmenopausal, 3/34 referred no history of abnormal bleeding, 21/34 were smokers, 6/34 used oral contraceptives, 2/34 used intrauterine devices, 1/34 took replacement of hormones, 4/34 had prior abnormal Pap smears human papillomavirus (HPV), or 1/34 had previous cancer (breast cancer). Colposcopy was

Evaluation of body weight-based vancomycin therapy and the incidence of nephrotoxicity: a retrospective study in the northwest of China.

PubMed

Dong, Mo-Han; Wang, Jing-Wen; Wu, Yin; Chen, Bei-Yu; Yu, Min; Wen, Ai-Dong

2015-08-01

To identify specific risk factors of vancomycin-induced nephrotoxicity in China, as the relationship between vancomycin therapy (dosing and trough concentration monitoring) and nephrotoxicity has been the subject of critical debate. The cases of 90 critically ill patients who received vancomycin therapy in Xijing Hospital in the northwest of China between March 2014 and January 2015 were reviewed retrospectively. Vancomycin dosing, blood serum trough concentration, and other independent risk factors associated with nephrotoxicity were evaluated in a multivariable model. Among the 90 critically ill patients, 59 were males; mean age was 46.3 years. The indications for vancomycin use were methicillin-resistant Staphylococcus aureus-associated pneumonia, central nervous system infection, and bacteremia. Clinical pharmacists prescribed weight-based dosing, ranging from 20 to 45mg/kg/day. Fourteen (15.6%) patients developed nephrotoxicity, with serum creatinine elevated significantly from a mean (standard deviation) of 90.0 (18.8) μmol/l to 133.8 (63.2) μmol/l (p = 0.015). It was found that those with a vancomycin dosage >38mg/kg/day (50.0% vs. 11.3%, p = 0.004) and a vancomycin serum trough concentration >20mg/l (57.1% vs. 12.0%, p = 0.01) were more likely to develop nephrotoxicity. The data from this study indicate that a vancomycin dosage >38mg/kg/day and a serum trough level >20mg/l are both independent factors associated with the development of nephrotoxicity, suggesting that renal function should be monitored closely during vancomycin treatment. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Potential improvements in medical education as retrospectively evaluated by candidates for specialist examinations].

PubMed

Hofer, M; Jansen, M; Soboll, S

2006-02-24

As part of the new regulations for licensing doctors there have been numerous attempts at reform by many medical faculties to consider interdisciplinary linkage of the curriculum with emphasis on teaching of small groups of students. This study was undertaken to help answer the question of how much weight should be given to the various subjects and what resources are needed for any reformed curriculum and what key areas of competence need to be given greater importance. 1029 candidates of specialist examinations of the Medical Council of North-Rhine in 2002 and 2003 filled in questionnaires to evaluate retrospectively the actual relevance of individual preclinical and clinical subjects, courses and areas of practical competence to their further medical education and related potentials for improvement in their studies. The participants were from 5 medical faculties in the North-Rhine area of Germany. They were also asked about methods of examination that were effective in aiding their learning behaviour. Those answering the questionnaire considered especially chemistry and physics as well as environmental, occupational and forensic medicine, bio-mathematics, radiotherapy and nuclear medicine among the less relevant subjects. On the other hand, anatomy, physiology, internal medicine, pharmacology and surgery were considered especially relevant. The greatest deficiencies in most of the medical curricula as taught in the North-Rhine medical courses are in the areas of competence in communication and practical clinical skills. Members of this group also pleaded for an increased use of standardized objective structured clinical examinations (OSCE).

Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark: a retrospective cohort study.

PubMed

Egelund, Gertrud Baunbæk; Jensen, Andreas Vestergaard; Andersen, Stine Bang; Petersen, Pelle Trier; Lindhardt, Bjarne Ørskov; von Plessen, Christian; Rohde, Gernot; Ravn, Pernille

2017-04-20

Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin-G/V monotherapy. Retrospective cohort study including hospitalized patients with x-ray confirmed CAP. We calculated the population-based incidence, reviewed types of empiric antibiotics and duration of antibiotic treatment. We evaluated the association between mortality and treatment with empiric penicillin-G/V using logistic regression analysis. We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated with penicillin-G/V as empiric monotherapy and they did not have a higher mortality compared to patients treated with broader-spectrum antibiotics (OR 0.92, CI 95% 0.55-1.53). The duration of treatment exceeded recommendations in European guidelines. Empiric monotherapy with penicillin-G/V was commonly used and not associated with increased mortality in patients with mild to moderate pneumonia. Our results are in agreement with current conservative antibiotic strategy as outlined in the Danish guidelines.

Intercomparison of retrospective radon detectors.

PubMed Central

Field, R W; Steck, D J; Parkhurst, M A; Mahaffey, J A; Alavanja, M C

1999-01-01

We performed both a laboratory and a field intercomparison of two novel glass-based retrospective radon detectors previously used in major radon case-control studies performed in Missouri and Iowa. The new detectors estimate retrospective residential radon exposure from the accumulation of a long-lived radon decay product, (210)Pb, in glass. The detectors use track registration material in direct contact with glass surfaces to measure the alpha-emission of a (210)Pb-decay product, (210)Po. The detector's track density generation rate (tracks per square centimeter per hour) is proportional to the surface alpha-activity. In the absence of other strong sources of alpha-emission in the glass, the implanted surface alpha-activity should be proportional to the accumulated (210)Po, and hence to the cumulative radon gas exposure. The goals of the intercomparison were to a) perform collocated measurements using two different glass-based retrospective radon detectors in a controlled laboratory environment to compare their relative response to implanted polonium in the absence of environmental variation, b) perform collocated measurements using two different retrospective radon progeny detectors in a variety of residential settings to compare their detection of glass-implanted polonium activities, and c) examine the correlation between track density rates and contemporary radon gas concentrations. The laboratory results suggested that the materials and methods used by the studies produced similar track densities in detectors exposed to the same implanted (210)Po activity. The field phase of the intercomparison found excellent agreement between the track density rates for the two types of retrospective detectors. The correlation between the track density rates and direct contemporary radon concentration measurements was relatively high, considering that no adjustments were performed to account for either the residential depositional environment or glass surface type

Intercomparison of retrospective radon detectors.

PubMed

Field, R W; Steck, D J; Parkhurst, M A; Mahaffey, J A; Alavanja, M C

1999-11-01

We performed both a laboratory and a field intercomparison of two novel glass-based retrospective radon detectors previously used in major radon case-control studies performed in Missouri and Iowa. The new detectors estimate retrospective residential radon exposure from the accumulation of a long-lived radon decay product, (210)Pb, in glass. The detectors use track registration material in direct contact with glass surfaces to measure the alpha-emission of a (210)Pb-decay product, (210)Po. The detector's track density generation rate (tracks per square centimeter per hour) is proportional to the surface alpha-activity. In the absence of other strong sources of alpha-emission in the glass, the implanted surface alpha-activity should be proportional to the accumulated (210)Po, and hence to the cumulative radon gas exposure. The goals of the intercomparison were to a) perform collocated measurements using two different glass-based retrospective radon detectors in a controlled laboratory environment to compare their relative response to implanted polonium in the absence of environmental variation, b) perform collocated measurements using two different retrospective radon progeny detectors in a variety of residential settings to compare their detection of glass-implanted polonium activities, and c) examine the correlation between track density rates and contemporary radon gas concentrations. The laboratory results suggested that the materials and methods used by the studies produced similar track densities in detectors exposed to the same implanted (210)Po activity. The field phase of the intercomparison found excellent agreement between the track density rates for the two types of retrospective detectors. The correlation between the track density rates and direct contemporary radon concentration measurements was relatively high, considering that no adjustments were performed to account for either the residential depositional environment or glass surface type

Contraindications in planned home birth in Iceland: A retrospective cohort study.

PubMed

Halfdansdottir, Berglind; Hildingsson, Ingegerd; Smarason, Alexander Kr; Sveinsdottir, Herdis; Olafsdottir, Olof A

2018-03-01

Icelandic national guidelines on place of birth list contraindications for home birth. Few studies have examined the effect of contraindication on home birth, and none have done so in Iceland. The aim of this study was to examine whether contraindications affect the outcome of planned home birth or have a different effect at home than in hospital. The study is a retrospective cohort study on the effect of contraindications for home birth on the outcome of planned home (n = 307) and hospital (n = 921) birth in 2005-2009. Outcomes were described for four different groups of women, by exposure to contraindications (unexposed vs. exposed) and planned place of birth (hospital vs. home). Linear and logistic regression analysis was used to evaluate the effect of the contraindications under study and to detect interactions between contraindications and planned place of birth. The key findings of the study were that contraindications were related to higher rates of adverse maternal and neonatal outcomes, regardless of place of birth; women exposed to contraindications had higher rates of adverse outcomes in planned home birth; and healthy, unexposed women had higher rates of adverse outcomes in planned hospital birth. Contraindications significantly increased the risk of transfer in labour and postpartum haemorrhage in planned home births. The defined contraindications for home birth had a negative effect on maternal and neonatal outcomes in Iceland, regardless of place of birth. The study results do not contradict the current national guidelines on place of birth. Copyright © 2017 Elsevier B.V. All rights reserved.

Can We Rule Out Meningitis from Negative Jolt Accentuation? A Retrospective Cohort Study.

PubMed

Sato, Ryota; Kuriyama, Akira; Luthe, Sarah Kyuragi

2017-04-01

Jolt accentuation has been considered to be the most sensitive physical finding to predict meningitis. However, there are only a few studies assessing the diagnostic accuracy of jolt accentuation. Therefore, we aimed to evaluate the diagnostic accuracy of jolt accentuation and investigate whether it can be extended to patients with mild altered mental status. We performed a single center, retrospective observational study on patients who presented to the emergency department in a Japanese tertiary care center from January 1, 2010 to March 31, 2016. Jolt accentuation evaluated in patients with fever, headache, and mild altered mental status with Glasgow Coma Scale no lower than E2 or M4 was defined as "jolt accentuation in the broad sense." Jolt accentuation evaluated in patients with fever, headache, and no altered mental status was defined as "jolt accentuation in the narrow sense." We evaluated the sensitivity and specificity in both groups. Among 118 patients, the sensitivity and specificity of jolt accentuation in the broad sense were 70.7% (95% confidence interval (CI): 58.0%-80.8%) and 36.7% (95% CI: 25.6%-49.3%). The positive likelihood ratio and negative likelihood ratio were 1.12 (95% CI: 0.87-1.44) and 0.80 (95% CI: 0.48-1.34), respectively. Among 108 patients, the sensitivity and specificity of jot accentuation in the narrow sense were 75.0% (95% CI: 61.8%-84.8%) and 35.1% (95% CI: 24.0%-48.0%). The positive likelihood ratio and negative likelihood ratio were 1.16 (95% CI: 0.90-1.48) and 0.71 (95% CI: 0.40-1.28), respectively. Jolt accentuation itself has a limited value in the diagnosis of meningitis regardless of altered mental status. Therefore, meningitis should not be ruled out by negative jolt accentuation. © 2017 American Headache Society.

Outcome of Isolated Premature Menarche: A Retrospective and Follow-Up Study.

PubMed

Ejaz, Sehar; Lane, Andrew; Wilson, Thomas

2015-01-01

Isolated premature menarche is isolated or recurrent vaginal bleeding in a female in the absence of appropriate secondary sexual characters. Retrospective chart review of patients with premature menarche, followed by a telephone questionnaire. Charts of patients evaluated in the Pediatric Endocrine Clinic for premature vaginal bleeding from 1982-2013 were reviewed. Of 21 patients identified, 17 could be contacted. Five newly diagnosed patients were recruited during the course of the study. The median age at initial presentation was 7 years. Most patients presented with Tanner I sexual development. Some had more advanced breast staging, which regressed later. All had prepubertal baseline and stimulated gonadotropins. Most of the patients reported a single or few episodes of menses. Two reported continuation of irregular bleeding into adulthood. All reported an adult height within the midparental target height. Premature menarche in the absence of other appropriate secondary sexual characteristics is a benign entity. Most patients have a few isolated episodes of menses that stop spontaneously; some may continue to have periods into adulthood. Unlike true puberty, these patients do not demonstrate advanced skeletal maturation, and the adult height is normal. Fertility appears to be normal. © 2015 S. Karger AG, Basel.

Retrospective Study on Fatal Melioidosis in Captive Zoo Animals in Thailand.

PubMed

Kasantikul, T; Sommanustweechai, A; Polsrila, K; Kongkham, W; Chaisongkram, C; Sanannu, S; Kongmakee, P; Narongwanichgarn, W; Bush, M; Sermswan, R W; Banlunara, W

2016-10-01

Melioidosis is caused by Burkholderia pseudomallei and is an important zoonotic infectious disease causing high mortality from fulminant septicaemia in humans and a wide variety of animal species. The incidence of fatal melioidosis in zoo animals has been significant in many Thai zoos. A total number of 32 cases were evaluated throughout the Thai zoo animal populations. The highest prevalence of disease has been reported from the north-eastern region followed by the zoos in the southern part of the country, approximately 47% and 38%, respectively, while the other zoos reported sporadic infections. Herbivores and non-human primates were the most commonly affected animals with incidences of 59% and 28%, respectively. This appears to be a seasonal correlation with the highest incidence of melioidosis in zoo animals reported in the rainy season (44%) or subdivided monthly in June (19%) followed by September and November (16% and 12%, respectively). The route of infection and the incubation period still remain unclear. This retrospective study examined the clinical presentation in various zoo species, pathological findings and epidemiological data as well as conducting an in depth literature review. © 2015 Blackwell Verlag GmbH.

Effects of women's body mass index on in vitro fertilization success: a retrospective cohort study.

PubMed

Haghighi, Zahra; Rezaei, Zahra; Es-Haghi Ashtiani, Somayyeh

2012-07-01

The purpose of this study is to evaluate the influence of body mass index (BMI) on the reproductive outcomes and clinical pregnancy rate after in vitro fertilization (IVF). This retrospective study was performed on 230 women undergoing first cycle of standard IVF between October 2008 and February 2010. The patients were classified into three groups according to their BMI (BMI < 20 kg/m², 20 kg/m² < BMI < 27.9 kg/m² and BMI > 28 kg/m²). Information regarding clinical pregnancy was compared within these three groups. There was no significant relation between BMI and age, the number of aspirated follicles, transferred embryos, mature oocytes, days of taking human menopausal gonadotropin (HMG) ampules and the total number of HMG ampules among three BMI studied groups. Statistically significant difference was detected between BMI and endometrial thickness. BMI has no effect on IVF outcomes and clinical pregnancy after IVF. However, losing weight in obese women seems reasonable to prevent possible obstetrics complications.

Asbestos-related lung cancers: A retrospective clinical and pathological study.

PubMed

Uguen, Marie; Dewitte, Jean-Dominique; Marcorelles, Pascale; Loddé, Brice; Pougnet, Richard; Saliou, Philippe; De Braekeleer, Marc; Uguen, Arnaud

2017-07-01

Exposure to asbestos results in serious risks of developing mesothelioma and lung cancer. The link between asbestos exposure and lung carcinoma is well established. Nevertheless, precise histopathological data are poorly considered when investigating the asbestos-cancer link in a compensatory approach. In the present study, we aim to describe the features of individuals with compensated lung cancer who were referred to an occupational disease center, regarding occupational exposure to asbestos, smoking history and pathological data. We led a retrospective study of compensated ARLC cases seen in our occupational disease center between 2003 and 2013. A total of 146 men were included (mean age at diagnosis, 63.2 years) of whom approximately 90% were heavy current or former smokers (mean value, 30.4 packs/year). The major industries associated with the lung cancer cases were shipbuilding (69.9%), and building construction (7.5%) in this harbor region. The results of the present study showed that lung upper lobe was most prevalent (61.6%) and an excess of adenocarcinoma was found (45.9%), followed by squamous cell carcinoma (38.4%) as well as thoracic sarcomas (2.1%). Neoplasm was not histologically proven in 6.8% of the cases. Subsequent pathology examinations also reclassified 2 tumors as metastases from esophageal and laryngeal origins. In conclusion, smoking prevention should be encouraged in asbestos-exposed workers as reflected by the number of smokers with asbestos-related lung cancer. Thus, histological data should be considered further to evaluate the potent relationship between asbestos exposure and lung malignancy, especially in a compensatory approach.

Early treatment of imported falciparum malaria in the intermediate and intensive care unit setting: an 8-year single-center retrospective study.

PubMed

Schwake, Lukas; Streit, Judith Pamela; Edler, Lutz; Encke, Jens; Stremmel, Wolfgang; Junghanss, Thomas

2008-01-01

Imported falciparum malaria is characterized by a broad spectrum of potentially life-threatening complications that may arise even after initiation of appropriate antimalarial drug therapy. Hence, at Heidelberg University Hospital, all patients with newly diagnosed falciparum malaria are initially treated in the intermediate care unit (IMC) or intensive care unit (ICU). The present study was undertaken to evaluate critically the benefit of this strategy, which includes daily consultation with senior specialists in tropical medicine. We conducted a retrospective cohort study at the 14-bed combined IMC/ICU of a 1,685-bed university hospital. A cohort of 122 patients with imported falciparum malaria admitted from 1 January 1996 to 31 December 2003 was included. Thirty-four patients (27.9%) developed complications, defined according to the current World Health Organization classification. Most patients (80.3%) studied did not take the recommended chemoprophylaxis against malaria. The majority of patients (89.3% [n = 109]) could be adequately treated in the IMC. Life-threatening complications requiring ICU support occurred in 13 patients (10.7%). All complications were successfully managed. Fifty-five patients (45.1%) fulfilling recently published criteria for outpatient treatment had an excellent therapeutic response and did not require ICU support. This retrospective evaluation demonstrated favourable therapeutic results in hospitalized patients with imported falciparum malaria. Both initial treatment in the medical IMC/ICU and close collaboration between intensivists and specialists in tropical medicine may improve disease outcome among affected patients. Prospective studies are needed to confirm these preliminary findings.

Cultured allogenic keratinocytes for extensive burns: a retrospective study over 15 years.

PubMed

Auxenfans, Celine; Shipkov, Hristo; Bach, Christine; Catherine, Zulma; Lacroix, Pierre; Bertin-Maghit, Marc; Damour, Odile; Braye, Fabienne

2014-02-01

The aim was to review the use and indications of cultured allogenic keratinocytes (CAlloK) in extensive burns and their efficiency. This retrospective study comprised 15 years (1997-2012). all patients who received CAlloK. patients who died before complete healing. Evaluation criteria were clinical. Time and success of wound healing after CAlloK use were evaluated. The CAlloK were used for 2 indications - STSG donor sites and deep 2nd degree burns in extensively burned patients. A total of 70 patients were included with severity Baux score of 99.2 (from 51 to 144) and mean percentage of TBSA of 63.49% (from 21 to 96%). Fifty nine patients received CAlloK for STSG donor sites with a mean number of applications of 4 and mean surface of 3800 cm(2) per patient. Treated donor sites were re-harvested 2.5 times. The mean time of complete epithelialization was 7 days. In 11 patients, CAlloK were used for deep 2nd degree burns. The mean percentage of burned surface was 73.7%. The mean surface of CAlloK per patient was 2545 cm(2). Complete healing was achieved in 6.4 days. The CAlloK allow rapid healing of STSG donor-sites and deep 2nd second degree burns in extensively burned patients. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Outcomes of office-based temporomandibular joint arthroscopy: a 5-year retrospective study.

PubMed

Hossameldin, R H; McCain, J P

2018-01-01

Temporomandibular joint (TMJ) arthroscopy is a minimally invasive surgical approach for intra-articular TMJ diseases. Office-based arthroscopy using the smallest TMJ scope allows for good visualization, as well as the ability to lavage the joint in an office setting. This study aimed to assess the efficacy of an office-based TMJ arthroscopic technique. A retrospective evaluation of 363 patients with a TMJ disorder was performed. These patients underwent office-based arthroscopy using the OnPoint 1.2mm Scope System (Biomet Microfixation, Jacksonville, FL, USA) in Florida, USA, from July 2007. The following outcomes of the procedure were assessed: improvement in painless range of mandibular motion, pain on loading, and functional jaw pain; these were evaluated using a visual analog scale (VAS) over an average follow-up period of 263.81±142.1 days. The statistical analysis was performed using IBM SPSS Statistics version 20. Statistically significant improvements in TMJ pain and function, and other variables (P=0.001) were shown following TMJ arthroscopic lysis and lavage. Office-based arthroscopy using the OnPoint System was demonstrated to be a safe and efficient procedure for the treatment of patients with TMJ disorders as the first level of the algorithm of care. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A diagnosis of bipolar spectrum disorder predicts diagnostic conversion from unipolar depression to bipolar disorder: a 5-year retrospective study.

PubMed

Woo, Young Sup; Shim, In Hee; Wang, Hee-Ryung; Song, Hoo Rim; Jun, Tae-Youn; Bahk, Won-Myong

2015-03-15

The major aims of this study were to identify factors that may predict the diagnostic conversion from major depressive disorder (MDD) to bipolar disorder (BP) and to evaluate the predictive performance of the bipolar spectrum disorder (BPSD) diagnostic criteria. The medical records of 250 patients with a diagnosis of MDD for at least 5 years were retrospectively reviewed for this study. The diagnostic conversion from MDD to BP was observed in 18.4% of 250 MDD patients, and the diagnostic criteria for BPSD predicted this conversion with high sensitivity (0.870) and specificity (0.917). A family history of BP, antidepressant-induced mania/hypomania, brief major depressive episodes, early age of onset, antidepressant wear-off, and antidepressant resistance were also independent predictors of this conversion. This study was conducted using a retrospective design and did not include structured diagnostic interviews. The diagnostic criteria for BPSD were highly predictive of the conversion from MDD to BP, and conversion was associated with several clinical features of BPSD. Thus, the BPSD diagnostic criteria may be useful for the prediction of bipolar diathesis in MDD patients. Copyright © 2014 Elsevier B.V. All rights reserved.

Comparative evaluation of 2.3 mm locking plate system vs conventional 2.0 mm non locking plate system for mandibular condyle fracture fixation: a seven year retrospective study.

PubMed

Zhang, J; Wang, X; Wu, R-H; Zhuang, Q-W; Gu, Q P; Meng, J

2015-01-01

This retrospective study evaluated the efficacy of a 2.3 mm locking plate/screw system compared with a 2.0-mm non-locking plate/screw system in fixation of isolated non comminuted mandibular condyle fractures. Surgical records of 101 patients who received either a 2.3 mm locking plate (group A, n = 51) or 2.0 mm non locking plate (group B, n = 50) were analyzed. All patients were followed up to a minimum of 6 months postoperatively and evaluated for hardware related complications, occlusal stability, need for and duration of MMF and mandibular functional results. Four complications occurred in the locking group and eighteen in the non locking group with complication rates equalling 8% and 36% respectively. When comparing the overall results according to plates used, the χ2 test showed a statistically significant difference between the locking and non locking plates (p < 0.001). Fewer patients required postoperative MMF in group A. Mandibular condyle fractures treated with a 2.3 mm locking plate exhibited stable osteosynthesis, were associated with minimal complications and resulted in acceptable mandibular range of motion compared with a 2.0 mm non locking plate.

Monotherapy versus Combination Therapy against Nonbacteremic Carbapenem-resistant Gram-negative Infections: A Retrospective Observational Study.

PubMed

Ghafur, Abdul; Devarajan, Vidyalakshmi; Raja, T; Easow, Jose; Raja, M A; Sreenivas, Sankar; Ramakrishnan, Balasubramaniam; Raman, S G; Devaprasad, Dedeepiya; Venkatachalam, Balaji; Nimmagadda, Ramesh

2017-12-01

Superiority of colistin-carbapenem combination therapy (CCCT) over colistin monotherapy (CMT) against carbapenem-resistant Gram-negative bacterial (CRGNB) infections is not conclusively proven. The aim of the current study was to analyze the effectiveness of both strategies against CRGNB nonbacteremic infections. This was a retrospective observational cohort study. Case record analysis of patients who had CRGNB nonbacteremic infections identified over a period of 4 years (January 2012-December 2015) was done by medical record review at a tertiary care center in India. P < 0.05 was considered as significant. Multivariate analysis was performed using Cox regression. Out of 153 patients (pneumonia 115, urinary tract infection 17, complicated skin and soft-tissue infection 18, intra-abdominal infection 1, and meningitis 2), 92 patients received CCCT and 61 received CMT. Univariate analysis revealed higher Acute Physiology and Chronic Health Evaluation II (APACHE II) score, pneumonia as the diagnosis, and Klebsiella as the causative organism to be the risk factors for higher 28-day mortality ( P = 0.036, 0.006, 0.016, respectively). Combination therapy had no significant impact on mortality (odds ratio [OR] = 0.91, 95% confidence interval [CI] = 0.327-2.535, P = 0.857). Multivariate analysis revealed that higher APACHE II score and infection due to Klebsiella were found to be independent risk factors for higher mortality (OR = 3.16 and 4.9, 95% CI = 1.34-7.4 and 2.19-11.2, P = 0.008 and 0.0001, respectively). In our retrospective single-center series of CRGNB nonbacteremic infections, CCCT was not superior to CMT. Multicenter large observational studies or prospective randomized clinical trials are the need of the hour.

Tooth loss due to periodontal abscess: a retrospective study.

PubMed

McLeod, D E; Lainson, P A; Spivey, J D

1997-10-01

This retrospective study focused on the frequency of tooth loss due to periodontal abscess among 42 patients who were treated by a single clinician over a 5- to 29-year period. A total of 114 patients were selected from the active periodontal recall schedule of a single periodontist at The University of Iowa College of Dentistry. The criteria for inclusion in the study included having a history of moderate to advanced periodontitis, being on 3 to 6 month recall periodontal maintenance care, and completion of active periodontal therapy prior to October 1987. Other parameters evaluated were age; gender; number of teeth present and missing at the initial, reevaluation, and last periodontal recall visit; initial periodontal prognosis; furcation involvement; non-surgical and surgical periodontal therapy; and reasons for tooth loss. Patients were grouped according to the number of teeth lost following active periodontal treatment into well-maintained (0 to 3), downhill (4 to 9), and extreme downhill (10 to 23) groups. Forty-two of the 114 patients were identified as having one or more periodontal abscesses. A total of 109 teeth were affected by periodontal abscess of which 49 (45%) teeth were lost and 60 (55%) were successfully maintained over an average of 12.5 years (5 to 29 years). More furcated teeth were lost than nonfurcated teeth and teeth given a hopeless prognosis were lost more consistently than those given a questionable prognosis in all groups. The frequency of periodontal abscess and tooth loss per patient was greater in the downhill and extreme downhill response groups than the well-maintained group. This suggests that teeth with a history of periodontal abscess can be treated and maintained for several years.

Impaction of permanent mandibular second molar: A retrospective study

PubMed Central

Altieri, Federica; Di Mambro, Alfonso; Galluccio, Gabriella; Barbato, Ersilia

2013-01-01

Objective: To determine the prevalence of impacted mandibular second molar (MM2) and the association between MM2 impaction and crowding. The clinical significance of the angle between first and second mandibular molar and of the space between the first mandibular molar (MM1) and the anterior margin of mandibular ramus in MM2 impaction were also evaluated. Material and Methods: In this retrospective study , from the dental records of 2,945 caucasian young orthodontics patients, 40 subjects with MM2 impaction were included in a study group (SG) and compared with a control group (CG) of 200 subjects without MM2 impactions. The crowding, the angle of inclination of MM2, the distance between MM1 and mandibular ramus, the canine and molar relationships, and the lower centre line discrepancy were measured. For the statistical analysis , descriptive statistics and t-Student for independent sample groups were used. Results: The prevalence of impacted MM2 was 1.36%. The independent-Samples t-Test between SG and CG showed: the presence of crowding (P≤0.001), an higher angle values of MM2 inclination (P≤0.001) and a smaller distance between MM1 and the anterior margin of mandibular ramus (P≤0.001) in the SG. Conclusion: The impaction of MM2 is a relatively rare occurrence in orthodontic caucasian populations. The crowding, a higher angle values of MM2 inclination and a reduced distance between MM1 and the anterior margin of mandibular ramus, at the time of one third of MM2 root formation (T1), characterize MM2 impaction. Key words:Impacted mandibular second molar, impaction, orthodontics. PMID:23524438

A retrospective clinical study of cervical restorations: longevity and failure-prognostic variables.

PubMed

Namgung, C; Rho, Y J; Jin, B H; Lim, B S; Cho, B H

2013-01-01

The aim of this retrospective clinical study was to compare the longevity of cervical restorations between resin composite (RC) and glass ionomer (GI) and to investigate variables predictive of their outcome. The clinical performance of the two restorative materials in function was compared using the ratings of the modified United States Public Health Service (USPHS) criteria. A total of 479 cervical restorations were included in the study. Ninety-one already-replaced restorations were reviewed from dental records. The other 388 restorations still in function were evaluated according to the modified USPHS criteria by two investigators. Longevity and prognostic variables were analyzed with the Kaplan-Meier survival analysis and multivariate Cox proportional hazard model. The clinical performances of the two materials were evaluated according to the ratings of the USPHS criteria and compared using the Pearson chi-square test and Fisher exact test. The longevity was not significantly different between RC and GI (median survival time, 10.4 ± 0.7 and 11.5 ± 1.1 years, respectively). The main reasons for failure were loss of retention (82.2%) and secondary caries (17.8%). The longevity of cervical restoration was significantly influenced by tooth group and operator group (Wald test, p<0.05), while material, gender, presence or absence of systemic diseases, arch, and reason for treatment did not affect the longevity. Contrary to the longevity, the clinical performance of RC was superior to GI in the criteria of retention, marginal discoloration, and marginal adaptation, but similar in secondary caries, wear, and postoperative sensitivity.

Treatment of rabbit cheyletiellosis with selamectin or ivermectin: a retrospective case study

PubMed Central

Mellgren, Marianne; Bergvall, Kerstin

2008-01-01

Background A retrospective study of rabbits treated against cheyletiellosis was performed to evaluate the efficacy and safety of selamectin or ivermectin in clinical practice. Methods Medical records from 53 rabbits with microscopically confirmed Cheyletiella infestation were collected from two small animal clinics. The rabbits were divided into three groups, based on treatment protocols. Group 1 included 11 rabbits treated with ivermectin injections at 200–476 μg kg-1 subcutaneously 2–3 times, with a mean interval of 11 days. In Group 2, 27 rabbits were treated with a combination of subcutaneous ivermectin injections (range 618–2185 μgkg-1) and oral ivermectin (range 616–2732 μgkg-1) administered by the owners, 3–6 times at 10 days interval. The last group (Group 3) included 15 rabbits treated with selamectin spot-on applications of 6.2–20,0 mgkg-1, 1–3 times with an interval of 2–4 weeks. Follow-up time was 4 months–4.5 years. Results Rabbits in remission were 9/11 (81,8%), 14/27 (51,9%) and 12/15 (80,8%) in groups 1, 2 and 3, respectively. Conclusion All treatment protocols seemed to be sufficiently effective and safe for practice use. Though very high doses were used in Group 2 (ivermectin injections followed by oral administration), the protocol seemed less efficacious compared to ivermectin injections (Group 1) and selamectin spot on (Group 3), respectively, although not statistically significant. Controlled prospective studies including larger groups are needed to further evaluate efficacy of the treatment protocols. PMID:18171479

Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study.

PubMed

Suomalainen, Anni; Stoor, Patricia; Mesimäki, Karri; Kontio, Risto K

2015-12-01

The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination - multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. In total 114 RP models were fabricated for 102 patients. The mean age of the patients at the time of the production of the model was 50.4 years. The indications for the modelling included malignant lesions (29%), secondary reconstruction (25%), prosthodontic treatment (22%), orthognathic surgery or asymmetry (13%), benign lesions (8%), and TMJ disorders (4%). MSCT examination was used in 92 and CBCT examination in 22 cases. Most of the models (75%) were conventional hard tissue models. Models with colored tumour or other structure(s) of interest were ordered in 24%. Two out of the 114 models were soft tissue models. The main benefit of the models was in treatment planning and in connection with the production of pre-bent plates or custom made implants. The RP models both facilitate and improve treatment planning and intraoperative efficiency. Rapid prototyping, radiology, computed tomography, cone beam computed tomography.

Retrospective study of combined splinting restorations in the aesthetic zone of periodontal patients

PubMed Central

Liu, X.; Zhang, Y.; Zhou, Z.; Ma, S.

2016-01-01

Aims This retrospective study evaluated the clinical performance of combining a fiber-reinforced, composite-resin (FRC) bonded splint; bridge; fiber post; and/or resin veneer for the restoration of periodontally-involved anterior teeth. Methods Sixty-three patients with periodontally-involved anterior teeth each received one of the following splinting restorations: FRC-bonded splint-bridges (SB), a combination of an FRC-bonded splint and resin veneer (SV), or FRC-bonded splints (S). Six patients with healthy periodontal teeth received orthodontic retainers with FRC-bonded splints (OS) as a control. Modified USPHS criteria were used to evaluate the effects of rehabilitation, and the periodontal pocket depth (PPD) and clinical attachment level (CAL) of the natural teeth were measured. Results All restorations resulted in good aesthetic outcomes. SV, S in combination with fiber posts and OS all resulted in 100% acceptable ratings for each category that was directly evaluated at each follow-up. The mean PPD was 3.5 ± 1.0 mm at baseline, decreased to 3.3 ± 1.0 mm after one year (p <0.05), and subsequently increased to 3.5±1.0 mm again after four years (p >0.05). These changes were similar to those in the mean CAL. Conclusion A combination of a FRC-bonded splint, bridge, fiber post and/or resin veneer for minimally invasive prosthodontic treatment in the aesthetic zone is a good choice for periodontal patients. PMID:26964599

Retrospective Evaluation of the Impact of a Geriatric Trauma Institute on Fragility Hip Fracture Patient Outcomes.

PubMed

Katrancha, Elizabeth D; Zipf, Jami; Abrahams, Nancy; Schroeder, Richard

Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes. Specific outcomes included length of stay (LOS), length of time from emergency department (ED) arrival to operating room (OR), complication rate, and discharge destination. This study is a single-center pre- and post-retrospective chart review. Data were collected using database queries within the hospital system. Pre-GTI (n = 326) patients older than 65 years with International Classification of Disease, Ninth Revision (ICD-9) codes 820.0-820.9 (hip fractures) admitted to either a primary care physician or orthopaedic surgeon service between April 1, 2011, and April 1, 2013, were compared with post-GTI (n = 245) patients older than 65 years with ICD-9 codes 820.0-820.9 (hip fractures) admitted to trauma services (GTI) between May 1, 2013, and May 1, 2015. Descriptive statistics including demographic data (age, sex) and comparison of outcomes (LOS, ED to OR time, complications, and disposition) across the groups using standard analysis of variance (ANOVA) and correlation techniques. No statistical difference was found between groups for age, sex, or time from ED to OR pre- versus post-time period using one-way ANOVA, F(1,569) = 1.08, p = .30. The complication rate was calculated pre- and post-GTI and compared using the 2-proportion z-test. The difference between the pre-GTI group (16.6%; 54 of 326 patients) and the post-GTI group (9.4%; 23 of 245 patients

Risk factors for acute surgical site infections after lumbar surgery: a retrospective study.

PubMed

Lai, Qi; Song, Quanwei; Guo, Runsheng; Bi, Haidi; Liu, Xuqiang; Yu, Xiaolong; Zhu, Jianghao; Dai, Min; Zhang, Bin

2017-07-19

Currently, many scholars are concerned about the treatment of postoperative infection; however, few have completed multivariate analyses to determine factors that contribute to the risk of infection. Therefore, we conducted a multivariate analysis of a retrospectively collected database to analyze the risk factors for acute surgical site infection following lumbar surgery, including fracture fixation, lumbar fusion, and minimally invasive lumbar surgery. We retrospectively reviewed data from patients who underwent lumbar surgery between 2014 and 2016, including lumbar fusion, internal fracture fixation, and minimally invasive surgery in our hospital's spinal surgery unit. Patient demographics, procedures, and wound infection rates were analyzed using descriptive statistics, and risk factors were analyzed using logistic regression analyses. Twenty-six patients (2.81%) experienced acute surgical site infection following lumbar surgery in our study. The patients' mean body mass index, smoking history, operative time, blood loss, draining time, and drainage volume in the acute surgical site infection group were significantly different from those in the non-acute surgical site infection group (p < 0.05). Additionally, diabetes mellitus, chronic obstructive pulmonary disease, osteoporosis, preoperative antibiotics, type of disease, and operative type in the acute surgical site infection group were significantly different than those in the non-acute surgical site infection group (p < 0.05). Using binary logistic regression analyses, body mass index, smoking, diabetes mellitus, osteoporosis, preoperative antibiotics, fracture, operative type, operative time, blood loss, and drainage time were independent predictors of acute surgical site infection following lumbar surgery. In order to reduce the risk of infection following lumbar surgery, patients should be evaluated for the risk factors noted above.

A retrospective analysis of toxicity studies in dogs and impact on the chronic reference dose for conventional pesticide chemicals.

PubMed

Dellarco, Vicki L; Rowland, Jess; May, Brenda

2010-01-01

Prior to October 2007, the US Environmental Protection Agency (EPA) required both 13-week and 1-year studies in Beagle dogs be submitted in support of registration for pesticides. Following an extensive retrospective analysis, we (the authors) determined that the 1-year toxicity dog study should be eliminated as a requirement for pesticide registration. The present work presents this retrospective analysis of results from 13-week and 1-year dog studies for 110 conventional pesticide chemicals, representing more than 50 classes of pesticides. The data were evaluated to determine if the 13-week dog study, in addition to the long-term studies in two rodent species (mice and rats), were sufficient for the identification of no observed adverse effect levels (NOAELs) and lowest observed adverse effect levels (LOAELs) for the derivation of chronic reference doses (RfD). Only pesticides with adequate 13-week and 1-year duration studies were included in the present evaluation. Toxicity endpoints and dose-response data from 13-week and 1-year studies were compared. The analysis showed that 70 of the 110 pesticides had similar critical effects regardless of duration and had NOAELs and LOAELs within a difference of 1.5-fold of each other. For the remaining 40 pesticides, 31 had lower NOAELs and LOAELs in the 1-year study, primarily due to dose selection and spacing. In only 2% of the cases were additional toxic effects identified in the 1-year study that were not observed in the 13-week study and/or in the rodent studies. In 8% of the cases, the 1-year dog had a lower NOAEL and/or LOAEL than the 13-week study, but there would have been no regulatory impact if the 1-year dog study had not been performed because adequate data were available from the other required studies. A dog toxicity study beyond 13-weeks does not have significant impact on the derivation of a chronic RfD for pesticide risk assessment.

Burning mouth syndrome and associated factors: A case-control retrospective study.

PubMed

Chimenos-Küstner, Eduardo; de Luca-Monasterios, Fiorella; Schemel-Suárez, Mayra; Rodríguez de Rivera-Campillo, María E; Pérez-Pérez, Alejandro M; López-López, José

2017-02-23

Burning mouth syndrome (BMS) can be defined as burning pain or dysesthesia on the tongue and/or other sites of the oral mucosa without a causative identifiable lesion. The discomfort is usually of daily recurrence, with a higher incidence among people aged 50 to 60 years, affecting mostly the female sex and diminishing their quality of life. The aim of this study was to evaluate the association between several pathogenic factors and burning mouth syndrome. 736 medical records of patients diagnosed of burning mouth syndrome and 132 medical records for the control group were studied retrospectively. The study time span was from January 1990 to December 2014. The protocol included: sex, age, type of oral discomfort and location, among other factors. Analysis of the association between pathogenic factors and BMS diagnosis revealed that only 3 factors showed a statistically significant association: triggers (P=.003), parafunctional habits (P=.006), and oral hygiene (P=.012). There were neither statistically significant differences in BMS incidence between sex groups (P=.408) nor association of BMS with the pathogenic factors of substance abuse (P=.915), systemic pathology (P=.685), and dietary habits (P=.904). Parafunctional habits like bruxism and abnormal movements of tongue and lips can explain the BMS main symptomatology. Psychological aspects and systemic factors should be always considered. As a multifactorial disorder, the treatment of BMS should be executed in a holistic way. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Basic nursing care: retrospective evaluation of communication and psychosocial interventions documented by nurses in the acute care setting.

PubMed

Juvé-Udina, Maria-Eulàlia; Pérez, Esperanza Zuriguel; Padrés, Núria Fabrellas; Samartino, Maribel Gonzalez; García, Marta Romero; Creus, Mònica Castellà; Batllori, Núria Vila; Calvo, Cristina Matud

2014-01-01

This study aimed to evaluate the frequency of psychosocial aspects of basic nursing care, as e-charted by nurses, when using an interface terminology. An observational, multicentre study was conducted in acute wards. The main outcome measure was the frequency of use of the psychosocial interventions in the electronic nursing care plans, analysed over a 12 month retrospective review. Overall, 150,494 electronic care plans were studied. Most of the intervention concepts from the interface terminology were used by registered nurses to illustrate the psychosocial aspects of fundamentals of care in the electronic care plans. The results presented help to demonstrate that the interventions of this interface terminology may be useful to inform psychosocial aspects of basic and advanced nursing care. The identification of psychosocial elements of basic nursing care in the nursing documentation may lead to obtain a deeper understanding of those caring interventions nurses consider essential to represent nurse-patient interactions. The frequency of psychosocial interventions may contribute to delineate basic and advanced nursing care. © 2013 Sigma Theta Tau International.

Electroconvulsive therapy in adolescents: a retrospective study from north India.

PubMed

Grover, Sandeep; Malhotra, Savita; Varma, Sannidhya; Chakrabarti, Subho; Avasthi, Ajit; Mattoo, Surendra K

2013-06-01

There are minimal data on the use of electroconvulsive therapy (ECT) in adolescents from India. The present study aimed to evaluate the clinical profile and effectiveness of ECT in adolescents (aged 13-18 years). A retrospective chart review was carried out to identify adolescents (aged 13-18 years) who had received ECT during the period 1999-2011. During the study period, 39 such patients received ECT; complete records of 25 patients were available. Details regarding their sociodemographic, clinical, and treatment data were extracted from these records for the present study. During the study period, 658 patients received ECT, of which 39 were aged 18 or younger (5.9%). Schizophrenia (n = 14; 56%) was the commonest diagnosis for which ECT was used in adolescents, followed by depression (n = 3; 12%). Catatonic symptoms (n = 17; 68%) were the most common symptoms among these subjects. Electroconvulsive therapy was considered as a treatment of choice taking the clinical picture account in about three fourths of the patients (n = 19; 76%). The mean (SD) numbers of ECTs administered per patient were 10.1 (4.87) (range, 2-21). The mean (SD) response rate to ECT was 76% (23.3%) (range, 31%-100%). Response rates according to diagnosis were the following: 76.3% for schizophrenia, 87.2% for depression, 81.8% for psychosis (not otherwise specified), and 77.7% for acute and transient psychosis. Response rate in patients with catatonia was 91.6%. Prolonged seizures, nausea and vomiting, and headache were reported in 2 cases each. Electroconvulsive therapy is used less frequently in children and adolescents compared to the older patients. This study shows that ECT is effective in the treatment of severe psychiatric disorders in adolescents and is associated with the same frequency of adverse effects as the adults.

Electrochemotherapy efficacy evaluation for treatment of locally advanced stage III cutaneous squamous cell carcinoma: a 22-cases retrospective analysis.

PubMed

Di Monta, Gianluca; Caracò, Corrado; Simeone, Ester; Grimaldi, Antonio Maria; Marone, Ugo; Di Marzo, Massimiliano; Vanella, Vito; Festino, Lucia; Palla, Marco; Mori, Stefano; Mozzillo, Nicola; Ascierto, Paolo Antonio

2017-04-26

Extensive squamous cell carcinoma has few therapeutic options. In such cases, electrochemotherapy involving electroporation combined with antineoplastic drug appears to be a new potential option and may be considered as an alternative treatment. The aim of this retrospective single-center study was to evaluate electrochemotherapy efficacy in treatment of locally advanced stage III squamous cell carcinoma, in which surgical procedures would have entailed wide tissue sacrifice. Clinical features, treatment response, and adverse effects were evaluated in 22 patients treated with electrochemotherapy with intravenous injection of bleomycin for extensive stage III cutaneous squamous cell carcinoma. Treatment of cutaneous lesions were performed according to the European Standard Operating Procedures of Electrochemotherapy. Overall response to electrochemotherapy treatment was observed in 18 (81.8%) patients. Clinical response with necrosis of tumor mass was observed from the first session and lasted for all follow up period that ranged between 5 and 48 months with a median of 34 months. Overall the treatment was well tolerated with a very low complication rate. Electrochemotherapy represents a safe and effective therapeutic approach, associated with a good tolerability.

Evaluation of the impact of collaborative work by teams from the National Medical Residency Committee and the Brazilian Society of Neurosurgery. Retrospective and prospective study.

PubMed

Santos, Renato Antunes Dos; Snell, Linda; Nunes, Maria do Patrocínio Tenório

2016-04-01

Training for specialist physicians in Brazil can take place in different ways. Closer liaison between institutions providing this training and assessment and health care services may improve qualifications. This article analyzes the impact of closer links and joint work by teams from the National Medical Residency Committee (Comissão Nacional de Residência Médica, CNRM) and the Brazilian Society of Neurosurgery (Sociedade Brasileira de Neurocirurgia, SBN) towards evaluating these programs. Retrospective and prospective study, conducted in a public university on a pilot project developed between CNRM and SBN for joint assessment of training programs across Brazil. The literature in the most relevant databases was reviewed. Documents and legislation produced by official government bodies were evaluated. Training locations were visited. Reports produced about residency programs were analyzed. Only 26% of the programs were immediately approved. The joint assessments found problems relating to teaching and to functioning of clinical service in 35% of the programs. The distribution of programs in this country has a strong relationship with the Human Development Index (HDI) of the regions and is very similar to the distribution of specialists. Closer collaboration between the SBN and CNRM had a positive impact on assessment of neurosurgery medical residency across the country. The low rates of direct approval have produced modifications and improvements to the quality of teaching and care (services). Closer links between the CNRM and other medical specialties have the capability to positively change the structure and function of specialty training in Brazil.

Icotinib Is an Active Treatment of Non-Small-Cell Lung Cancer: A Retrospective Study

PubMed Central

Liu, Yiqian; Liu, Ping; Yin, Yongmei; Guo, Renhua; Lu, Kaihua; Gu, Yanhong; Liu, Lianke; Wang, Jinghua; Wang, Zhaoxia; Røe, Oluf Dimitri; Shu, Yongqian; Zhu, Lingjun

2014-01-01

Background Icotinib hydrochloride is a novel epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) with preclinical and clinical activity in non-small cell lung cancer (NSCLC). This retrospective analysis was performed to assess the efficacy of icotinib on patients with non-small-cell lung cancer (NSCLC). Methods 82 consecutive patients treated with icotinib as first (n = 24) or second/third line (n = 58) treatment at three hospitals in Nanjing were enrolled into our retrospective research. The Response Evaluation Criteria in Solid Tumors (RECIST) was used to evaluate the tumor responses and the progression-free survival (PFS) and overall survival (OS) was evaluated by the Kaplan-Meier method. Results Median PFS was 4.0 months (95% CI 2.311–5.689). Median OS was 11.0 months (95% CI 8.537–13.463) in this cohort. Median PFS for first and second/third line were 7.0 months (95% CI 2.151–11.8) and 3.0 months (95% CI 1.042–4.958), respectively. Median OS for first and second/third line were 13.0 months (95% CI 10.305–15.695) and 10.0 months (95% CI 7.295–12.70), respectively. In patients with EGFR mutation (n = 19), icotinib significantly reduced the risk of progression (HR 0.36, 95% CI 0.18–0.70, p = 0.003) and death (HR 0.10, 95% CI 0.02–0.42, p = 0.002) compared with those EGFR status unknown (n = 63). The most common adverse events were acne-like rash (39.0%) and diarrhea (20.7%). Conclusions Icotinib is active in the treatment of patients with NSCLC both in first or second/third line, especially in those patients harbouring EGFR mutations, with an acceptable adverse event profile. PMID:24836053

Icotinib is an active treatment of non-small-cell lung cancer: a retrospective study.

PubMed

Chen, Xiaofeng; Zhu, Quan; Liu, Yiqian; Liu, Ping; Yin, Yongmei; Guo, Renhua; Lu, Kaihua; Gu, Yanhong; Liu, Lianke; Wang, Jinghua; Wang, Zhaoxia; Røe, Oluf Dimitri; Shu, Yongqian; Zhu, Lingjun

2014-01-01

Icotinib hydrochloride is a novel epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) with preclinical and clinical activity in non-small cell lung cancer (NSCLC). This retrospective analysis was performed to assess the efficacy of icotinib on patients with non-small-cell lung cancer (NSCLC). 82 consecutive patients treated with icotinib as first (n = 24) or second/third line (n = 58) treatment at three hospitals in Nanjing were enrolled into our retrospective research. The Response Evaluation Criteria in Solid Tumors (RECIST) was used to evaluate the tumor responses and the progression-free survival (PFS) and overall survival (OS) was evaluated by the Kaplan-Meier method. Median PFS was 4.0 months (95% CI 2.311-5.689). Median OS was 11.0 months (95% CI 8.537-13.463) in this cohort. Median PFS for first and second/third line were 7.0 months (95% CI 2.151-11.8) and 3.0 months (95% CI 1.042-4.958), respectively. Median OS for first and second/third line were 13.0 months (95% CI 10.305-15.695) and 10.0 months (95% CI 7.295-12.70), respectively. In patients with EGFR mutation (n = 19), icotinib significantly reduced the risk of progression (HR 0.36, 95% CI 0.18-0.70, p = 0.003) and death (HR 0.10, 95% CI 0.02-0.42, p = 0.002) compared with those EGFR status unknown (n = 63). The most common adverse events were acne-like rash (39.0%) and diarrhea (20.7%). Icotinib is active in the treatment of patients with NSCLC both in first or second/third line, especially in those patients harbouring EGFR mutations, with an acceptable adverse event profile.

Community-acquired Clostridium difficile infection in children: A retrospective study.

PubMed

Borali, Elena; Ortisi, Giuseppe; Moretti, Chiara; Stacul, Elisabetta Francesca; Lipreri, Rita; Gesu, Giovanni Pietro; De Giacomo, Costantino

2015-10-01

Community acquired-Clostridium difficile infection (CDI) has increased also in children in the last years. To determine the incidence of community-acquired CDI and to understand whether Clostridium difficile could be considered a symptom-triggering pathogen in infants. A five-year retrospective analysis (January 2007-December 2011) of faecal specimens from 124 children hospitalized in the Niguarda Ca' Granda Hospital for prolonged or muco-haemorrhagic diarrhoea was carried out. Stool samples were evaluated for common infective causes of diarrhoea and for Clostridium difficile toxins. Patients with and without CDI were compared for clinical characteristics and known risk factors for infection. Twenty-two children with CDI were identified in 5 years. An increased incidence of community-acquired CDI was observed, ranging from 0.75 per 1000 hospitalizations in 2007 to 9.8 per 1000 hospitalizations in 2011. Antimicrobial treatment was successful in all 19 children in whom it was administered; 8/22 CDI-positive children were younger than 2 years. No statistically significant differences in clinical presentation were observed between patients with and without CDI, nor in patients with and without risk factors for CDI. Our study shows that Clostridium difficile infection is increasing and suggests a possible pathogenic role in the first 2 years of life. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Comparative evaluation of the immunogenicity of combined hepatitis A and B vaccine by a prospective and retrospective trial.

PubMed

Wolters, Bernd; Müller, Tobias; Ross, R Stefan; Clauberg, Ralf; Werfel, Uwe; Roggendorf, Hedwig; Siggelkow, Cornelius; Hausen, Thomas; Roggendorf, Michael

2009-04-01

In the past, immunogenicity of hepatitis A and B vaccines needed to be questioned in persons of advanced age, especially in those of 40 years and older. We performed a comparative multicenter prospective and retrospective study with the combined hepatitis A and B vaccine Twinrix to identify factors influencing the results of the vaccination in a population of all age groups. Out of 489 subjects enrolled, 241 were vaccinated in a prospective study (group 1) and 248 subjects in a retrospective study (group 2) in 17 German centers with median age of 40.1 (14-79) years. Following three applications of the combined hepatitis A/B vaccine we found 96.2% with protective antibodies against HAV and 88.7% were protected against HBV. With increasing age the subjects developed decreasing anti-HBs antibody levels whereas the seroprotection rate was significantly reduced by age (p < 0.05) in the retrospective study group only. Subjects with arterial hypertension and thyroid disease showed significantly decreased protection rates. The timing of the HBV antibody control seems to be important especially in low-responders because protective antibodies may drop below the detection limit within some month. The combined hepatitis A and B vaccine Twinrix proved to be highly effective against HBV, although antibody concentrations and seroprotection rates decreased with increasing age.

Bacterial meningoencephalomyelitis in dogs: a retrospective study of 23 cases (1990-1999).

PubMed

Radaelli, Simona T; Platt, Simon R

2002-01-01

The clinical records of 23 dogs (1990-1999) with histopathologically confirmed bacterial meningoencephalomyelitis were evaluated retrospectively. No breed, age, sex, or weight predisposition was found. All the dogs presented with clinical signs of a brain lesion, whereas 5 of 23 had neck pain. Pyrexia was detected in 11 of 23 dogs on admission. CBCs revealed neutrophilic leucocytosis in 7 of 21 dogs and thrombocytopenia in 3 of 21 dogs. The serum chemistry profiles were abnormal in 15 of 21 dogs. The results of cerebrospinal fluid (CSF) analysis were abnormal in 13 of 14 dogs and aerobic CSF culture was positive for bacteria in 1of 8 samples. At postmortem examination, the lesions were localized to the central nervous system. Escherichia coli, Streptococcus, and Klebsiella spp were the most frequently isolated bacteria from cultures collected at postmortem examination. Twelve papers reporting 51 total clinical cases of canine bacterial meningoencephalomyelitis were reviewed. The clinical signs and results of the CBC, serum chemistry, blood culture, and CSF analysis were collated and compared with those of this study. The results of the CSF analysis in this study were similar to those in the literature. CSF cultures documented in the literature were positive for Staphylococcus, Pasteurella. Actinomyces, Nocardia spp, and various anaerobic species including Peptostreptococcus, Eubacterium, and Bacteroides spp.

Mortality among Coast Guard Shipyard workers: A retrospective cohort study of specific exposures.

PubMed

Rusiecki, Jennifer; Stewart, Patricia; Lee, Dara; Alexander, Melannie; Krstev, Srmena; Silverman, Debra; Blair, Aaron

2018-01-02

In a previous analysis of a cohort of shipyard workers, we found excess mortality from all causes, lung cancer, and mesothelioma for longer work durations and in specific occupations. Here, we expand the previous analyses by evaluating mortality associated with 5 chemical exposures: asbestos, solvents, lead, oils/greases, and wood dust. Data were gathered retrospectively for 4,702 workers employed at the Coast Guard Shipyard, Baltimore, MD (1950-1964). The cohort was traced through 2001 for vital status. Associations between mortality and these 5 exposures were calculated via standardized mortality ratios (SMRs). We found all 5 substances to be independently associated with mortality from mesothelioma, cancer of the respiratory system, and lung cancer. Findings from efforts to evaluate solvents, lead, oils/greases, and wood dust in isolation of asbestos suggested that the excesses from these other exposures may be due to residual confounding from asbestos exposure.

Examining Convergence of Retrospective and Ecological Momentary Assessment Measures of Negative Affect and Eating Disorder Behaviors

PubMed Central

Wonderlich, Joseph A.; Lavender, Jason M.; Wonderlich, Stephen A.; Peterson, Carol B.; Crow, Scott J.; Engel, Scott G.; Le Grange, Daniel; Mitchell, James E.; Crosby, Ross D.

2017-01-01

Objective Data gathered via retrospective forms of assessment are subject to various recall biases. Ecological momentary assessment (EMA) is an alternative approach involving repeated momentary assessments within a participant's natural environment, thus reducing recall biases and improving ecological validity. EMA has been used in numerous prior studies examining various constructs of theoretical relevance to eating disorders. Method This investigation includes data from three previously published studies with distinct clinical samples: (a) women with anorexia nervosa (N=118), (b) women with bulimia nervosa (N=133), and (c) obese men and women (N=50; 9 with current binge eating disorder). Each study assessed negative affective states and eating disorder behaviors using traditional retrospective assessments and EMA. Spearman rho correlations were used to evaluate the concordance of retrospective versus EMA measures of affective and/or behavioral constructs in each sample. Bland-Altman plots were also used to further evaluate concordance in the assessment of eating disorder behaviors. Results There was moderate to strong concordance for the measures of negative affective states across all three studies. Moderate to strong concordance was also found for the measures of binge eating and exercise frequency. The strongest evidence of concordance across measurement approaches was found for purging behaviors. Discussion Overall, these preliminary findings support the convergence of retrospective and EMA assessments of both negative affective states and various eating disorder behaviors. Given the advantages and disadvantages associated with each of these assessment approaches, the specific questions being studied in future empirical studies should inform decisions regarding selection of the most appropriate method. PMID:25195932

Off-label use of TNF-alpha inhibitors in a dermatological university department: retrospective evaluation of 118 patients.

PubMed

Sand, Freja Lærke; Thomsen, Simon Francis

2015-01-01

Tumor necrosis factor-alpha (TNF)-alpha inhibitors are licensed for patients with severe refractory psoriasis and psoriatic arthritis. However, TNF-alpha inhibitors have also been used off-label for various recalcitrant mucocutaneous diseases. This study aimed to evaluate the efficacy and safety of TNF-alpha inhibitors used for off-label dermatological indications. We retrospectively evaluated patient records of 118 patients treated off-label with TNF-alpha inhibitors in a dermatological university department. Patients presented with severe aphthous stomatitis/genital aphthous lesions (26), chronic urticaria (25), hidradenitis suppurativa (29), acne conglobata (11), dissecting cellulitis of the scalp (two), orofacial granulomatosis (four), sarcoidosis (four), granuloma annulare (two), granulomatous rosacea (one), granuloma faciale (one), subcorneal pustulosis (one), pyoderma gangrenosum (four), Sweet's syndrome (four), Well's syndrome (one), benign familial pemphigus (one), lichen planus (one), and folliculitis decalvans (one). A significant number of these patients went into remission during therapy with TNF-alpha inhibitors. A total of 11 patients (9%) experienced severe adverse effects during therapy. Off-label therapy with TNF-alpha inhibitors may be considered for selected patients with severe recalcitrant mucocutaneous diseases. The risk of severe adverse effects signals that a thorough benefit-risk assessment should be performed before initiating off-label treatment with TNF-alpha inhibitors for these conditions. © 2015 Wiley Periodicals, Inc.

Pattern of refractive errors among the Nepalese population: a retrospective study.

PubMed

Shrestha, S P; Bhat, K S; Binu, V S; Barthakur, R; Natarajan, M; Subba, S H

2010-01-01

Refractive errors are a major cause of visual impairment in the population. To find the pattern of refractive errors among patients evaluated in a tertiary care hospital in the western region of Nepal. The present hospital-based retrospective study was conducted in the Department of Ophthalmology of the Manipal Teaching Hospital, situated in Pokhara, Nepal. Patients who had refractive error of at least 0.5 D (dioptre) were included for the study. During the study period, 15,410 patients attended the outpatient department and 10.8% of the patients were identified as having refractive error. The age of the patients in the present study ranged between 5 - 90 years. Myopia was the commonest refractive error followed by hypermetropia. There was no difference in the frequency of the type of refractive errors when they were defined using right the eye, the left eye or both the eyes. Males predominated among myopics and females predominated among hypermetropics. The majority of spherical errors was less than or equal to 2 D. Astigmatic power above 1D was rarely seen with hypermetropic astigmatism and was seen in around 13 % with myopic astigmatism. "Astigmatism against the rule" was more common than "astigmatism with the rule", irrespective of age. Refractive errors progressively shift along myopia up to the third decade and change to hypermetropia till the seventh decade. Hyperopic shift in the refractive error in young adults should be well noted while planning any refractive surgery in younger patients with myopia. © Nepal Ophthalmic Society.

Risk factors and classification of stillbirth in a Middle Eastern population: a retrospective study.

PubMed

Kunjachen Maducolil, Mariam; Abid, Hafsa; Lobo, Rachael Marian; Chughtai, Ambreen Qayyum; Afzal, Arjumand Muhammad; Saleh, Huda Abdullah Hussain; Lindow, Stephen W

2017-12-21

To estimate the incidence of stillbirth, explore the associated maternal and fetal factors and to evaluate the most appropriate classification of stillbirth for a multiethnic population. This is a retrospective population-based study of stillbirth in a large tertiary unit. Data of each stillbirth with a gestational age >/=24 weeks in the year 2015 were collected from electronic medical records and analyzed. The stillbirth rate for our multiethnic population is 7.81 per 1000 births. Maternal medical factors comprised 52.4% in which the rates of hypertensive disorders, diabetes and other medical disorders were 22.5%, 20.8% and 8.3%, respectively. The most common fetal factor was intrauterine growth restriction (IUGR) (22.5%) followed by congenital anomalies (21.6%). All cases were categorized using the Wigglesworth, Aberdeen, Tulip, ReCoDe and International Classification of Diseases-perinatal mortality (ICD-PM) classifications and the rates of unclassified stillbirths were 59.2%, 46.6%, 16.6%, 11.6% and 7.5%, respectively. An autopsy was performed in 9.1% of cases reflecting local religious and cultural sensitivities. This study highlighted the modifiable risk factors among the Middle Eastern population. The most appropriate classification was the ICD-PM. The low rates of autopsy prevented a detailed evaluation of stillbirths, therefore it is suggested that a minimally invasive autopsy [postmortem magnetic resonance imaging (MRI)] may improve the quality of care.

Reproducing a Prospective Clinical Study as a Computational Retrospective Study in MIMIC-II.

PubMed

Kury, Fabrício S P; Huser, Vojtech; Cimino, James J

2015-01-01

In this paper we sought to reproduce, as a computational retrospective study in an EHR database (MIMIC-II), a recent large prospective clinical study: the 2013 publication, by the Japanese Association for Acute Medicine (JAAM), about disseminated intravascular coagulation, in the journal Critical Care (PMID: 23787004). We designed in SQL and Java a set of electronic phenotypes that reproduced the study's data sampling, and used R to perform the same statistical inference procedures. All produced source code is available online at https://github.com/fabkury/paamia2015. Our program identified 2,257 eligible patients in MIMIC-II, and the results remarkably agreed with the prospective study. A minority of the needed data elements was not found in MIMIC-II, and statistically significant inferences were possible in the majority of the cases.

Retrospective Case Study in Killdeer, North Dakota, Study of the Potential Impacts of Hydraulic Fracturing on Drinking Water Resources.

EPA Science Inventory

This report describes the retrospective case study conducted near Killdeer, Dunn County, North Dakota. The Killdeer study area is the location of historical oil and gas production, with current unconventional oil and gas production occurring in the late Devonian/early Mississipp...

Rapid Clinical Score for the Diagnosis of Tuberculous Meningitis: A Retrospective Cohort Study

PubMed Central

Jipa, Raluca; Olaru, Ioana D.; Manea, Eliza; Merisor, Simona; Hristea, Adriana

2017-01-01

Objective: The aim of our study was to retrospectively validate a previously described rapid clinical score (RCS) in distinguishing tuberculous meningitis (TBM) from viral meningitis (VM) in people who are at increased risk of tuberculosis, as well as from cryptococcal meningitis (CM) in HIV-infected patients. Methods: We performed a retrospective study of patients admitted with a diagnosis of aseptic meningitis between January 2012 and December 2015, to a referral hospital for infectious diseases. The variables included in RCS were duration of symptoms before admission, neurological stage, cerebrospinal fluid (CSF) to blood glucose ratio, and CSF protein. We included in this retrospective study 31 patients with definite or probable TBM including 14 HIV-infected patients, 62 HIV-noninfected patients with VM, and 18 HIV-infected patients with CM. Results: The sensitivity of RCS to distinguish TBM from VM was 96.7%, with a specificity of 81.1% and the area under the receiver operating characteristic (ROC) curve was 0.949 (0.90–0.99). When all four criteria from the RCS were present, the specificity increased at 100%. In HIV-infected patients, the sensitivity and specificity of RCS in differentiating TBM from CM were 86.6% and 27.7%, respectively, and the area under the ROC curve was 0.669 (0.48–0.85). Conclusion: This easy-to-use RCS was found to be helpful in differentiating TBM from VM, with a better sensitivity than molecular amplification techniques and a relatively good specificity. However, the RCS was not useful to differentiate between TBM and CM in HIV-infected patients. PMID:29184338

Prognostic Factors in Peptic Ulcer Perforations: A Retrospective 14-Year Study

PubMed Central

Unver, Mutlu; Fırat, Özgür; Ünalp, Ömer Vedat; Uğuz, Alper; Gümüş, Tufan; Sezer, Taylan Özgür; Öztürk, Şafak; Yoldaş, Tayfun; Ersin, Sinan; Güler, Adem

2015-01-01

Regarding the complications of peptic ulcer, a perforation remains the most important fatal complication. The aim of our retrospective study was to determine relations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer. In total, 239 patients who underwent emergency surgery for perforated peptic ulcer in Ege University General Surgery Department, between June 1999 and May 2013 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively. One hundred seventy-five of the 239 patients were male (73.2%) and 64 were female (26.8%). Mean American Society of Anesthesiologists (ASA) score was 1 in the patients without morbidity, but mean ASA score was 3 in the morbidity and mortality groups. Primary suture and omentoplasty was the selected procedure in 228 of the patients. Eleven patients underwent resection. In total, 105 patients (43.9%) had comorbidities. Thirty-seven patients (67.3%) in the morbidity group had comorbid diseases. Thirteen (92.9%) patients in the mortality group had comorbid diseases. Perforation as a complication of peptic ulcer disease still remains among the frequent indications of urgent abdominal surgery. Among the analyzed parameters, age, ASA score, and having comorbid disease were found to have an effect on both mortality and morbidity. The controversial subject in the present study is regarding the duration of symptoms. The duration of symptoms had no effect on mortality nor morbidity in our study. PMID:26011220

Prognostic factors in peptic ulcer perforations: a retrospective 14-year study.

PubMed

Unver, Mutlu; Fırat, Özgür; Ünalp, Ömer Vedat; Uğuz, Alper; Gümüş, Tufan; Sezer, Taylan Özgür; Öztürk, Şafak; Yoldaş, Tayfun; Ersin, Sinan; Güler, Adem

2015-05-01

Regarding the complications of peptic ulcer, a perforation remains the most important fatal complication. The aim of our retrospective study was to determine relations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer. In total, 239 patients who underwent emergency surgery for perforated peptic ulcer in Ege University General Surgery Department, between June 1999 and May 2013 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively. One hundred seventy-five of the 239 patients were male (73.2%) and 64 were female (26.8%). Mean American Society of Anesthesiologists (ASA) score was 1 in the patients without morbidity, but mean ASA score was 3 in the morbidity and mortality groups. Primary suture and omentoplasty was the selected procedure in 228 of the patients. Eleven patients underwent resection. In total, 105 patients (43.9%) had comorbidities. Thirty-seven patients (67.3%) in the morbidity group had comorbid diseases. Thirteen (92.9%) patients in the mortality group had comorbid diseases. Perforation as a complication of peptic ulcer disease still remains among the frequent indications of urgent abdominal surgery. Among the analyzed parameters, age, ASA score, and having comorbid disease were found to have an effect on both mortality and morbidity. The controversial subject in the present study is regarding the duration of symptoms. The duration of symptoms had no effect on mortality nor morbidity in our study.

Fall incidence in Germany: results of two population-based studies, and comparison of retrospective and prospective falls data collection methods.

PubMed

Rapp, Kilian; Freiberger, Ellen; Todd, Chris; Klenk, Jochen; Becker, Clemens; Denkinger, Michael; Scheidt-Nave, Christa; Fuchs, Judith

2014-09-20

Fall incidence differs considerably between studies and countries. Reasons may be differences between study samples or different assessment methods. The aim was to derive estimates of fall incidence from two population-based studies among older community-living people in Germany and compare retrospective and prospective falls data collection methods. Data were derived from the 2008-11 wave of the German health interview and examination survey for adults (DEGS1), and the Activity and Function of the Elderly in Ulm study (ActiFE-Ulm). Data collection took place in community facilities (DEGS1) or participants' homes (ActiFE-Ulm). Participation rates were 42% (newly recruited) and 64% (panel component) in DEGS1 and 19.8% in ActiFE-Ulm. Self-report retrospective fall data covering the previous 12 month period in DEGS1 and ActiFE-Ulm were collected, but only ActiFE-Ulm used prospective 12 month fall calendars. The incidence of 'any fall' and 'recurrent falls' were calculated for both methods. Fall rates increased with age in men but not women. The ActiFE-Ulm prospectively assessed incidence (95% confidence interval) in women and men aged 65- < 90 years were 38.7 (36.9-40.5) and 29.7 (28.1-31.3) fallers/year and 13.7 (12.5-14.9) and 10.9 (9.9-12.0) recurrent fallers/year, respectively. Retrospective and prospective fall incidence in ActiFE-Ulm did not differ.The retrospectively assessed incidence of 'any fall' among persons 65- < 80 years were significantly lower in DEGS1 than ActiFE-Ulm (women: 25.7% (22.4-29.2) versus 37.4% (34.8-39.9); men: 16.3% (13.6-19.3) versus 28.9% (26.6-31.1). Retrospective incidence estimates of recurrent falls were similar in both studies for women (10.4% (8.3-12.9) versus 10.2% (8.5-11.8)) and men (6.1% (4.3-8.5) versus 8.4% (7.1-9.8)). Both studies were population-based, but retrospective self-reported fall incidence differed between studies. Study design influences retrospective reported fall incidence considerably. Costly

Clinical performance of bonded ceramic inlays/onlays: A 5- to 18-year retrospective longitudinal study.

PubMed

Borgia Botto, Ernesto; Baró, Rosario; Borgia Botto, José Luis

2016-08-01

This retrospective longitudinal study evaluated the clinical performance of bonded ceramic inlays/onlays, placed by the first author in his private practice, in a 5 to 18-year period. The patients evaluated had been treated in the office for at least 7 years and were still in the practice up to year 2013. 130 randomly selected patients agreed to participate in the study. 93 bonded ceramic inlays/onlays (BCRs), were placed on posterior teeth in 47 subjects. Gender, age, tooth preparation, number, type, extent, location, quality and survival of the restorations, ceramic materials, luting resins cements, parafunctional habits, secondary caries and maintenance therapy were the variables evaluated. Cohen 's Kappa coefficient, on the quality analysis of the restorations, ranged from 0.78 to 1. Fisher 's exact test, Chi Square test, Kruskal-Wallis test and Mann-Whitney non-parametric test were indicated to analyze significant differences. At the initial examination, 87 (93.5%) restorations were in function and six failed (6.5%). 81 (93%) were rated as clinical successes. The observed mean survival time of those that remained functional was 11 years. The standard deviation was 4 years, with a 95% CI for the overall observed mean survival time (10 years-11 years, 9 months). 87 of 93 BCRs had a functional success of 93.5%, with an observed mean survival of 11 years. The clinical performance of bonded ceramic onlays was very acceptable. Bonded ceramic onlays showed a predictable, esthetic, and functional treatment, with acceptable longevity.

Adverse drug events with hyperkalaemia during inpatient stays: evaluation of an automated method for retrospective detection in hospital databases

PubMed Central

2014-01-01

Background Adverse drug reactions and adverse drug events (ADEs) are major public health issues. Many different prospective tools for the automated detection of ADEs in hospital databases have been developed and evaluated. The objective of the present study was to evaluate an automated method for the retrospective detection of ADEs with hyperkalaemia during inpatient stays. Methods We used a set of complex detection rules to take account of the patient’s clinical and biological context and the chronological relationship between the causes and the expected outcome. The dataset consisted of 3,444 inpatient stays in a French general hospital. An automated review was performed for all data and the results were compared with those of an expert chart review. The complex detection rules’ analytical quality was evaluated for ADEs. Results In terms of recall, 89.5% of ADEs with hyperkalaemia “with or without an abnormal symptom” were automatically identified (including all three serious ADEs). In terms of precision, 63.7% of the automatically identified ADEs with hyperkalaemia were true ADEs. Conclusions The use of context-sensitive rules appears to improve the automated detection of ADEs with hyperkalaemia. This type of tool may have an important role in pharmacoepidemiology via the routine analysis of large inter-hospital databases. PMID:25212108

Adverse drug events with hyperkalaemia during inpatient stays: evaluation of an automated method for retrospective detection in hospital databases.

PubMed

Ficheur, Grégoire; Chazard, Emmanuel; Beuscart, Jean-Baptiste; Merlin, Béatrice; Luyckx, Michel; Beuscart, Régis

2014-09-12

Adverse drug reactions and adverse drug events (ADEs) are major public health issues. Many different prospective tools for the automated detection of ADEs in hospital databases have been developed and evaluated. The objective of the present study was to evaluate an automated method for the retrospective detection of ADEs with hyperkalaemia during inpatient stays. We used a set of complex detection rules to take account of the patient's clinical and biological context and the chronological relationship between the causes and the expected outcome. The dataset consisted of 3,444 inpatient stays in a French general hospital. An automated review was performed for all data and the results were compared with those of an expert chart review. The complex detection rules' analytical quality was evaluated for ADEs. In terms of recall, 89.5% of ADEs with hyperkalaemia "with or without an abnormal symptom" were automatically identified (including all three serious ADEs). In terms of precision, 63.7% of the automatically identified ADEs with hyperkalaemia were true ADEs. The use of context-sensitive rules appears to improve the automated detection of ADEs with hyperkalaemia. This type of tool may have an important role in pharmacoepidemiology via the routine analysis of large inter-hospital databases.

Class, type and position of 9148 surgically removed third molars in 3206 patients: A retrospective study

PubMed Central

Rocha-Navarro, Miriam L.; Acosta-Veloz, Anselmo L.; Juárez-Hernández, Angélica

2012-01-01

Objective: To investigate the class, type, position, diagnosis and most common procedures used in the surgical removal of third molars, and evaluate the sex and age distribution in a representative sample of Mexican patients. Study Design: A retrospective descriptive study was made covering the period 1993-2008 in relation to 9148 extracted third molars in 3206 patients treated in the Dental School of Salle Bajío University, A.C. (Mexico). Patients of either sex and aged 11-59 years, with at least one third molar programmed for surgical removal, were included in the study. A descriptive statistical study was made. Results: The mean patient age was 27.6 ± 10.6 years. There were 2093 females (65.3%) and 1111 males (34.6%). In relation to the 4025 upper molars, extraction was decided for prophylactic reasons in 3827 cases (95.08%). Type A presentations were recorded in 1929 cases (47.9%), with a vertical position in 1931 teeth (48%). In relation to the 5123 lower third molars, extraction was likewise most often indicated for prophylactic reasons (4424 cases, 86.36%). A total of 2353 teeth corresponded to type A (45.9%), 2545 were class I cases (49.7%), and a mesioangular position was observed in 1850 cases (36.1%). Conclusions: The present study shows that in Mexican patients, upper third molars most often correspond to type A and class I, with a vertical position, while lower third molars predominantly correspond to type A and class I, with a mesioangular position. This information can help dental surgeons take better decisions before and after surgery, to the benefit of their patients. Key words:Third molars, retrospective review, surgical removal. PMID:22143723

Carpal valgus in llamas and alpacas: Retrospective evaluation of patient characteristics, radiographic features and outcomes following surgical treatment

PubMed Central

Hunter, Barbara; Duesterdieck-Zellmer, Katja F.; Huber, Michael J.; Parker, Jill E.; Semevolos, Stacy A.

2014-01-01

This study evaluated outcomes of surgical treatment for carpal valgus in New World camelids and correlated successful outcome (absence of carpal valgus determined by a veterinarian) with patient characteristics and radiographic features. Univariable and multivariable analyses of retrospective case data in 19 camelids (33 limbs) treated for carpal valgus between 1987 and 2010 revealed that procedures incorporating a distal radial transphyseal bridge were more likely (P = 0.03) to result in success after a single surgical procedure. A greater degree of angulation (> 19°, P = 0.02) and younger age at surgery (< 4 months, P = 0.03) were associated with unsuccessful outcome. Overall, 74% of limbs straightened, 15% overcorrected, and 11% had persistent valgus following surgical intervention. To straighten, 22% of limbs required multiple procedures, not including implant removal. According to owners, valgus returned following implant removal in 4 limbs that had straightened after surgery. PMID:25477542

Retrospective Case Study in Southwestern Pennsylvania, Study of the Potential Impacts of Hydraulic Facturing on Drinking Water Resources

EPA Science Inventory

This report describes the retrospective case study for southwestern Pennsylvania, which was conducted in Amwell, Cross Creek, Hopewell, and Mount Pleasant Townships in Washington County, locations that have witnessed unconventional gas production from the Devonian-age Marcellus S...

Evaluating the Effectiveness of Website Content Features Using Retrospective Pretest Methodology: An Experimental Test.

PubMed

Mueller, Christoph Emanuel

2015-06-01

In order to assess website content effectiveness (WCE), investigations have to be made into whether the reception of website contents leads to a change in the characteristics of website visitors or not. Because randomized controlled trials (RCTs) are not always the method of choice, researchers may have to follow other strategies such as using retrospective pretest methodology (RPM), a straightforward and easy-to-implement tool for estimating intervention effects. This article aims to introduce RPM in the context of website evaluation and test its viability under experimental conditions. Building on the idea that RCTs deliver unbiased estimates of the true causal effects of website content reception, I compared the performance of RPM with that of an RCT within the same study. Hence, if RPM provides effect estimates similar to those of the RCT, it can be considered a viable tool for assessing the effectiveness of the website content features under study. RPM was capable of delivering comparatively resilient estimates of the effects of a YouTube video and a text feature on knowledge and attitudes. With regard to all of the outcome variables considered, the differences between the sizes of the effects estimated by the RCT and RPM were not significant. Additionally, RPM delivered relatively accurate effect size estimates in most of the cases. Therefore, I conclude that RPM could be a viable alternative for assessing WCE in cases where RCTs are not the preferred method. © The Author(s) 2015.

Blunt Cardiac Injury in the Severely Injured – A Retrospective Multicentre Study

PubMed Central

Hanschen, Marc; Kanz, Karl-Georg; Kirchhoff, Chlodwig; Khalil, Philipe N.; Wierer, Matthias; van Griensven, Martijn; Laugwitz, Karl-Ludwig; Biberthaler, Peter; Lefering, Rolf; Huber-Wagner, Stefan

2015-01-01

Background Blunt cardiac injury is a rare trauma entity. Here, we sought to evaluate the relevance and prognostic significance of blunt cardiac injury in severely injured patients. Methods In a retrospective multicentre study, using data collected from 47,580 patients enrolled to TraumaRegister DGU (1993-2009), characteristics of trauma, prehospital / hospital trauma management, and outcome analysis were correlated to the severity of blunt cardiac injury. The severity of cardiac injury was assessed according to the abbreviated injury score (AIS score 1-6), the revised injury severity score (RISC) allowed comparison of expected outcome with injury severity-dependent outcome. N = 1.090 had blunt cardiac trauma (AIS 1-6) (2.3% of patients). Results Predictors of blunt cardiac injury could be identified. Sternal fractures indicate a high risk of the presence of blunt cardiac injury (AIS 0 [control]: 3.0%; AIS 1: 19.3%; AIS 2-6: 19.1%). The overall mortality rate was 13.9%, minor cardiac injury (AIS 1) and severe cardiac injury (AIS 2-6) are associated with higher rates. Severe blunt cardiac injury (AIS 4 and AIS 5-6) is associated with a higher mortality (OR 2.79 and 4.89, respectively) as compared to the predicted average mortality (OR 2.49) of the study collective. Conclusion Multiple injured patients with blunt cardiac trauma are at high risk to be underestimated. Careful evaluation of trauma patients is able to predict the presence of blunt cardiac injury. The severity of blunt cardiac injury needs to be stratified according to the AIS score, as the patients’ outcome is dependent on the severity of cardiac injury. PMID:26136126

Four dimensional magnetic resonance imaging with retrospective k-space reordering: A feasibility study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Yilin; Yin, Fang-Fang; Cai, Jing, E-mail: jing.cai@duke.edu

Purpose: Current four dimensional magnetic resonance imaging (4D-MRI) techniques lack sufficient temporal/spatial resolution and consistent tumor contrast. To overcome these limitations, this study presents the development and initial evaluation of a new strategy for 4D-MRI which is based on retrospective k-space reordering. Methods: We simulated a k-space reordered 4D-MRI on a 4D digital extended cardiac-torso (XCAT) human phantom. A 2D echo planar imaging MRI sequence [frame rate (F) = 0.448 Hz; image resolution (R) = 256 × 256; number of k-space segments (N{sub KS}) = 4] with sequential image acquisition mode was assumed for the simulation. Image quality of themore » simulated “4D-MRI” acquired from the XCAT phantom was qualitatively evaluated, and tumor motion trajectories were compared to input signals. In particular, mean absolute amplitude differences (D) and cross correlation coefficients (CC) were calculated. Furthermore, to evaluate the data sufficient condition for the new 4D-MRI technique, a comprehensive simulation study was performed using 30 cancer patients’ respiratory profiles to study the relationships between data completeness (C{sub p}) and a number of impacting factors: the number of repeated scans (N{sub R}), number of slices (N{sub S}), number of respiratory phase bins (N{sub P}), N{sub KS}, F, R, and initial respiratory phase at image acquisition (P{sub 0}). As a proof-of-concept, we implemented the proposed k-space reordering 4D-MRI technique on a T2-weighted fast spin echo MR sequence and tested it on a healthy volunteer. Results: The simulated 4D-MRI acquired from the XCAT phantom matched closely to the original XCAT images. Tumor motion trajectories measured from the simulated 4D-MRI matched well with input signals (D = 0.83 and 0.83 mm, and CC = 0.998 and 0.992 in superior–inferior and anterior–posterior directions, respectively). The relationship between C{sub p} and N{sub R} was found best represented by an exponential

[Lupus erythematosus treatment with belimumab in daily practice: Retrospective study of 15 patients].

PubMed

Garval, E; Pennaforte, J-L; Jaussaud, R; Servettaz, A; Bernard, P; Reguiai, Z

2018-01-01

Belimumab (an anti-BLyS monoclonal antibody) was recently approved for the treatment of systemic lupus erythematosus (SLE). The aim of the study was to describe efficacy and safety of the drug as well as its impact on serologic parameters and the role of long-term systemic sparing of treatment in clinical practice in LE. We conducted a retrospective study at Reims University Hospital between 2012 and 2016 including consecutive patients with LE treated with belimumab. Efficacy was evaluated in terms of clinical progression, and normalisation of laboratory factors (anti-DNA antibody and C3 serum levels) and sparing of associated long-term systemic therapies for LE. Among the 15 patients included, a therapeutic response was obtained in 9 patients (60%), with partial remission in 8 of 9 cases. The median titre of anti-DNA antibody was 50IU/mL (range: 4-50) and the median C3 level was 0.82g/L (range: 0.36-1.23) before initiation of belimumab, vs. 25.5IU/mL (range: 2-50) and 0.89g/L (range: 0.34-1.22) at the last evaluation, respectively, without significant modification (P=0.12 and P=0.45). The median dose of prednisone at the time of the first belimumab infusion was reduced from 9.5mg/day (range: 0-18) to 6mg/day (range: 0-20) at the last clinical evaluation. Eight patients (53%) experienced adverse events, and these were very slight or moderate in all cases. Belimumab appears to be an effective and well-tolerated treatment for moderately severe systemic LE, allowing sparing of maintenance corticosteroid therapy in order to decrease its frequent adverse events. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

The outcome and survival of palliative surgery in thoraco-lumbar spinal metastases: contemporary retrospective cohort study.

PubMed

Nemelc, R M; Stadhouder, A; van Royen, B J; Jiya, T U

2014-11-01

Purpose: To evaluate outcome and survival and to identify prognostic variables for patients surgically treated for spinal metastases. Methods: A retrospective study was performed on 86 patients, surgically treated for spinal metastases. Preoperative analyses of the ASIA and spinal instability neoplastic scores (SINS) were performed. Survival curves of different prognostic variables were made by Kaplan–Meier analysis and the variables entered in a Cox proportional hazards model to determine their significance on survival. The correlation between preoperative radiotherapy and postoperative wound infections was also evaluated. Results: Survival analysis was performed on 81 patients,37 women and 44 men. Five patients were excluded due to missing data. Median overall survival was 38 weeks [95 % confidence interval (CI) 27.5–48.5 weeks], with a 3-month survival rate of 81.5 %. Breast tumor had the best median survival of 127 weeks and lung tumor the worst survival of 18 weeks. Univariate analysis showed tumor type, preoperative ASIA score (p = 0.01) and visceral metastases(p = 0.18) were significant prognostic variables for survival.Colon tumors had 5.53 times hazard ratio compared to patients with breast tumor. ASIA-C score had more than 13.03 times the hazard ratio compared to patients with an ASIA-E score. Retrospective analysis of the SINS scores showed 34 patients with a score of 13–18 points, 44 patients with a score of 7–12 points, and 1 patient with a score of 6 points. Preoperative radiotherapy had no influence on the postoperative incidence of deep surgical wound infections (p = 0.37). Patients with spinal metastases had a median survival of 38 weeks postoperative. The primary tumor type and ASIA score were significant prognostic factors for survival. Preoperative radiotherapy neither had influence on survival nor did it constitute a risk for postoperative surgical wound infections.

Retrospective Case Study in Northeastern Pennsylvania, Study of the Potential Impacts of Hydraulic Fracturing On Drinking Water Resources

EPA Science Inventory

This report describes the retrospective case study for northeastern Pennsylvania, which was conducted in Bradford and Susquehanna Counties where some of the most intensive unconventional gas production from the Devonian-age Marcellus Shale has occurred. Gas production from the M...

Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study

PubMed Central

Stoor, Patricia; Mesimäki, Karri; Kontio, Risto K.

2015-01-01

Background The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. Material and Methods The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination – multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. Results In total 114 RP models were fabricated for 102 patients. The mean age of the patients at the time of the production of the model was 50.4 years. The indications for the modelling included malignant lesions (29%), secondary reconstruction (25%), prosthodontic treatment (22%), orthognathic surgery or asymmetry (13%), benign lesions (8%), and TMJ disorders (4%). MSCT examination was used in 92 and CBCT examination in 22 cases. Most of the models (75%) were conventional hard tissue models. Models with colored tumour or other structure(s) of interest were ordered in 24%. Two out of the 114 models were soft tissue models. Conclusions The main benefit of the models was in treatment planning and in connection with the production of pre-bent plates or custom made implants. The RP models both facilitate and improve treatment planning and intraoperative efficiency. Key words:Rapid prototyping, radiology, computed tomography, cone beam computed tomography. PMID:26644837

A Retrospective Study of Gay Gifted, Young Adult Males' Perceptions of Giftedness and Suicide

ERIC Educational Resources Information Center

Sedillo, Paul James

2013-01-01

This qualitative, retrospective study investigated suicidal ideation among 32 young adult men. Participants were asked to report their experiences as adolescents. The primary focus of the study was to discover how gay gifted adolescents dealt with issues of suicide and suicidal ideation. Participants were selected using a purposive sampling…

Retrospective Study of Root Canal Configurations of Mandibular Third Molars Using CBCT- Part-II.

PubMed

Somasundaram, Pavithra; Rawtiya, Manjusha; Wadhwani, Shefali; Uthappa, Roshan; Shivagange, Vinay; Khan, Sheeba

2017-06-01

Abnormal root canal morphologies of third molars can be diagnostically and technically challenging during root canal treatment. The aim of this retrospective study was to investigate the root and canal morphology of mandibular third molars in Central India population by using Cone Beam Computed Tomography (CBCT) analysis. CBCT images of 171 mandibular third molars were observed and data regarding number of roots, number of canals, Vertucci's classification in each root, prevalence of C shaped canal, gender and topographical relation of morphology in mandibular third molar was statistically evaluated. Majority of mandibular third molars had two roots (84.2%) and three canals (64.3%). Most mesial root had Vertucci Type II (55.6%) and Vertucci Type IV (22.2%), distal root had Type I canals (87.5%). Over all prevalence of C shaped canals in mandibular third molars was 9.4%. There was a high prevalence of two rooted mandibular third molars with three canals.

Retrospective Study of Root Canal Configurations of Mandibular Third Molars Using CBCT- Part-II

PubMed Central

Somasundaram, Pavithra; Wadhwani, Shefali; Uthappa, Roshan; Shivagange, Vinay; Khan, Sheeba

2017-01-01

Introduction Abnormal root canal morphologies of third molars can be diagnostically and technically challenging during root canal treatment. Aim The aim of this retrospective study was to investigate the root and canal morphology of mandibular third molars in Central India population by using Cone Beam Computed Tomography (CBCT) analysis. Materials and Methods CBCT images of 171 mandibular third molars were observed and data regarding number of roots, number of canals, Vertucci’s classification in each root, prevalence of C shaped canal, gender and topographical relation of morphology in mandibular third molar was statistically evaluated. Results Majority of mandibular third molars had two roots (84.2%) and three canals (64.3%). Most mesial root had Vertucci Type II (55.6%) and Vertucci Type IV (22.2%), distal root had Type I canals (87.5%). Over all prevalence of C shaped canals in mandibular third molars was 9.4%. Conclusion There was a high prevalence of two rooted mandibular third molars with three canals. PMID:28764294

Surgical volume and conversion rate in laparoscopic hysterectomy: does volume matter? A multicenter retrospective cohort study.

PubMed

Keurentjes, José H M; Briët, Justine M; de Bock, Geertruida H; Mourits, Marian J E

2018-02-01

A multicenter, retrospective, cohort study was conducted in the Netherlands. The aim was to evaluate whether surgical volume of laparoscopic hysterectomies (LHs) performed by proven skilled gynecologists had an impact on the conversion rate from laparoscopy to laparotomy. In 14 hospitals, all LHs performed by 19 proven skilled gynecologists between 2007 and 2010 were included in the analysis. Surgical volume, conversion rate and type of conversion (reactive or strategic) were retrospectively assessed. To estimate the impact of surgical volume on the conversion rate, logistic regressions were performed. These regressions were adjusted for patient's age, Body Mass Index (BMI), ASA classification, previous abdominal surgery and the indication (malignant versus benign) for the LH. During the study period, 19 proven skilled gynecologists performed a total of 1051 LHs. Forty percent of the gynecologists performed over 20 LHs per year (median 17.3, range 5.4-49.5). Conversion to laparotomy occurred in 5.0% of all LHs (53 of 1051); 38 (3.6%) were strategic and 15 (1.4%) were reactive conversions. Performing over 20 LHs per year was significantly associated with a lower overall conversion rate (OR adjusted 0.43, 95% CI 0.24-0.77), a lower strategic conversion rate (OR adjusted 0.32, 95% CI 0.16-0.65), but not with a lower reactive conversion rate (OR adjusted 0.96, 95% CI 0.33-2.79). A higher annual surgical volume of LHs by proven skilled gynecologists is inversely related to the conversion rate to laparotomy, and results in a lower strategic conversion rate.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

PubMed

Guarnieri, R; Cavallini, C; Vernucci, R; Vichi, M; Leonardi, R; Barbato, E

2016-11-01

The prevalence of impacted maxillary canine is reported to be between 1% and 3%. The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors. An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography. 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements. Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If β angle <18° and Lindauer = I, the probability of resorption is 0.06. Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of

Retrospective Study of Lithium Use for Institutionalized Mentally Retarded Individuals with Behavior Disorders.

ERIC Educational Resources Information Center

Langee, Harvey R.

1990-01-01

Severely and profoundly mentally retarded institutionalized residents (N=74) who received lithium carbonate for behavior disorders were followed in a 10-year retrospective study. Thirty-one subjects demonstrated a sustained major reduction or elimination of behavioral symptoms. Lithium responders were likely to be older and to present symptoms of…

Implant failure and history of failed endodontic treatment: A retrospective case-control study.

PubMed

Chatzopoulos, Georgios S; Wolff, Larry F

2017-11-01

Residual bacterial biofilm and/or bacteria in planktonic form may be survived in the bone following an extraction of an infected tooth that was endodontically treated unsuccessfully Failed endodontic treatment may be associated with failure of implants to osseointegrate in the same sites. Therefore, the aim of this retrospective case-control study is to examine the risk of implant failure in previous failed endodontic sites. This retrospective case-control study is based on 94 dental records of implants placed at the University of Minnesota School of Dentistry. Dental records of patients who received an implant in sites with previously failed endodontic therapy in the dental school were identified from the electronic database, while control subjects were obtained from the same pool of patients with the requirement to have received an implant in a site that was not endodontically treated. The mean age of the population was 62.89±14.17 years with 57.4% of the sample being females and 42.6% of them being males. In regards to the socio-economic status and dental insurance, 84.0% of this population was classified as low socio-economic status and 68.1% had dental insurance. Tobacco use was self-reported by 9.6% and hypercholesterolemia was the most prevalent systemic medical condition. Dental implant failure was identified in two of the included records (2.1%), both of which were placed in sites with a history of failed endodontic treatment. Within the limitations of this retrospective case-control study, further investigation with a larger population group into implant failure of sites that previously had unsuccessful endodontic treatment would be warranted. Implant failure may be associated with a history of failed endodontic treatment. Key words: Implantology, endodontics, osseointegration, treatment outcome, case-control study.

The aim of this retrospective study is to evaluate the efficacy and safety of posterior-only vertebral column resection (PVCR) for the treatment of angular and isolated congenital kyphosis.

PubMed

Wang, Shengru; Aikenmu, Kahaer; Zhang, Jianguo; Qiu, Guixing; Guo, Jianwei; Zhang, Yanbin; Weng, Xisheng

2017-07-01

The aim of this retrospective study is to evaluate the efficacy and safety of posterior-only vertebral column resection (PVCR) for the treatment of angular and isolated congenital kyphosis. 24 patients with isolated angular congenital kyphosis treated by PVCR in our hospital were retrospectively studied. The patients' radiographs and hospital records were reviewed. Deformity in sagittal planes and global sagittal alignment were analyzed for correction and maintenance of the correction in preoperative, postoperative, and follow-up radiographs. The complications and related risk factors were analyzed. The average age was 13.9 (4-40) years. Three of them were revision surgeries. Two patients have intraspinal anomalies. The mean follow-up is 56.9 (26-129) months. The mean operation time was 293.1 (170-480) min. The averaged blood loss was 993.8 (250-3000) ml. The segmental kyphosis was 87.3° before surgery, 17.6° post surgery and 20.4° at the latest the follow-up. And the sagittal vertical axis was improved from 43.1 mm to 9.2 mm. Mean total score of SRS-22 was 89.3. Complications occurred in 4 patients, including 1 screw pullout due to pseudarthrosis, 1 proximal junctional kyphosis, 1 incomplete spinal cord injury and 1 root injuries. Posterior-only vertebral column resection is an ideal procedure for severe rigid congenital kyphosis. However, it is still a highly technical demanding procedure. Neurological compromises still remain the biggest challenges. Sufficient height of anterior reconstruction, avoidance sacrifice of bilateral roots in the same level in the thoracic spine, avoidance of the sagittal translation of the upper and lower vertebras, intra-operative neuromonitoring, and preoperative surgical release of diastematomyelia and tethered cord may help to improve the safety.

Methodological Considerations in Evaluating Long-Term Systems Change: A Case Study From Eastern Nepal

ERIC Educational Resources Information Center

Koleros, Andrew; Jupp, Dee; Kirwan, Sean; Pradhan, Meeta S.; Pradhan, Pushkar K.; Seddon, David; Tumbahangfe, Ansu

2016-01-01

This article presents discussion and recommendations on approaches to retrospectively evaluating development interventions in the long term through a systems lens. It is based on experiences from the implementation of an 18-month study to investigate the impact of development interventions on economic and social change over a 40-year period in the…

Transition in Dental Treatment Utilization in Jammu And Kashmir, India - A 10 Year Retrospective Study

PubMed Central

Batra, Manu; Ishrat, A.

2016-01-01

Background: Utilization of health services is the actual attendance by the members of the public at health care facilities to receive care. Utilization, serves as an important tool for oral health policy decision-making. The aim of the present study was to retrospectively gauge and assess the utilization pattern of the dental treatments which was given in hospital for last 10 years. Materials and Methods: This retrospective infirmary based study was carried out at Sheri Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu and Kashmir, India. The yearly outpatient department (OPD) records for the utilization of specific dental treatment of a total of 103963 patients were assessed retrospectively from 2014 to 2003. Trend analysis was used to assess the trend of utilization of each speciality with best fitted linear trend lines. Results: The pattern of new patients has also shown a constant rise during the study period except for 2008 and 2009. The utilization of oral surgery speciality has shown a tremendous fall from 2003 to 2014 whereas the number of patients coming to periodontics and conservative dentistry has shown an increasing pattern. Conclusion: Utilization of oral health care has long been used as an indicator of oral health related behaviour of a population. In the present study it can be conclude that the outlook of the population under study has changed from blood and vulcanite dentistry outlook and is moving towards restorative dentistry. . PMID:28804675

Experiences of Individuals with Visual Impairments in Integrated Physical Education: A Retrospective Study

ERIC Educational Resources Information Center

Haegele, Justin A.; Zhu, Xihe

2017-01-01

Purpose: The purpose of this retrospective study was to examine the experiences of adults with visual impairments during school-based integrated physical education (PE). Method: An interpretative phenomenological analysis (IPA) research approach was used and 16 adults (ages 21-48 years; 10 women, 6 men) with visual impairments acted as…

Association between chronic periodontitis and the risk of Alzheimer's disease: a retrospective, population-based, matched-cohort study.

PubMed

Chen, Chang-Kai; Wu, Yung-Tsan; Chang, Yu-Chao

2017-08-08

Although recent short-term cross-sectional studies have revealed that chronic periodontitis (CP) may be a risk factor for increased cognitive impairment in patients with Alzheimer's disease (AD), systematic reviews and long-term longitudinal studies have provided less clear evidence regarding the relationship between CP and AD. Therefore, we conducted a retrospective cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan to determine whether patients with CP are at increased risk of developing AD. We conducted a retrospective matched-cohort study using the NHIRD of Taiwan. We identified 9291 patients newly diagnosed with CP between 1997 and 2004. A total of 18,672 patients without CP were matched to the patient cohort according to sex, age, index year, co-morbidity and urbanisation level. Cox proportional hazards regression analyses were performed to evaluate the subsequent risk of AD. Patients with CP had a higher prevalence of hyperlipidaemia, depression, traumatic brain injury and co-morbidities, as well as higher urbanisation levels, than those in the unexposed cohort (all p < 0.01). At the final follow-up, totals of 115 (1.24%) and 208 (1.11%) individuals in the CP exposed and unexposed groups, respectively, had developed AD. Patients with 10 years of CP exposure exhibited a higher risk of developing AD than unexposed groups (adjusted HR 1.707, 95% CI 1.152-2.528, p = 0.0077). Our findings demonstrate that 10-year CP exposure was associated with a 1.707-fold increase in the risk of developing AD. These findings highlight the need to prevent progression of periodontal disease and promote healthcare service at the national level.

Palpation Versus Ultrasound-Guided Acromioclavicular Joint Intra-articular Corticosteroid Injections: A Retrospective Comparative Clinical Study.

PubMed

Park, Ki Deok; Kim, Tai Kon; Lee, Jihae; Lee, Woo Yong; Ahn, Jae Ki; Park, Yongbum

2015-01-01

Primary osteoarthritis (OA) is the most common cause of pain arising from the acromioclavicular (AC) joint. The true incidence is unknown because of differences in the criteria used to define arthritis in various studies. The proper diagnosis of AC joint OA requires a thorough physical examination, radiographic findings, and a diagnostic local anesthetic injection. The goal of this study was to assess the effects and safety of ultrasound (US) versus palpation-guided acromioclavicular (AC) joint intra-articular (IA) corticosteroid injection for patients with osteoarthritis (OA) of the AC joint. Retrospective, compared clinical study. University hospital outpatient pain clinic. We retrospectively reviewed the charts of patients with AC joint degenerative OA who had undergone US or palpation-guided AC joint IA corticosteroid injection between January 2012 and December 2013 at our outpatient clinic. One hundred consecutive patients identified from chart review met inclusion criteria. Patients (N = 50) in US guide AC joint IA steroid injection group were administered a mixture of 0.5% lidocaine (1 mL) with triamcinolone (20 mg/mL; 0.5 mL) and radiographic contrast material (0.5 mL) and patients (N = 50) in palpation-guided AC joint IA steroid injection group were administered a mixture of 0.5% lidocaine (1 mL) with triamcinolone (20 mg/mL; 0.5 mL) and 0.5 mL of radiographic contrast material. Results were measured using the Shoulder Pain and Disability Index (SPADI), Verbal Numeric pain Scale (VNS) at rest (VNSar), under local pressure (VNSlp) ,and the arm adduction test (VNSaat) at the joint space area before injections and at one, 3, and 6 months after the injections. Successful treatment occurred when patients obtained significant pain relief (as measured by > 50% improvement in the VNS score and 20 point improvement in the SPADI) at one, 3, and 6 months after the injections. Univariable analysis was performed to evaluate the relationship between possible outcome

Transient evoked oto-acoustic emission screening in newborns in Bogotá, Colombia: a retrospective study.

PubMed

Rojas, Jorge A; Bernal, Jaime E; García, Mary A; Zarante, Ignacio; Ramírez, Natalia; Bernal, Constanza; Gelvez, Nancy; Tamayo, Marta L

2014-10-01

The aim of this study was to investigate the characteristics and performance of transient evoked oto-acoustic emission (TEOAE) hearing screening in newborns in Colombia, and analyze all possible variables and factors affecting the results. An observational, descriptive and retrospective study with bivariate analysis was performed. The study population consisted of 56,822 newborns evaluated at the private institution, PREGEN. TEOAE testing was carried out as a pediatric hearing screening test from December 2003 to March 2012. The database from PREGEN was revised, and the protocol for evaluation included the same screening test performed twice. Demographic characteristics were recorded and the newborn's background was evaluated. Basic statistics of the qualitative and quantitative variables, and statistical analysis were obtained using the chi-square test. Of the 56,822 records examined, 0.28% were classed as abnormal, which corresponded to a prevalence of 1 in 350. In the screened newborns, 0.08% had a major abnormality or other clinical condition diagnosed, and 0.29% reported a family history of hearing loss. A prevalence of 6.7 in 10,000 was obtained for microtia, which is similar to the 6.4 in 10,000 previously reported in Colombia (database of the Latin-American Collaborative Study of Congenital Malformations - ECLAMC). Statistical analysis demonstrated an association between presenting with a major anomaly and a higher frequency of abnormal results on both TEOAE tests. Newborns in Colombia do not currently undergo screening for the early detection of hearing impairment. The results from this study suggest TEOAE screening tests, when performed twice, are able to detect hearing abnormalities in newborns. This highlights the need to improve the long-term evaluation and monitoring of patients in Colombia through diagnostic tests, and to provide tests that are both sensitive and specific. Furthermore, the use of TEOAE screening is justified by the favorable cost

Examining the Frequency of Stimulant Misuse among Patients with Primary Disorders of Hypersomnolence: A Retrospective Cohort Study

PubMed Central

Mantyh, William G.; Auger, R. Robert; Morgenthaler, Timothy I.; Silber, Michael H.; Moore, Wendy R.

2016-01-01

Study Objectives: Narcolepsy and idiopathic hypersomnia are commonly treated by sleep specialists and encountered by other medical providers. Although pharmacotherapy with modafinil and traditional stimulants is considered the mainstay of treatment, physicians are often uncomfortable with their prescription because of concerns regarding misuse. The goal of this study was to assess the frequency of stimulant misuse in this population. Methods: A retrospective cohort study was performed evaluating patients 18 years and older diagnosed with narcolepsy with and without cataplexy and idiopathic hypersomnia with and without long sleep between 2003–2008. Patients were included if they obtained stimulant prescriptions from and had at least one follow-up visit subsequent to initial diagnosis at our center. Stimulant misuse was defined by multiple prescription sources or early refill requests, which are systematically entered into the record by nursing staff. Results: A total of 105 patients met inclusion criteria for the study; 45 (42%) were male. Mean age at multiple sleep latency test was 42 (± 16). Twelve (11%) patients had a history of illicit substance misuse, and one (1%) patient demonstrated previous stimulant misuse. Fifty-seven (54%) patients carried psychiatric diagnoses, 88% of whom reported depression. Median duration of monitored stimulant therapy was 26 months (range 1–250). None of the 105 patients was found to have evidence of stimulant misuse. Conclusion: This study suggests that the frequency of stimulant misuse in patients with narcolepsy and idiopathic hypersomnia is extremely low. Concerns regarding drug misuse should not leverage decisions to provide long-term therapy. Citation: Mantyh WG, Auger RR, Morgenthaler TI, Silber MH, Moore WR. Examining the frequency of stimulant misuse among patients with primary disorders of hypersomnolence: a retrospective cohort study. J Clin Sleep Med 2016;12(5):659–662. PMID:26943713

A retrospective metagenomics approach to studying Blastocystis.

PubMed

Andersen, Lee O'Brien; Bonde, Ida; Nielsen, Henrik Bjørn; Stensvold, Christen Rune

2015-07-01

Blastocystis is a common single-celled intestinal parasitic genus, comprising several subtypes. Here, we screened data obtained by metagenomic analysis of faecal DNA for Blastocystis by searching for subtype-specific genes in coabundance gene groups, which are groups of genes that covary across a selection of 316 human faecal samples, hence representing genes originating from a single subtype. The 316 faecal samples were from 236 healthy individuals, 13 patients with Crohn's disease (CD) and 67 patients with ulcerative colitis (UC). The prevalence of Blastocystis was 20.3% in the healthy individuals and 14.9% in patients with UC. Meanwhile, Blastocystis was absent in patients with CD. Individuals with intestinal microbiota dominated by Bacteroides were much less prone to having Blastocystis-positive stool (Matthew's correlation coefficient = -0.25, P < 0.0001) than individuals with Ruminococcus- and Prevotella-driven enterotypes. This is the first study to investigate the relationship between Blastocystis and communities of gut bacteria using a metagenomics approach. The study serves as an example of how it is possible to retrospectively investigate microbial eukaryotic communities in the gut using metagenomic datasets targeting the bacterial component of the intestinal microbiome and the interplay between these microbial communities. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Bile leakage after liver resection: A retrospective cohort study].

PubMed

Menclová, K; Bělina, F; Pudil, J; Langer, D; Ryska, M

2015-12-01

Many previous reports have focused on bile leakage after liver resection. Despite the improvements in surgical techniques and perioperative care the incidence of this complication rather keeps increasing. A number of predictive factors have been analyzed. There is still no consensus regarding their influence on the formation of bile leakage. The objective of our analysis was to evaluate the incidence of bile leakage, its impact on mortality and duration of hospitalization at our department. At the same time, we conducted an analysis of known predictive factors. The authors present a retrospective review of the set of 146 patients who underwent liver resection at the Department of Surgery of the 2nd Faculty of Medicine of the Charles University and Central Military Hospital Prague, performed between 20102013. We used the current ISGLS (International Study Group of Liver Surgery) classification to evaluate the bile leakage. The severity of this complication was determined according to the Clavien-Dindo classification system. Statistical significance of the predictive factors was determined using Fishers exact test and Students t-test. The incidence of bile leakage was 21%. According to ISGLS classification the A, B, and C rates were 6.5%, 61.2%, and 32.3%, respectively. The severity of bile leakage according to the Clavien-Dindo classification system - I-II, IIIa, IIIb, IV and V rates were 19.3%, 42%, 9.7%, 9.7%, and 19.3%, respectively. We determined the following predictive factors as statistically significant: surgery for malignancy (p<0.001), major hepatic resection (p=0.001), operative time (p<0.001), high intraoperative blood loss (p=0.02), construction of HJA (p=0.005), portal venous embolization/two-stage surgery (p=0.009) and ASA score (p=0.02). Bile leakage significantly prolonged hospitalization time (p<0.001). In the group of patients with bile leakage the perioperative mortality was 23 times higher (p<0.001) than in the group with no leakage. Bile

Health Sector Reform, Emotional Exhaustion, and Nursing Burnout: A Retrospective Panel Study in Iran.

PubMed

Sadati, Ahmad Kalateh; Rahnavard, Farnaz; Heydari, Seyed Taghi; Hemmati, Soroor; Ebrahimzadeh, Najmeh; Lankarani, Kamran Bagheri

2017-10-01

Nursing burnout is affected by various factors, including work overload. Since the inauguration of the Health Sector Evolution Plan (HSEP) in Iran in 2014, government hospitals have been required to provide health services to the public at all levels. This decision, however, has increased the volume of patients admitted to government hospitals. Because nurses are on the front line of health services, they are faced with a greater load of care provision. This study aimed to evaluate nursing burnout before and after HSEP in Iran, with an emphasis on the differences between government and private hospitals. This retrospective panel study used Maslach's burnout inventory to evaluate nursing burnout in 371 nurses working in government and private hospitals in Shiraz, Iran, before and 7 months after the health sector reform. Chi-square test and paired t test were used to compare burnout scores. The results showed that nursing burnout had changed significantly after HSEP was launched (p = .030). A more detailed assessment found that burnout and emotional exhaustion had both increased significantly in the government-hospital group (ps = .014 and .001, respectively). However, no significant change in burnout was found in the private-hospital group over the same period. The findings of this study indicate an increase in nursing burnout in government hospitals. An important issue in every health sector reform is nursing resource management, with a focus on burnout. Accordingly, policymakers should consider the work overload situation of nurses and work to prevent increased burnout, especially emotional exhaustion.

Anesthetic management of prophylactic cervical cerclage: a retrospective multicenter cohort study.

PubMed

Ioscovich, Alexander; Popov, Alla; Gimelfarb, Yuri; Gozal, Yaacov; Orbach-Zinger, Sharon; Shapiro, Joel; Ginosar, Yehuda

2015-03-01

Cervical incompetence complicates approximately 1 in 500 pregnancies and is the most common cause of second-trimester spontaneous abortion and preterm labor. No prospective or large retrospective studies have compared regional and general anesthesia for cervical cerclage. Following IRB approval, we performed a retrospective study in the two main medical centers over an 8-year period to assess the association of anesthesia choice with anesthetic and obstetric outcomes. Anesthetic and perioperative details were retrospectively collected from fails of all patients undergoing cervical cerclage from 01/01/2005 until 31/12/2012. Details included demographic data, anesthetic technique, PACU data and perioperative complications. We identified 487 cases of cervical cerclage in 327 women during the study period. The most commonly used anesthetic technique was general anesthesia (GA) (402/487; 82.5%) compared with regional anesthesia (RA) (85/487; 17.5%). When GA was performed, facemask was the most commonly used technique (275/402; 68.4%), followed by intravenous deep sedation (61/402; 15.2%); LMA (51/402; 12.7%) and tracheal intubation (13/402; 3.2%). There were no significant differences in demographic characteristics between women receiving general and regional anesthesia. Average duration of suturing the cervix among the GA group was 9.8 ± 1.6 and 10.6 ± 2.1 min in the RA group (p < 0.001). Average length of stay in the operating room in the GA group was 20.5 ± 3.9 and 23 ± 4.6 min in the RA group (p < 0.001). Patients receiving GA received in the PACU more opioids (6.2 versus 1.2%; p < 0.05) and more non-opioids analgesics (36.8 versus 9.4%; p < 0.001). Duration of PACU stay was shorter after GA (49.5 ± 18 min) than after RA (62.4 ± 28 min; p < 0.001). There were no other differences in anesthetic or perioperative outcome between groups. This study was not designed to provide evidence that RA reduces the risk of pulmonary aspiration, airway complications or

Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: A retrospective study

PubMed Central

Samieirad, Sahand; Aboutorabzade, Mohammad-Reza; Tohidi, Elahe; Shaban, Baratollah; Khalife, Hussein; Salami, Hamid-Reza

2017-01-01

Background The epidemiology of facial injuries varies based on lifestyle, cultural background and socioeconomic status in different countries and geographic zones. This study evaluated the epidemiology of maxillofacial fractures and treatment plans in hospitalized patients in Northeast of Iran (2015-2016). Material and Methods In this retrospective study, the medical records of 502 hospitalized patients were evaluated in the Department of Maxillofacial Surgery in Kamyab Hospital in Mashhad, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. Data were analyzed with Mann–Whitney test, chi-squared test and Fisher’s exact test, using SPSS 21. Results The majority of patients were male (80.3%). Most subjects were in 20-30-year age range (43.2%). The fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the body of the mandible. There was a significant association between the type of treatment and age. In fact, the age range of 16-59 years underwent open reduction internal fixation (ORIF) more than other age ranges (P=0.001). Also, there was a significant association between gender and fractures (P=0.002). Conclusions It was concluded that patient age and gender and trauma significantly affected the prevalence of maxillofacial traumas, fracture types and treatment plans. This information would be useful for making better health policy strategies. Key words:Epidemiology, treatment, facial injuries, maxillofacial fractures, trauma. PMID:28809369

Treating drug dependence with the aid of ibogaine: a retrospective study.

PubMed

Schenberg, Eduardo Ekman; de Castro Comis, Maria Angélica; Chaves, Bruno Rasmussen; da Silveira, Dartiu Xavier

2014-11-01

Ibogaine is an alkaloid purported to be an effective drug dependence treatment. However, its efficacy has been hard to evaluate, partly because it is illegal in some countries. In such places, treatments are conducted in underground settings where fatalities have occurred. In Brazil ibogaine is unregulated and a combined approach of psychotherapy and ibogaine is being practiced to treat addiction. To evaluate the safety and efficacy of ibogaine, we conducted a retrospective analysis of data from 75 previous alcohol, cannabis, cocaine and crack users (72% poly-drug users). We observed no serious adverse reactions or fatalities, and found 61% of participants abstinent. Participants treated with ibogaine only once reported abstinence for a median of 5.5 months and those treated multiple times for a median of 8.4 months. This increase was statistically significant (p < 0.001), and both single or multiple treatments led to longer abstinence periods than before the first ibogaine session (p < 0.001). These results suggest that the use of ibogaine supervised by a physician and accompanied by psychotherapy can facilitate prolonged periods of abstinence, without the occurrence of fatalities or complications. These results suggest that ibogaine can be a safe and effective treatment for dependence on stimulant and other non-opiate drugs. © The Author(s) 2014.

Laboratory Biomarkers to Facilitate Differential Diagnosis between Measles and Kawasaki Disease in a Pediatric Emergency Room: A Retrospective Study.

PubMed

Buonsenso, Danilo; Macchiarulo, Giulia; Supino, Maria Chiara; La Penna, Francesco; Scateni, Simona; Marchesi, Alessandra; Reale, Antonino; Boccuzzi, Elena

2018-01-01

This retrospective study was conducted to analyze clinical and laboratoristic parameters to individuate specific differences and facilitate differential diagnosis between Measles and Kawasaki Disease (KD) at first evaluation in an emergency room. We found similar clinical features as duration of fever and number of KD criteria (p > 0.5) but significant differences in white blood cell count, neutrophils, CRP and LDH levels (p < 0.001). LDH value ≥ 800 mg/dl had sensibility of 89% and specificity of 90% for Measles while CRP ≥ 3 mg/dl had sensibility 89% and specificity of 85% for KD. The combined use of CRP, LDH and AST showed accuracy of 86.67%.

Localized severe scleroderma: a retrospective study of 26 pediatric patients.

PubMed

Beltramelli, Matilde; Vercellesi, Paolo; Frasin, Adina; Gelmetti, Carlo; Corona, Fabrizia

2010-01-01

Juvenile localized scleroderma includes different conditions characterized by skin hardening with increased collagen deposition. Although juvenile localized scleroderma is considered a relatively benign disease, lesions may extend through the dermis, subcutaneous tissue, muscles, and the underlying bone, leading to significant functional and cosmetic deformities. Furthermore, extracutaneous manifestations are described. We retrospectively analyzed a cohort of 26 patients with severe Juvenile localized scleroderma with particular attention to clinical features, therapy, and long-term outcome. A subgroup of three patients has been further evaluated with infrared thermography. Our findings were consistent with the current literature for demographic, laboratory, and clinical characteristics at disease onset, but, with our patients, the prevalence of extracutaneous manifestations was higher, thus confirming the potential for severe juvenile localized scleroderma to affect organs other than the skin, without increased risk of development toward systemic sclerosis. Correlation between various treatments and clinical endpoint showed that systemic therapy lead to a better outcome: in particular, methotrexate appeared the most effective drug, capable in halting the progression of the disease and sometimes inducing its regression. © 2010 Wiley Periodicals, Inc.

Evaluation of salivary catalase, vitamin C, and alpha-amylase in smokers and non-smokers: a retrospective cohort study.

PubMed

Ahmadi-Motamayel, Fatemeh; Falsafi, Parisa; Goodarzi, Mohammad Taghi; Poorolajal, Jalal

2017-05-01

Saliva and its defence systems such as antioxidants and minerals are very important in the pathogenesis of different diseases. Cigarette smoking has many destructive effects. Oxidative stresses play an important role in the side effects of smoking. This study assessed the effect of cigarette smoking on salivary levels of catalase, vitamin C, and α-amylase. This retrospective cohort study was carried out in Hamadan, Iran, on 510 subjects; 259 subjects were smokers (the exposed group) and 251 were non-smokers (the unexposed group). Five microliters of unstimulated saliva was collected by spitting method. Catalase, vitamin C, and α-amylase salivary levels were determined by spectrophotometric assay. Data were analyzed with t-test using STATA 12. Vitamin C level in smokers was significantly lower than that in non-smokers. The salivary catalase levels were lower and α-amylase levels were higher in smokers, but the differences were not statistically significant (P = 0.416 and P = 0.265, respectively). Smokers were younger than non-smokers. Smoking resulted in a change in salivary antioxidant levels. Changes in antioxidant levels can influence the deleterious effects of smoking on oral mucosa; it might also indicate systemic changes and changes in the serum levels of oxidative agents. Further studies are necessary to understand the mechanisms and real effects of smoking, to determine the benefits of supplementary antioxidants for treatment and to reduce the dangerous side effects of smoking. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Implementation of external cephalic version in the Netherlands: a retrospective cohort study.

PubMed

Vlemmix, Floortje; Rosman, Ageeth N; te Hoven, Susan; van de Berg, Suzanne; Fleuren, Margot A H; Rijnders, Marlies E; Beuckens, Antje; Opmeer, Brent C; Mol, Ben Willem J; Kok, Marjolein

2014-12-01

External cephalic version (ECV) reduces the rate of elective cesarean sections as a result of breech presentation. Several studies have shown that not all eligible women undergo an ECV attempt. The aim of this study was to evaluate the implementation of ECV in the Netherlands and to explain variation in implementation rates with hospital characteristics and individual factors. We invited 40 hospitals to participate in this retrospective cohort study. We reviewed hospital charts for all singleton breech deliveries from 36 weeks' gestation and onwards between January 2008 and December 2009. We documented whether an ECV attempt was performed, reasons for not performing an attempt, mode of delivery, and hospital characteristics. We included 4,770 women from 36 hospitals. ECV was performed in 2,443 women (62.2% of eligible women, range 8.2-83.6% in different hospitals). Implementation rates were higher in teaching hospitals, hospitals with special office hours for ECV, larger obstetric units, and hospitals located in larger cities. Suboptimal implementation was mainly caused by health care providers who did not offer ECV. ECV implementation rates vary widely among hospitals. Suboptimal implementation is mostly caused by the care provider not offering the treatment and secondly due to women not opting for the offered attempt. A prerequisite for designing a proper implementation strategy is a detailed understanding of the exact reasons for not offering and not opting for ECV. © 2014 Wiley Periodicals, Inc.

Dosimetric characterization of two radium sources for retrospective dosimetry studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Candela-Juan, C., E-mail: ccanjuan@gmail.com; Karlsson, M.; Lundell, M.

2015-05-15

Purpose: During the first part of the 20th century, {sup 226}Ra was the most used radionuclide for brachytherapy. Retrospective accurate dosimetry, coupled with patient follow up, is important for advancing knowledge on long-term radiation effects. The purpose of this work was to dosimetrically characterize two {sup 226}Ra sources, commonly used in Sweden during the first half of the 20th century, for retrospective dose–effect studies. Methods: An 8 mg {sup 226}Ra tube and a 10 mg {sup 226}Ra needle, used at Radiumhemmet (Karolinska University Hospital, Stockholm, Sweden), from 1925 to the 1960s, were modeled in two independent Monte Carlo (MC) radiationmore » transport codes: GEANT4 and MCNP5. Absorbed dose and collision kerma around the two sources were obtained, from which the TG-43 parameters were derived for the secular equilibrium state. Furthermore, results from this dosimetric formalism were compared with results from a MC simulation with a superficial mould constituted by five needles inside a glass casing, placed over a water phantom, trying to mimic a typical clinical setup. Calculated absorbed doses using the TG-43 formalism were also compared with previously reported measurements and calculations based on the Sievert integral. Finally, the dose rate at large distances from a {sup 226}Ra point-like-source placed in the center of 1 m radius water sphere was calculated with GEANT4. Results: TG-43 parameters [including g{sub L}(r), F(r, θ), Λ, and s{sub K}] have been uploaded in spreadsheets as additional material, and the fitting parameters of a mathematical curve that provides the dose rate between 10 and 60 cm from the source have been provided. Results from TG-43 formalism are consistent within the treatment volume with those of a MC simulation of a typical clinical scenario. Comparisons with reported measurements made with thermoluminescent dosimeters show differences up to 13% along the transverse axis of the radium needle. It has been

Natural history of Niemann-Pick disease type C in a multicentre observational retrospective cohort study.

PubMed

Wraith, J E; Guffon, N; Rohrbach, M; Hwu, W L; Korenke, G C; Bembi, B; Luzy, C; Giorgino, R; Sedel, F

2009-11-01

Niemann-Pick disease type C (NP-C) is a devastating genetic disorder characterised by progressive neurological deterioration. However, data on the progression of neurological manifestations, particularly across different patient age-of-disease onsets, are limited. This is an observational retrospective cohort study designed to assess the progression of neurological disease in patients with NP-C. Physicians were asked to retrospectively complete a web-based questionnaire for each patient, at diagnosis and at up to three follow-up visits. An NP-C-specific disability scale was used to measure disease progression. The scale comprised four key parameters of neurological disease progression; ambulation, manipulation, language and swallowing. Disease progression was evaluated based on the annual rate of change in each parameter and the composite score using a linear mixed model analysis, and by classifying patients according to the number of worsened parameters during the observation period. Data were collected from 57 patients. The rate of deterioration was similar across the four individual parameters of the disability scale. The mean (95% CI) annual disease progression was +0.12 (0.09, 0.15) units. Among patients with a time interval of at least 1 year between diagnosis and last visit (n=49), 42 (86%) patients had progressed disease and 7 (14%) patients had stable disease. Disease progression was consistently more rapid in patients diagnosed in early childhood, compared with those diagnosed in late childhood, or with juvenile or adult presentation. In conclusion, our findings showed a progression in all four parameters of the disability scale, representing a continuous, unbroken progression of neurological manifestations.

Cutaneous sarcoidosis: A retrospective case series and a hospital-based case-control study in Taiwan.

PubMed

Liu, Kwei-Lan; Tsai, Wen-Chien; Lee, Chih-Hung

2017-10-01

Sarcoidosis is a systemic granulomatous disorder of unknown etiology often involving skin. Studies on cutaneous sarcoidosis and comorbidities are limited. This study is aimed to describe the clinical features of cutaneous sarcoidosis diagnosed in our hospital and to determine the relationships between cutaneous sarcoidosis and comorbidities.This retrospective study evaluates patients with cutaneous sarcoidosis in a tertiary center in Taiwan from 1996 to 2015. The records of 38 patients with cutaneous sarcoidosis were reviewed for clinical characteristics and evaluated by analysis of variance. A 1:4 case-control analysis was conducted with 152 age- and sex-matched controls who underwent biopsy for other benign skin tumors.The male to female ratio was 1:4.4. The average age at diagnosis was 51.7 years. Female patients were on average 13.9 years older than male patients. The correlation of age with gender was statistically significant (P = .037). The most common cutaneous lesions were plaques (47.4%) and confined to the face (71.1%). Of the 38 patients, 26.3% had diabetes mellitus. Age over 40 (P = .014) and female (P = .014) were associated with facial involvement. In the case-control study, a higher percentage of patients with cutaneous sarcoidosis than of control subjects had diabetes mellitus (P = .001), hearing loss (P = .031) and eye diseases (P = .047).The present study demonstrates a striking female predominance and high proportions of facial involvement. Diabetes mellitus, hearing loss, and eye diseases may be associated with Taiwanese patients with cutaneous sarcoidosis.

Mitigating driver distraction with retrospective and concurrent feedback.

PubMed

Donmez, Birsen; Boyle, Linda Ng; Lee, John D

2008-03-01

An experiment was conducted to assess the effects of retrospective and combined retrospective and concurrent feedback on driver performance and engagement in distracting activities. A previous study conducted by the authors showed that concurrent (or real time) feedback can help drivers better modulate their distracting activities. However, research also shows that concurrent feedback can pose additional distractions due to the limited time and resources available during driving. Retrospective feedback, which is presented at the end of a trip (i.e., post-drive), can include additional information on safety critical situations during a trip and help the driver learn safe driving habits. A driving simulator study was conducted with 48 participants and 3 conditions: retrospective feedback, combined feedback (both retrospective and concurrent), and no feedback (baseline case). The feedback conditions (retrospective and combined) resulted in faster response to lead vehicle braking events as depicted by shorter accelerator release times. Moreover, combined feedback also resulted in longer glances to the road. The results suggest that both feedback types have potential to improve immediate driving performance and driver engagement in distractions. Combined feedback holds the most promise for mitigating the effects of distraction from in-vehicle information systems.

Retrospective Revaluation: The Phenomenon and Its Theoretical Implications

PubMed Central

Miller, Ralph R.; Witnauer, James E.

2015-01-01

Retrospective revaluation refers to an increase (or decrease) in responding to conditioned stimulus (CS X) as a result of decreasing (or increasing) the associative strength of another CS (A) with respect to the unconditioned stimulus (i.e., A-US) that was previously trained in compound with the target CS (e.g., AX−US or just AX). We discuss the conditions under which retrospective revaluation phenomena are most apt to be observed and their implications for various models of learning that are able to account for retrospective revaluation (e.g., Dickinson and Burke, 1996; Miller and Matzel, 1988; Van Hamme and Wasserman, 1994). Although retroactive revaluation is relatively parameter specific, it is seen to be a reliable phenomenon observed across many tasks and species. As it is not anticipated by many conventional models of learning (e.g., Rescorla and Wagner, 1972), it serves as a critical benchmark for evaluating traditional and newer models. PMID:26342855

Clinical features of epistaxis in dogs: a retrospective study of 35 cases (1999-2002).

PubMed

Strasser, Jennifer L; Hawkins, Eleanor C

2005-01-01

Epistaxis was retrospectively evaluated in 35 dogs. Systemic disease was diagnosed in seven dogs and intranasal disease in 29. Nineteen dogs with intranasal disease had neoplasia. Dogs with neoplasia were older (mean 10.0 years) than dogs with nonneoplastic intranasal disease (mean 5.6 years). Signs persisting for >1 month occurred more often in dogs with intranasal than systemic disease. Unilateral epistaxis did not distinguish intranasal from systemic disease. Only dogs with intranasal disease had facial deformity, decreased airflow, or regional sub-mandibular lymphadenopathy. Dogs with systemic disease had a lower packed cell volume (mean 31.8%) than dogs with intranasal disease (mean 42.7%).

Sequencing of bimaxillary surgery in the correction of vertical maxillary excess: retrospective study.

PubMed

Salmen, F S; de Oliveira, T F M; Gabrielli, M A C; Pereira Filho, V A; Real Gabrielli, M F

2018-06-01

The aim of this study was to evaluate the precision of bimaxillary surgery performed to correct vertical maxillary excess, when the procedure is sequenced with mandibular surgery first or maxillary surgery first. Thirty-two patients, divided into two groups, were included in this retrospective study. Group 1 comprised patients who received bimaxillary surgery following the classical sequence with repositioning of the maxilla first. Patients in group 2 received bimaxillary surgery, but the mandible was operated on first. The precision of the maxillomandibular repositioning was determined by comparison of the digital prediction and postoperative tracings superimposed on the cranial base. The data were tabulated and analyzed statistically. In this sample, both surgical sequences provided adequate clinical accuracy. The classical sequence, repositioning the maxilla first, resulted in greater accuracy for A-point and the upper incisor edge vertical position. Repositioning the mandible first allowed greater precision in the vertical position of pogonion. In conclusion, although both surgical sequences may be used, repositioning the mandible first will result in greater imprecision in relation to the predictive tracing than repositioning the maxilla first. The classical sequence resulted in greater accuracy in the vertical position of the maxilla, which is key for aesthetics. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A retrospective detection algorithm for extraction of weak targets in clutter and interference environments

NASA Astrophysics Data System (ADS)

Prengaman, R. J.; Thurber, R. E.; Bath, W. G.

The usefulness of radar systems depends on the ability to distinguish between signals returned from desired targets and noise. A retrospective processor uses all contacts (or 'plots') from several past radar scans, taking into account all possible target trajectories formed from stored contacts for each input detection. The processor eliminates many false alarms, while retaining those contacts describing resonable trajectories. The employment of a retrospective processor makes it, therefore, possible to obtain large improvements in detection sensitivity in certain important clutter environments. Attention is given to the retrospective processing concept, a theoretical analysis of the multiscan detection process, the experimental evaluation of retrospective data filter, and aspects of retrospective data filter hardware implementation.

How reliable are relatives' retrospective reports of terminal illness? Patients and relatives' accounts compared.

PubMed

Hinton, J

1996-10-01

To assess the accuracy of relatives' recollections of patients' terminal illness 71 out of 77 caring relatives were re-interviewed about 4 months after they and the patients had given regular interviews throughout care. Current and retrospective ratings of problems and feelings have been compared for agreement, using the kappa index. Several volunteered symptoms showed poor agreement, notably pain, anorexia and depression (kappa = 0.03-0.21), but vomiting, dyspnoea and immobility ratings agreed moderately well (kappa = 0.43-0.68). Current ratings from patients' and relatives' were always in better agreement with each other than with the relatives retrospective ratings. Bias sometimes altered apparent prevalence; pain was described as more severe in retrospect, but weakness, malaise, depression and relatives' stress were under-rated later. Ratings of "discomfort only" became less common for all symptoms retrospectively. The regular current assessments of patients' and relatives' emotional state also agreed only slightly with relatives' follow-up accounts of depression but somewhat better for anxiety. Patients stated knowledge of diagnosis, awareness and acceptance of dying matched the relatives' retrospective assessments moderately well (kappa = 0.70, 0.50 and 0.41). This study and other available evidence indicate that relatives' retrospective reports of terminal illness, measured against current ratings, are moderately reliable for some items but can vary or be potentially misleading over other aspects, including pain. This could affect evaluations of care.

Prevalence and severity of antipsychotic related constipation in patients with schizophrenia: a retrospective descriptive study

PubMed Central

2011-01-01

Background Antipsychotic are the cornerstone in the treatment of schizophrenia. They also have a number of side-effects. Constipation is thought to be common, and a potential serious side-effect, which has received little attention in recent literature. Method We performed a retrospective study in consecutively admitted patients, between 2007 and 2009 and treated with antipsychotic medication, linking different electronic patient data to evaluate the prevalence and severity of constipation in patients with schizophrenia under routine treatment conditions. Results Over a period of 22 months 36.3% of patients (99) received at least once a pharmacological treatment for constipation. On average medication for constipation was prescribed for 273 days. Severe cases (N = 50), non-responsive to initial treatment, got a plain x-ray of the abdomen. In 68.4% fecal impaction was found. Conclusion A high prevalence of constipation, often severe and needing medical interventions, was confirmed during the study period. Early detection, monitoring over treatment and early intervention of constipation could prevent serious consequences such as ileus. PMID:21385443

Retrospective Case Study in Wise County, Texas, Study of the Potential Impacts of Hydraulic Fracturing on Drinking Water Resources

EPA Science Inventory

This report describes the retrospective case study in north central Texas, conducted at three locations in Wise County where both conventional and unconventional gas production occurred in the past. Currently unconventional gas production occurs from the Mississippian-aged Barne...

Outcome of oral dysplasia: a retrospective hospital-based study of 207 patients with a long follow-up.

PubMed

Arduino, Paolo G; Surace, Antonio; Carbone, Mario; Elia, Alessandra; Massolini, Gianluca; Gandolfo, Sergio; Broccoletti, Roberto

2009-07-01

The aim of this retrospective hospital-based study was to review and evaluate the long-term outcome of patients with oral epithelial dysplasia (OED), with or without surgical intervention, to identify factors affecting clinical course and malignant evolution. Patients with a follow-up of at least 12 months were included. Data collected were statistically analyzed. The mean age was 63.58 years for women (n = 100) and 64.17 years for men (n = 107). One hundred and thirty-five of the patients had lesions with histopathological features of mild OED, 50 had moderate OED and 22 had severe OED. Gender and risk factors seemed not to be related with the development of OED. One hundred and thirty-three patients underwent active treatment. During the period considered, 39.4% of the 207 lesions disappeared; 19.66% remained stable and 33.7% of the total cases showed a new dysplastic event after treatment. Fifteen (7.24%) out of 207 developed a squamous cell carcinoma during follow-up. Our data showed that speckled lesions are more often associated with high histological grade. The risk of malignant development does not seem to be predictable. Surrounded by the limitations of the retrospective designs, we have showed that there is no eminent benefit of surgical intervention of OED in preventing recurrences and malignant development.

Combined topical and systemic clonazepam therapy for the management of burning mouth syndrome: a retrospective pilot study.

PubMed

Amos, Kate; Yeoh, Sue-Ching; Farah, Camile S

2011-01-01

To evaluate retrospectively the efficacy of administering an anticonvulsant medication, clonazepam, by dissolving tablets slowly orally before swallowing, for the management of burning mouth syndrome (BMS). A retrospective clinical records audit was performed of patients diagnosed with BMS between January 2006 and June 2009. Patients were prescribed 0.5 mg clonazepam three times daily, and changes were made to this regimen based on their individual response. Patients were asked to dissolve the tablet orally before swallowing and were reviewed over a 6-month period. Pain was assessed by patients on an 11-point numerical scale (0 to 10). A nonparametric (Spearman) two-tailed correlation matrix and a two-tailed Mann-Whitney test were performed. A total of 36 patients (27 women, 9 men) met the criteria for inclusion. The mean (± SEM) pain score reduction between pretreatment and final appointment was 4.7 ± 0.4 points. A large percentage (80%) of patients obtained more than a 50% reduction in pain over the treatment period. One patient reported no reduction in pain symptoms, and one third of the patients had complete pain resolution. Approximately one third of patients experienced side effects that were transient and mild. This pilot study provides preliminary evidence that the novel protocol of combined topical and systemic clonazepam administration provides an effective BMS management tool.

Recent change in congenital syphilis in Korea: Retrospective 10 year study.

PubMed

Kang, Sung-Han; Lee, Ji-Hyun; Choi, Sun-Hee; Lee, Jin; Yoon, Hoi Soo; Cha, Sung-Ho; Choi, Yong-Sung

2015-12-01

This study was conducted to evaluate recent clinical and anthropologic features of neonates with reactive serology for syphilis and their mothers from three institutions in Korea over an 11-year-period. The medical records of 20 neonates with reactive serology for syphilis and their mothers at three centers (Kyung Hee University Hospital, Kyung Hee University Hospital at Gangdong, and Korea Electric Power Corporation Hospital) seen between January 2000 and December 2010 were reviewed retrospectively. Among 20 mothers, 16 (80%) were native Korean and four (20%) were foreign-born immigrants. Two mothers (10%) were unmarried. The annual distribution of cases was three (15%) in 2000, one each (5%) in 2005 and 2006, respectively, two each (10%) in 2007 and 2008, respectively, six (30%) in 2009, and five (25%) in 2010. Just over half (55%) occurred across 2009 and 2010. All neonates, by definition, were diagnosed with presumptive congenital syphilis (CS). Among the neonates, four had positive cerebrospinal fluid venereal disease research laboratory test, and three exhibited symptoms and signs. In three centers in Seoul, Korea, the observed number of CS cases was higher in 2009 and 2010 than in previous years. This finding is consistent with a trend toward increasing prevalence of international marriage and suggests that more meticulous screening of CS is needed. © 2015 Japan Pediatric Society.

STUDY OF THE SUITABILITY OF ISRAELI HOUSEHOLD SALT FOR RETROSPECTIVE DOSIMETRY.

PubMed

Datz, Hanan; Druzhyna, Sofia; Oster, Leonid; Orion, Itzhak; Horowitz, Yigal

2016-09-01

The first results of an in-depth evaluation of the practical potential of common household Israeli salt as a retrospective dosemeter in the event of a nuclear accident or terror attack are presented. Ten brands of salt were investigated with emphasis on four of the bestselling brands that constitute 76 % of the total consumer market. Eight of the ten brands show similar glow curves with two main glow peaks at maximum temperatures of ∼176°C and ∼225°C measured at a heating rate of 1°C s(-1) Chemical analysis of three major brands indicates substantial impurity levels of 200-500 ppm of Ca, K, Mg and S and significant differences of additional ppm trace impurities, which lead to an ∼50 % difference in the TL response of the three major brands. Fading in the dark is in significant but under room light is of the order of 35 % per day. The dose response is linear/supralinear with the threshold of supralinearity at ∼0.01 Gy reaching maximum value of ∼4 at 0.5-1 Gy for two of the major brands. The precision of repeated measurements is ∼10 % (1 SD), but the accuracy of dose assessment under field conditions requires further study. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Radiologically defining horizontal gaze using EOS imaging-a prospective study of healthy subjects and a retrospective audit.

PubMed

Hey, Hwee Weng Dennis; Tan, Kimberly-Anne; Ho, Vivienne Chien-Lin; Azhar, Syifa Bte; Lim, Joel-Louis; Liu, Gabriel Ka-Po; Wong, Hee-Kit

2018-06-01

As sagittal alignment of the cervical spine is important for maintaining horizontal gaze, it is important to determine the former for surgical correction. However, horizontal gaze remains poorly-defined from a radiological point of view. The objective of this study was to establish radiological criteria to define horizontal gaze. This study was conducted at a tertiary health-care institution over a 1-month period. A prospective cohort of healthy patients was used to determine the best radiological criteria for defining horizontal gaze. A retrospective cohort of patients without rigid spinal deformities was used to audit the incidence of horizontal gaze. Two categories of radiological parameters for determining horizontal gaze were tested: (1) the vertical offset distances of key identifiable structures from the horizontal gaze axis and (2) imaginary lines convergent with the horizontal gaze axis. Sixty-seven healthy subjects underwent whole-body EOS radiographs taken in a directed standing posture. Horizontal gaze was radiologically defined using each parameter, as represented by their means, 95% confidence intervals (CIs), and associated 2 standard deviations (SDs). Subsequently, applying the radiological criteria, we conducted a retrospective audit of such radiographs (before the implementation of a strict radioimaging standardization). The mean age of our prospective cohort was 46.8 years, whereas that of our retrospective cohort was 37.2 years. Gender was evenly distributed across both cohorts. The four parameters with the lowest 95% CI and 2 SD were the distance offsets of the midpoint of the hard palate (A) and the base of the sella turcica (B), the horizontal convergents formed by the tangential line to the hard palate (C), and the line joining the center of the orbital orifice with the internal occipital protuberance (D). In the prospective cohort, good sensitivity (>98%) was attained when two or more parameters were used. Audit using Criterion B

Factors affecting symptoms and functionality of patients with carpal tunnel syndrome: a retrospective study

PubMed Central

Yucel, Hulya

2015-01-01

[Purpose] The aim of this retrospective study was to determine the associations between clinical, physical, and neurophysiological outcomes and self-reported symptoms and functions of patients after surgical carpal tunnel release. [Subjects and Methods] Among 261 patients who had undergone open surgical carpal tunnel release within the last three years, 83 (mean age 50.27 ± 11.13 years) participated in this study. Their socio-demographics and comorbidities were recorded. The intensity of pain, paresthesia, and fatigue symptoms in the hand were assessed by means of a Visual Analogue Scale, the Semmes-Weinstein Monofilaments test of light touch pressure sensation, and Jamar dynamometry for measurement of grip and pinch strengths. The Boston Carpal Tunnel Questionnaire evaluated the severity of symptoms and hand functional status, and the variables were analyzed by multivariate linear regression. [Results] The severity of the symptoms and functional status of release surgery patients was associated with diabetes mellitus, migraine, night pain, paresthesia and fatigue symptoms, impaired light touch pressure, and lack of medical treatment. [Conclusion] Appropriate post-surgery treatment programs for these factors should be taken into consideration to help patients obtain optimal functionality and health in their daily lives. PMID:25995565

Analysis of Complaints from Patients During Mechanical Ventilation After Cardiac Surgery: A Retrospective Study.

PubMed

Wang, Yi; Li, Hua; Zou, Honglin; Li, Yaxiong

2015-08-01

This study analyzed major complaints from patients during mechanical ventilation after cardiac surgery and identified the most common complaints to reduce adverse psychologic responses. Retrospective. A single tertiary university hospital. Patients with heart disease who were on mechanical ventilation after cardiac surgery (N = 800). The major complaints of the patients during mechanical ventilation after cardiac surgery were analyzed. Patients' comfort was evaluated using a visual analog scale, and the factors affecting comfort were analyzed. The average visual analog scale score in all patients was 5.8±2.0, and most patients presented moderate discomfort. The factors affecting comfort included dry mouth, thirst, tracheal intubation, aspiration of sputum, communication barriers, limited mobility, fear/anxiety, patient-ventilator dyssynchrony, and poor environmental conditions. Of these factors, 8 were independent predictors of the visual analog scale score. Patients considered mechanical ventilation to be the worst part of their hospitalization. The study identified 8 independent factors causing discomfort in patients during mechanical ventilation after cardiac surgery. Clinicians should take appropriate measures and implement nursing interventions to reduce suffering, physical and psychologic trauma, and adverse psychologic responses and to promote recovery. Copyright © 2015 Elsevier Inc. All rights reserved.

Minimally invasive unicompartmental knee replacement: retrospective clinical and radiographic evaluation of 83 patients.

PubMed

Bruni, Danilo; Iacono, Francesco; Russo, Alessandro; Zaffagnini, Stefano; Marcheggiani Muccioli, Giulio Maria; Bignozzi, Simone; Bragonzoni, Laura; Marcacci, Maurilio

2010-06-01

We performed a retrospective clinical and radiographic evaluation of 83 nonconsecutive patients operated in our institute between February 1996 and March 2003 with a mean follow-up of 60 months to assess the efficiency of unicompartmental knee replacement (UKR) performed with a minimally invasive technique. The aim of this study was to correlate the clinical outcome with the pre- and post-operative alignment and with implant positioning on coronal and sagittal plane. Eighty-three nonconsecutive patients (60 males, 23 females) underwent cemented UKR (De Puy Preservation Uni with all-poly tibial component), for both medial OA (80 patients) and AVN of the medial femoral condyle (3 patients). All patients were available at final follow-up evaluation, and they all presented an evident varus alignment at pre-operative clinical and radiographic evaluation. At radiographic measurement, we considered a knee with femoro-tibial angle (FTA) > 175 degrees as varus knee, 170 degrees < FTA < 175 degrees as normal knee and a knee with a FTA < 170 degrees as a valgus knee. Moreover, we considered a tibial plateau angle (TPA) > 90 degrees for valgus knee and a TPA < 90 degrees for varus knee. According to Hospital for Special Surgery (HSS) scoring system, at a mean follow-up of 60 months, 61 (74%) cases were excellent (100-85 points), 15 (18%) cases were good (84-70 points) and 7 cases (8%) had fair results (<70 points). In our series, patients with an excellent clinical result presented a mean varus deformity of 7.2 degrees (3.6 degrees-10.8 degrees) pre-operatively. According to literature, we demonstrated that a small amount of undercorrection with a small amount of residual varus deformity of 3 degrees-5 degrees is the goal to be reached in order to avoid both rapid degeneration of the nonreplaced compartment and the premature loosening of the replaced compartment. We performed a mean axial correction of 5 degrees (SD 3.9 degrees), leaving a mean axial varus deformity of 2

Evaluation of Patients with Facial Palsy and Ophthalmic Sequelae: A 23-Year Retrospective Review.

PubMed

Joseph, Shannon S; Joseph, Andrew W; Smith, Jane I; Niziol, Leslie M; Musch, David C; Nelson, Christine C

2017-10-01

Facial palsy (FP) can result in serious ophthalmic sequelae including loss of vision. We describe the clinical characteristics of FP patients presenting for ophthalmologic evaluation and the timing for initiating ophthalmologic care. We performed a retrospective review of 96 consecutive FP patients presenting between 1992 and 2015 at a tertiary eye center. The main outcome measures were time interval from the diagnosis of FP and onset of ocular symptoms to the initial ophthalmologic evaluation (IOE), and the severity of exposure keratopathy and eyelid malposition on IOE. The median time interval from the diagnosis of FP to the IOE was 1.6 years (interquartile range; IQR = 0.5-9.2), and from the onset of ocular symptoms to IOE was 0.8 years (IQR = 0.3-2.3). The most common ocular symptoms were dryness (47.9%; n = 46), irritation (39.6%; n = 38), and tearing (30.2%; n = 29). A total of 26.0% (n = 25) of patients were bothered by the appearance of their eyes. Only 13.5% (n = 13) noted change in vision. On IOE, 81.6% (n = 75) of patients had punctate epithelial erosions (PEE), of which 52.3% (n = 35) had moderate to severe PEE, 3.3% (n = 3) had corneal ulcers and 2.2% (n = 2) had corneal abrasions. The average margin-reflex distance 2 was 6.4 mm (SD = 2.4) with average lagophthalmos of 3.5 mm (SD = 3.1). Among FP patients presenting for ophthalmologic evaluation, exposure keratopathy (as evidenced by PEE and corneal ulcers/abrasions) is highly prevalent and moderately severe on IOE, despite only 13.5% of patients noting decreased vision. These findings underscore the importance of timely and thorough ophthalmologic evaluation of FP patients.

Epidemiological, Clinical, and Laboratory Evaluation of Plasmodium falciparum Malaria Cases Followed in Firat University Hospital: A 6-Year Retrospective Analysis.

PubMed

Sağmak Tartar, Ayşe; Akbulut, Ayhan

2018-03-01

Malaria is an infectious disease caused by Plasmodium parasite. Sporadic cases have not been observed in Turkey since 2010, but imported malaria cases are still prevalent owing to migration. The present study aimed to evaluate Plasmodium falciparum malaria in patients hospitalized in our hospital. A total of 15 adult patients (14 males and 1 female) who were diagnosed with malaria and who were managed at our clinic between January 2011 and 2017 were evaluated retrospectively for their epidemiological, clinical, and laboratory findings; treatment; and prognosis. Of the 15 cases, 14 (93.3%) were male and (6.7%), female. All patients had a history of travelling to endemic areas, and none of them undertook regular chemoprophylaxis. Fever (100%), splenomegaly (86.7%), hepatomegaly (26.7%), leukopenia (13.3%), thrombocytopenia (80%), elevated liver function tests (40%), and increased serum creatinine levels (13.3%) were found in the patients. The number of import cases is increasing owing to tourism, migration, and deficiency in eradication programs. Malaria caused by P. falciparum is an import case in Turkey. The current study emphasizes on the necessity of providing proper education to Turkish individuals traveling to endemic areas for the purpose of work or travel and on the necessity of initiating chemoprophylaxis.

Triangular stimulation method utilizing combination spinal cord stimulation with peripheral subcutaneous field stimulation for chronic pain patients: a retrospective study.

PubMed

Navarro, Rosa M; Vercimak, Danika C

2012-01-01

This retrospective data collection study aims to evaluate the responses of patients who have been implanted with a neuromodulation system using a combination of spinal cord stimulation (SCS) and peripheral subcutaneous field stimulation (PSFS) leads for chronic intractable pain. Forty patients with chronic, intractable pain implanted with both SCS and PSFS leads were enrolled in a retrospective data collection study. Pre-implant data (demographics, pain levels, pain location, and medication use) and post-implant data (pain levels, medication use, and device programming reports) were compared to measure short- and long-term improvements in pain for a period of approximately six months. Device system use and parameter data were collected. The majority of patients experienced immediate and short-term pain relief and reduction in oral pain medications as a result of combination SCS/PSFS therapy. The improvements were maintained for some, but not all patients by six months. Patients cycled through multiple programs over follow-up; the use of triangular stimulation was consistent over time, and by six months, patients preferred this program over others. Limitations of the retrospective chart review included missing data and variable follow-up times, and may have made determinations of long-term efficacy difficult. This study demonstrates that combination SCS and PSFS therapy is potentially a beneficial treatment option for reducing pain levels and oral pain medication compared with baseline in previously resistive chronic pain patients. There is a need for further study of this therapy in a greater number of subjects and in a prospective, controlled setting. In the author's general experience, triangular stimulation is very effective for treating isolated low back pain, because it covers larger topographic areas of the lower back than flow or field stimulation. An investigational device exemption study will be necessary for subcutaneous field stimulation indicated for

Retrospective evaluation of the efficacy of isolating bacteria from synovial fluid in dogs with suspected septic arthritis.

PubMed

Scharf, V F; Lewis, S T; Wellehan, J F; Wamsley, H L; Richardson, R; Sundstrom, D A; Lewis, D D

2015-06-01

To evaluate the efficacy of synovial fluid culture in obtaining the causative organism from dogs with suspected septic arthritis. In this retrospective evaluation, synovial fluid cytology and microbiology submissions from dogs with suspected septic arthritis from March 2007 to August 2011 were reviewed. Synovial fluid cytology consistent with joint sepsis was identified. Cultures of synovial fluid from dogs with clinical histories and abnormalities consistent with septic arthritis were used to evaluate the efficacy of bacterial isolation. In total, 36 dogs met the inclusion criteria. Initial aerobic cultures of joint fluid yielded bacterial growth in 44% of these dogs. All anaerobic cultures were negative. In 19% of the dogs with positive cultures, antibiotics had been administered prior to arthrocentesis compared with 10% of dogs with negative cultures. There was no association between culture efficacy and the administration of antimicrobial treatment prior to synovial fluid culture or recent surgery involving the affected joint (P=0.637 and P=0.106, respectively). Culture of synovial fluid from dogs with suspected septic arthritis has a low yield, necessitating a more effective means of identifying bacteria from suspected septic joints in dogs. © 2015 Australian Veterinary Association.

Evaluability Assessment: A Retrospective Illustration and Review.

ERIC Educational Resources Information Center

Smith, Nick L.

1981-01-01

Rutman's view of evaluability assessment is reviewed, evaluation planning activities are illustrated via flow diagram for a large educational evaluation designed to increase citizen participation in local school activities, and some of the limitations of Rutman's evaluability procedures are outlined. (RL)

Game Coaching System Design and Development: A Retrospective Case Study of FPS Trainer

ERIC Educational Resources Information Center

Tan, Wee Hoe

2013-01-01

This paper is a retrospective case study of a game-based learning (GBL) researcher who cooperated with a professional gamer and a team of game developers to design and develop a coaching system for First-Person Shooter (FPS) players. The GBL researcher intended to verify the ecological validity of a model of cooperation; the developers wanted to…

Complications of Peripherally Inserted Central Venous Catheters: A Retrospective Cohort Study

PubMed Central

Jose Amo-Setién, Francisco; Herrero-Montes, Manuel; Olavarría-Beivíde, Encarnación; Rodríguez-Rodríguez, Mercedes; Torres-Manrique, Blanca; Rodríguez-de la Vega, Carlos; Caso-Álvarez, Vanesa; González-Parralo, Laura

2016-01-01

Background and Aim The use of venous catheters is a widespread practice, especially in oncological and oncohematological units. The objective of this study was to evaluate the complications associated with peripherally inserted central catheters (PICCs) in a cohort of patients. Materials and Methods In this retrospective cohort study, we included all patient carrying PICCs (n = 603) inserted at our institute between October 2010 and December 2013. The main variables collected were medical diagnosis, catheter care, location, duration of catheterization, reasons for catheter removal, complications, and nursing care. Complications were classified as infection, thrombosis, phlebitis, migration, edema, and/or ecchymosis. Results All patients were treated according to the same “nursing care” protocol. The incidence rate of complications was two cases per 1000 days of catheter duration. The most relevant complications were infection and thrombosis, both with an incidence of 0.17 cases per 1000 days of the total catheterization period. The total average duration of catheterization was 170 days [SD 6.06]. Additionally to “end of treatment” (48.42%) and “exitus”, (22.53%) the most frequent cause of removal was migration (displacement towards the exterior) of the catheter (5.80%). Conclusions PICCs are safe devices that allow the administration of long-term treatment and preserve the integrity of the venous system of the patient. Proper care of the catheter is very important to improve the quality life of patients with oncologic and hematologic conditions. Therefore, correct training of professionals and patients as well as following the latest scientific recommendations are particularly relevant. PMID:27588946

Cleft lip and palate: a descriptive comparative, retrospective, and prospective study of patients with cleft deformities managed at 2 hospitals in Kenya.

PubMed

Wanjeri, Joseph Kimani; Wachira, John Makanga

2009-09-01

This was a combined retrospective and prospective study in which 2 sets of results from 2 hospitals in Nairobi were analyzed and compared. The retrospective study was conducted at Kenyatta National Hospital, whereas the prospective study was conducted at Metropolitan Hospital.The main objective of the study was to establish the presentation and pattern of patients with cleft lip and palate and complications of repair at the 2 hospitals.In the retrospective arm of the study, files of all patients presenting with clefts at Kenyatta National Hospital between January 1998 and December 2007 were retrieved, and a questionnaire was filled out for each of them, whereas all patients seen and operated on for clefts at the Metropolitan Hospital from January 2007 to October 2008 were recruited into the prospective study.There was a predominance of male participants in both studies, and most clefts were on the left side. The retrospective and prospective studies had positive family history in 3.5% and 30.9%, respectively. Associated congenital malformations were 8.2% for the retrospective study and 25% for the prospective study. In both studies, the central province had the largest number of clefts, whereas the coast province had very few.Cleft lip and palate is a significant congenital malformation in Kenya, and there seems to be a higher incidence of familial tendency and associated congenital malformations than that reported elsewhere.

Extracapsular local infiltration analgesia in hip arthroscopy: a retrospective study

PubMed Central

Kahn, Timothy L; Adeyemi, Temitope F; Maak, Travis G

2018-01-01

ABSTRACT Many hip arthroscopy patients experience significant pain in the immediate postoperative period. Although peripheral nerve blocks have demonstrated efficacy in alleviating some of this pain, they come with significant costs. Local infiltration analgesia (LIA) may be a significantly cheaper and efficacious treatment modality. Although LIA has been well studied in hip and knee arthroplasty, its efficacy in hip arthroscopy is unclear. The purpose of this retrospective study is to determine the efficacy of a single extracapsular injection of bupivacaine–epinephrine during hip arthroscopy in reducing the rate of elective postoperative femoral nerve blocks. A retrospective review of 100 consecutive patients who underwent primary hip arthroscopy at a single medical center was performed. The control group consisted of 50 patients before the implementation of the current LIA protocol, whereas another 50 patients received a 20-ml extracapsular injection of 0.25% bupivacaine–epinephrine under direct arthroscopic visualization after capsular closure. In the post-anesthesia care unit (PACU), patients were offered a femoral nerve block for uncontrolled pain. The rate of femoral nerve block, and total opioid consumption, was compared between groups. The proportion of patients receiving elective femoral nerve blocks was significantly less in the LIA group (34%) as compared with the control group (56%; P = 0.027). There was no significant difference in total PACU opioid consumption between groups (P = 0.740). The decreased utilization of postoperative nerve blocks observed in the LIA group suggests that LIA may improve postoperative pain management and should be considered as a potentially cost-effective tool in pain management in hip arthroscopy patients. Level of Evidence: III PMID:29423252

MOPP chemotherapy for treatment of resistant lymphoma in dogs: a retrospective study of 117 cases (1989-2000).

PubMed

Rassnick, Kenneth M; Mauldin, Glenna E; Al-Sarraf, Renee; Mauldin, G Neal; Moore, Antony S; Mooney, Samantha C

2002-01-01

The purpose of this retrospective study was to evaluate the efficacy and toxicity of the MOPP chemotherapy protocol (mechlorethamine, vincristine, procarbazine, and prednisone) as a rescue regimen in dogs with lymphoma. One hundred seventeen dogs that had resistance to previously administered chemotherapy were evaluated. Before treatment with MOPP, all dogs received a median of 6 chemotherapy drugs for a median duration of 213 days. Thirty-one percent (36 of 117) had a complete response (CR) to MOPP for a median of 63 days, and 34% (40 of 117) had a partial response (PR) for a median of 47 days. Sixteen percent (19 of 117) had stable disease (SD) for a median of 33 days. Predictors for response to MOPP were not identified. Gastrointestinal (GI) toxicity occurred in 28% (33 of 117) of the dogs, and 13% (15 dogs) required hospitalization. Five dogs developed septicemia, and 2 died as a result. MOPP was an effective treatment for dogs with resistant lymphoma and was well tolerated by the majority of affected dogs.

Impacted mandibular third molars and their influence on mandibular angle and condyle fractures--a retrospective study.

PubMed

Gaddipati, Rajasekhar; Ramisetty, Sudhir; Vura, Nandagopal; Kanduri, Rajeev Reddy; Gunda, Vinay Kumar

2014-10-01

Previous retrospective analyses prove that impacted mandibular third molars (M3s) increase the risk of angle fractures and decrease the risk of concomitant fractures to the condyle. A retrospective cohort was designed for patients reported to the Department of Oral and Maxillofacial Surgery from January 2011 till June 2013. The study variables are presence or absence of third molar, if it is present, their position, classified using the Pell and Gregory system; angulation, classified using Shiller's method. The outcome variables were angle and condyle fractures. Hospital records and panoramic radiographs were used to determine and classify these variables. The study sample comprised of 118 mandibular angle and condyle fractures in 110 patients. Database was constructed and analysed using SPSS version 10.0. This present retrospective study concluded that the presence of impacted third molar predisposes the angle to fracture and reduces the risk of a concomitant condylar fracture. However absence of impacted third molar increases the risk of condylar fracture. The highest incidence of angle fracture was observed in position A impacted mandibular third molars. And there is no significant relationship, concerning ramus position and angulation of impacted mandibular third molars with the angle fracture. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Candidemia in the intensive care unit: A 12-year retrospective cohort study in Reunion Island.

PubMed

Hoarau, G; Picot, S; Lemant, J; Peytral, J; Poubeau, P; Zunic, P; Mohr, C; Coueffe, X; Gerardin, P; Antok, E

2018-05-09

We aimed to describe the epidemiology of Candida bloodstream infection in an intensive care unit (ICU) in Reunion Island. We performed a retrospective cohort study and evaluated 63 candidemia episodes, which occurred between January 2004 and December 2015 in the ICU of a University Hospital in St-Pierre. The incidence rate of candidemia in the ICU was estimated at 7.6%. Candida albicans was the most common yeast pathogen species recovered (54%), followed by Candida glabrata (17%), Candida tropicalis (12%) and Candida parapsilosis (10%). Between 2012 and 2015, we also observed a modification of antifungal use. The epidemiology of candidemia in Reunion Island is characterized by the predominance of Candida albicans and by the relative importance of Candida tropicalis. This pattern corresponds to a model of epidemiological transition between the one usually observed in tropical areas and the one observed in temperate countries. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Perioperative management of patients for osteo-odonto-kreatoprosthesis under general anaesthesia: A retrospective study.

PubMed

Garg, Rakesh; Khanna, Puneet; Sinha, Renu

2011-05-01

An osteo-odonto-keratoprosthesis (OOKP) procedure is indicated in patients with failed corneal transplant but having intact retina for visual improvement. We studied perioperative concerns of patients who underwent the staged OOKP procedure. This was a retrospective analysis of patients who underwent OOKP. The information regarding symptoms, associated comorbidities, perioperative events including anaesthetic management were collected. Eight patients (five females and three males) underwent the staged OOKP procedure. The median age was 18 years. The median weight was 45 kg. The median duration of loss of vision was 4 years. The aetiology of blindness included Stevens-Johnson's syndrome (SJS) (7) and chemical burn (1). Four patients had generalized skin problem due to SJS. All cases were managed under general anaesthesia, and airway management included nasotracheal intubation for stage I and orotracheal intubation for stage II. The median mallampati classification was I prior to OOKP stage I procedure while it changed to II at stage II procedure. Two patients required fibreoptic nasotracheal intubation. One patient had excessive oozing from the mucosal harvest site and was managed conservatively. In one patient, tooth harvesting was done twice as the first tooth was damaged during creating a hole in it. We conclude that OOKP requires multidisciplinary care. Anaesthesiologist should evaluate the airway carefully and disease-associated systemic involvements. The use of various drugs requires caution and steroid supplementation should be done. Airway difficulty should be anticipated, mandating thorough evaluation. Re-evaluation of airway is prudent as it may become difficult during the staged OOKP procedure.

Perioperative management of patients for osteo-odonto-kreatoprosthesis under general anaesthesia: A retrospective study

PubMed Central

Garg, Rakesh; Khanna, Puneet; Sinha, Renu

2011-01-01

An osteo-odonto-keratoprosthesis (OOKP) procedure is indicated in patients with failed corneal transplant but having intact retina for visual improvement. We studied perioperative concerns of patients who underwent the staged OOKP procedure. This was a retrospective analysis of patients who underwent OOKP. The information regarding symptoms, associated comorbidities, perioperative events including anaesthetic management were collected. Eight patients (five females and three males) underwent the staged OOKP procedure. The median age was 18 years. The median weight was 45 kg. The median duration of loss of vision was 4 years. The aetiology of blindness included Stevens-Johnson's syndrome (SJS) (7) and chemical burn (1). Four patients had generalized skin problem due to SJS. All cases were managed under general anaesthesia, and airway management included nasotracheal intubation for stage I and orotracheal intubation for stage II. The median mallampati classification was I prior to OOKP stage I procedure while it changed to II at stage II procedure. Two patients required fibreoptic nasotracheal intubation. One patient had excessive oozing from the mucosal harvest site and was managed conservatively. In one patient, tooth harvesting was done twice as the first tooth was damaged during creating a hole in it. We conclude that OOKP requires multidisciplinary care. Anaesthesiologist should evaluate the airway carefully and disease-associated systemic involvements. The use of various drugs requires caution and steroid supplementation should be done. Airway difficulty should be anticipated, mandating thorough evaluation. Re-evaluation of airway is prudent as it may become difficult during the staged OOKP procedure. PMID:21808400

Fracture patterns in the maxillofacial region: a four-year retrospective study

PubMed Central

2015-01-01

Objectives The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures. PMID:26734557

Reproducibility of Brain Morphometry from Short-Term Repeat Clinical MRI Examinations: A Retrospective Study

PubMed Central

Liu, Hon-Man; Chen, Shan-Kai; Chen, Ya-Fang; Lee, Chung-Wei; Yeh, Lee-Ren

2016-01-01

Purpose To assess the inter session reproducibility of automatic segmented MRI-derived measures by FreeSurfer in a group of subjects with normal-appearing MR images. Materials and Methods After retrospectively reviewing a brain MRI database from our institute consisting of 14,758 adults, those subjects who had repeat scans and had no history of neurodegenerative disorders were selected for morphometry analysis using FreeSurfer. A total of 34 subjects were grouped by MRI scanner model. After automatic segmentation using FreeSurfer, label-wise comparison (involving area, thickness, and volume) was performed on all segmented results. An intraclass correlation coefficient was used to estimate the agreement between sessions. Wilcoxon signed rank test was used to assess the population mean rank differences across sessions. Mean-difference analysis was used to evaluate the difference intervals across scanners. Absolute percent difference was used to estimate the reproducibility errors across the MRI models. Kruskal-Wallis test was used to determine the across-scanner effect. Results The agreement in segmentation results for area, volume, and thickness measurements of all segmented anatomical labels was generally higher in Signa Excite and Verio models when compared with Sonata and TrioTim models. There were significant rank differences found across sessions in some labels of different measures. Smaller difference intervals in global volume measurements were noted on images acquired by Signa Excite and Verio models. For some brain regions, significant MRI model effects were observed on certain segmentation results. Conclusions Short-term scan-rescan reliability of automatic brain MRI morphometry is feasible in the clinical setting. However, since repeatability of software performance is contingent on the reproducibility of the scanner performance, the scanner performance must be calibrated before conducting such studies or before using such software for retrospective

Validation of the ULCEAT methodology by applying it in retrospect to the Roboticbed.

PubMed

Nakamura, Mio; Suzurikawa, Jun; Tsukada, Shohei; Kume, Yohei; Kawakami, Hideo; Inoue, Kaoru; Inoue, Takenobu

2015-01-01

In answer to the increasing demand for care by the Japanese oldest portion of the population, an extensive programme of life support robots is under development, advocated by the Japanese government. Roboticbed^® (RB) is developed to facilitate patients in their daily life in making independent transfers from and to the bed. The bed is intended both for elderly and persons with a disability. The purpose of this study is to examine the validity of the user and user's life centred clinical evaluation of assistive technology (ULCEAT) methodology. To support user centred development of life support robots the ULCEAT method was developed. By means of the ULCEAT method the target users and the use environment were re-established in an earlier study. The validity of the method is tested by re-evaluating the development of RB in retrospect. Six participants used the first prototype of RB (RB1) and eight participants used the second prototype of RB (RB2). The results indicated that the functionality was improved owing to the end-user evaluations. Therefore, we confirmed the content validity of the proposed ULCEAT method. In this study we confirmed the validation of the ULCEAT methodology by applying it in retrospect to RB using development process. This method will be used for the development of Life-support robots and prototype assistive technologies.

Aspergillus otitis in small animals--a retrospective study of 17 cases.

PubMed

Goodale, Elizabeth C; Outerbridge, Catherine A; White, Stephen D

2016-02-01

Aspergillus spp. are saprophytic opportunistic fungal organisms and are a common cause of otomycosis in humans. Although there have been case reports of Aspergillus otitis externa in dogs, to the best of the authors' knowledge, this is the first retrospective case series describing Aspergillus otitis in dogs and cats. To characterize signalment, putative risk factors, treatments and outcomes of a case series of dogs and cats with Aspergillus otitis. Eight dogs and nine cats diagnosed with Aspergillus otitis. A retrospective review of medical records from 1989 to 2014 identified animals diagnosed with Aspergillus otitis based on culture. All dogs weighed greater than 23 kg. The most common putative risk factors identified in this study were concurrent diseases, therapy causing immunosuppression or a history of an otic foreign body. Aspergillus otitis was unilateral in all study dogs and most cats. Concurrent otitis media was confirmed in three dogs and one cat, and suspected in two additional cats. Aspergillus fumigatus was the most common isolate overall and was the dominant isolate in cats. Aspergillus niger and A. terreus were more commonly isolated from dogs. Animals received various topical and systemic antifungal medications; however, otic lavage under anaesthesia and/or surgical intervention increased the likelihood of resolution of the fungal infection. Aspergillus otitis is uncommon, typically seen as unilateral otitis externa in cats and larger breed dogs with possible risk factors that include immunosuppression and otic foreign bodies; previous antibiotic usage was common. © 2015 ESVD and ACVD.

Diagnostic Performance and Utility of Quantitative EEG Analyses in Delirium: Confirmatory Results From a Large Retrospective Case-Control Study.

PubMed

Fleischmann, Robert; Tränkner, Steffi; Bathe-Peters, Rouven; Rönnefarth, Maria; Schmidt, Sein; Schreiber, Stephan J; Brandt, Stephan A

2018-03-01

The lack of objective disease markers is a major cause of misdiagnosis and nonstandardized approaches in delirium. Recent studies conducted in well-selected patients and confined study environments suggest that quantitative electroencephalography (qEEG) can provide such markers. We hypothesize that qEEG helps remedy diagnostic uncertainty not only in well-defined study cohorts but also in a heterogeneous hospital population. In this retrospective case-control study, EEG power spectra of delirious patients and age-/gender-matched controls (n = 31 and n = 345, respectively) were fitted in a linear model to test their performance as binary classifiers. We subsequently evaluated the diagnostic performance of the best classifiers in control samples with normal EEGs (n = 534) and real-world samples including pathologic findings (n = 4294). Test reliability was estimated through split-half analyses. We found that the combination of spectral power at F3-P4 at 2 Hz (area under the curve [AUC] = .994) and C3-O1 at 19 Hz (AUC = .993) provided a sensitivity of 100% and a specificity of 99% to identify delirious patients among normal controls. These classifiers also yielded a false positive rate as low as 5% and increased the pretest probability of being delirious by 57% in an unselected real-world sample. Split-half reliabilities were .98 and .99, respectively. This retrospective study yielded preliminary evidence that qEEG provides excellent diagnostic performance to identify delirious patients even outside confined study environments. It furthermore revealed reduced beta power as a novel specific finding in delirium and that a normal EEG excludes delirium. Prospective studies including parameters of pretest probability and delirium severity are required to elaborate on these promising findings.

Adalimumab-based treatment versus DMARDs for venous thrombosis in Behçet syndrome. A retrospective study of 70 patients with vascular involvement.

PubMed

Emmi, Giacomo; Vitale, Antonio; Silvestri, Elena; Boddi, Maria; Becatti, Matteo; Fiorillo, Claudia; Fabiani, Claudia; Frediani, Bruno; Emmi, Lorenzo; Scala, Gerardo Di; Goldoni, Matteo; Bettiol, Alessandra; Vaglio, Augusto; Cantarini, Luca; Prisco, Domenico

2018-04-20

Since Behçet syndrome (BS) is the prototype of inflammation-induced thrombosis, immunosuppressants are recommended in place of anticoagulants. Here we assessed the clinical efficacy and the corticosteroid-sparing effect of adalimumab (ADA)-based treatment versus DMARDs in a large retrospective cohort of patients with BS-related venous thrombosis. We retrospectively collected data from 70 BS patients treated with DMARDs or ADA-based regimens (ADA ± DMARDs) because of venous complications. Clinical and imaging evaluations were performed to define vascular response. We explored differences in outcomes between ADA-based regimens and DMARDs, with respect to efficacy, corticosteroid-sparing role and time on treatment. We also evaluated the role of anticoagulants as concomitant treatment. After a mean follow-up of 25.7±23.2 months, ADA-based regimens induced clinical and instrumental improvement of venous thrombosis more frequently (p=0.001) and rapidly (p<0.0001) than DMARDs. The mean dose of corticosteroids administered at the last follow-up was significantly lower in the ADA-based regimens than in the DMARDs one (p<0.0001). The time on treatment was significantly longer in ADA-based regimens than in the DMARDs one (p=0.002). No differences were found in terms of efficacy and time on treatment between DMARDs or ADA-based regimens among subjects receiving anticoagulants and those who did not. In this large retrospective study we have shown that ADA-based regimen is more effective and rapid in inducing resolution of venous thrombosis in BS patients than DMARDs, allowing reduction of steroid exposure. Moreover, our findings suggest that anticoagulation does not modify the efficacy on venous complications of either ADA-based regimens or DMARDs. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Biological behaviour of canine mandibular osteosarcoma. A retrospective study of 50 cases (1999-2007).

PubMed

Coyle, V J; Rassnick, K M; Borst, L B; Rodriguez, C O; Northrup, N C; Fan, T M; Garrett, L D

2015-06-01

The purpose of this retrospective study was to describe the biological behaviour of canine mandibular osteosarcoma (OSA) and to examine factors for their impact on metastasis-free interval (MFI) and survival time (ST). Records from dogs treated with mandibulectomy for OSA (1999-2007) were reviewed. Archived tumour samples were evaluated for mitotic index (MI) and tumour grade. Fifty dogs were included, 21 received chemotherapy. Twenty-nine dogs (58%) developed metastatic disease. The median MFI was 627 days, and median ST was 525 days. In univariate analysis MI > 40 was prognostic for decreased MFI and ST. Grade also influenced MFI and ST, with 5/21 (24%) dogs with grade II/III tumours metastasis-free at one year versus 16/22 (72%) dogs with grade I tumours (P = 0.002); and 5/21 (24%) dogs with grade II/III tumours alive versus 17/22 (77%) dogs with grade I tumours (P = 0.001). In multivariate analysis, histological grade and adjuvant chemotherapy were prognostic for MFI and ST. © 2013 Blackwell Publishing Ltd.

Refugee trauma versus torture trauma: a retrospective controlled cohort study of Tibetan refugees.

PubMed

Holtz, T H

1998-01-01

A retrospective cohort study of 35 refugee Tibetan nuns and lay students who were arrested and tortured in Tibet matched with 35 controls who were not arrested or tortured was carried out in India. Subjects were administered the Hopkins Checklist-25, evaluating anxiety symptoms, effective disturbances, somatic complaints, and social impairment. The prevalence of symptom scores in the clinical range for both cohorts was 41.4% for anxiety symptoms and 14.3% for depressive symptoms. The torture survivors had a statistically significant higher proportion of elevated anxiety scores than did the nontortured cohort (54.3% vs. 28.6%, p = .05). This was not true for elevated depressive scores. The results suggest that torture has long-term consequences on mental health over and above the effects of being uprooted, fleeing one's country, and living in exile as a refugee, though the additional effects were small. Political commitment, social support in exile, and prior knowledge of and preparedness for confinement and torture in the imprisoned cohort served to foster resilience against psychological sequelae. The contribution of Buddhist spirituality plays an active role in the development of protective coping mechanisms among Tibetan refugees.

A Retrospective Study Evaluating the Effect of Low Doses of Perineural Dexamethasone on Ropivacaine Brachial Plexus Peripheral Nerve Block Analgesic Duration.

PubMed

Schnepper, Gregory D; Kightlinger, Benjamin I; Jiang, Yunyun; Wolf, Bethany J; Bolin, Eric D; Wilson, Sylvia H

2017-09-23

Examination of the effectiveness of perineural dexamethasone administered in very low and low doses on ropivacaine brachial plexus block duration. Retrospective evaluation of brachial plexus block duration in a large cohort of patients receiving peripheral nerve blocks with and without perineural dexamethasone in a prospectively collected quality assurance database. A single academic medical center. A total of 1,942 brachial plexus blocks placed over a 16-month period were reviewed. Demographics, nerve block location, and perineural dexamethasone utilization and dose were examined in relation to block duration. Perineural dexamethasone was examined as none (0 mg), very low dose (2 mg or less), and low dose (greater than 2 mg to 4 mg). Continuous catheter techniques, local anesthetics other than ropivacaine, and block locations with fewer than 15 subjects were excluded. Associations between block duration and predictors of interest were examined using multivariable regression models. A subgroup analysis of the impact of receiving dexamethasone on block duration within each block type was also conducted using a univariate linear regression approach. A total of 1,027 subjects were evaluated. More than 90% of brachial plexus blocks contained perineural dexamethasone (≤4 mg), with a median dose of 2 mg. Increased block duration was associated with receiving any dose of perineural dexamethasone (P < 0.0001), female gender (P = 0.022), increased age (P = 0.048), and increased local anesthetic dose (P = 0.01). In a multivariable model, block duration did not differ with very low- or low-dose perineural dexamethasone after controlling for other factors (P = 0.420). Perineural dexamethasone prolonged block duration compared with ropivacaine alone; however, duration was not greater with low-dose compared with very low-dose perineural dexamethasone. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e

Where we used to live: validating retrospective measures of childhood neighborhood context for life course epidemiologic studies.

PubMed

Osypuk, Theresa L; Kehm, Rebecca; Misra, Dawn P

2015-01-01

Early life exposures influence numerous social determinants of health, as distal causes or confounders of later health outcomes. Although a growing literature is documenting how early life socioeconomic position affects later life health, few epidemiologic studies have tested measures for operationalizing early life neighborhood context, or examined their effects on later life health. In the Life-course Influences on Fetal Environments (LIFE) Study, a retrospective cohort study among Black women in Southfield, Michigan (71% response rate), we tested the validity and reliability of retrospectively-reported survey-based subjective measures of early life neighborhood context(N=693). We compared 3 subjective childhood neighborhood measures (disorder, informal social control, victimization), with 3 objective childhood neighborhood measures derived from 4 decades of historical census tract data 1970-2000, linked through geocoded residential histories (tract % poverty, tract % black, tract deprivation score derived from principal components analysis), as well as with 2 subjective neighborhood measures in adulthood. Our results documented that internal consistency reliability was high for the subjective childhood neighborhood scales (Cronbach's α =0.89, 0.93). Comparison of subjective with objective childhood neighborhood measures found moderate associations in hypothesized directions. Associations with objective variables were strongest for neighborhood disorder (rhos=.40), as opposed to with social control or victimization. Associations between subjective neighborhood context in childhood versus adulthood were moderate and stronger for residentially-stable populations. We lastly formally tested for, but found little evidence of, recall bias of the retrospective subjective reports of childhood context. These results provide evidence that retrospective reports of subjective neighborhood context may be a cost-effective, valid, and reliable method to operationalize early

Leg ulcer treatment outcomes with new ovine collagen extracellular matrix dressing: a retrospective case series.

PubMed

Bohn, Gregory A; Gass, Kimberly

2014-10-01

The purpose of this study was to describe the rate of closure observed in venous leg ulcers during treatment with ovine collagen extracellular matrix dressings and compression. Fourteen patients with 23 wounds were retrospectively evaluated with respect to healing rates, time to closure, and weekly facility charge fees.

Is rigorous retrospective harmonization possible? Application of the DataSHaPER approach across 53 large studies

PubMed Central

Fortier, Isabel; Doiron, Dany; Little, Julian; Ferretti, Vincent; L’Heureux, François; Stolk, Ronald P; Knoppers, Bartha M; Hudson, Thomas J; Burton, Paul R

2011-01-01

Background Proper understanding of the roles of, and interactions between genetic, lifestyle, environmental and psycho-social factors in determining the risk of development and/or progression of chronic diseases requires access to very large high-quality databases. Because of the financial, technical and time burdens related to developing and maintaining very large studies, the scientific community is increasingly synthesizing data from multiple studies to construct large databases. However, the data items collected by individual studies must be inferentially equivalent to be meaningfully synthesized. The DataSchema and Harmonization Platform for Epidemiological Research (DataSHaPER; http://www.datashaper.org) was developed to enable the rigorous assessment of the inferential equivalence, i.e. the potential for harmonization, of selected information from individual studies. Methods This article examines the value of using the DataSHaPER for retrospective harmonization of established studies. Using the DataSHaPER approach, the potential to generate 148 harmonized variables from the questionnaires and physical measures collected in 53 large population-based studies (6.9 million participants) was assessed. Variable and study characteristics that might influence the potential for data synthesis were also explored. Results Out of all assessment items evaluated (148 variables for each of the 53 studies), 38% could be harmonized. Certain characteristics of variables (i.e. relative importance, individual targeted, reference period) and of studies (i.e. observational units, data collection start date and mode of questionnaire administration) were associated with the potential for harmonization. For example, for variables deemed to be essential, 62% of assessment items paired could be harmonized. Conclusion The current article shows that the DataSHaPER provides an effective and flexible approach for the retrospective harmonization of information across studies. To implement

Multicystic dysplastic kidney: a retrospective study.

PubMed

Sharada, Sathish; Vijayakumar, Mahalingam; Nageswaran, Prahlad; Ekambaram, Sudha; Udani, Amish

2014-08-01

To report the renal structural and functional anomalies in children with multicystic dysplastic kidneys. Retrospective descriptive analysis of 47 children with multicystic dysplastic kidney seen in a pediatric nephrology unit over a period of 6 years. Antenatal diagnosis of multicystic dysplastic kidney was made in 34 (72.3%) patients. On follow up of 31 children for more than 12 months, 21 (68%) had involution, 4 [13%] had non-regression, and 4 (13%) were nephrectomized. Vesico-ureteric reflux (n=13; 28%) was the commonest renal abnormality. The serum creatinine values were higher (P=0.006) in children with contralateral reflux. Sub-nephrotic proteinuria was noted in 9 (29%) and was significantly associated with complete involution (P=<0.023). None of the patients developed hypertension and 2 (6.4%) had renal failure. Close nephrological follow-up is needed in children with multicystic dysplasia of kidneys.

Risk indicators related to peri-implant disease: an observational retrospective cohort study

PubMed Central

2016-01-01

Purpose The aim of the present study was to retrospectively investigate the influence of potential risk indicators on the development of peri-implant disease. Methods Overall, 103 patients referred for implant treatment from 2000 to 2012 were randomly enrolled. The study sample consisted of 421 conventional-length (>6 mm) non-turned titanium implants that were evaluated clinically and radiographically according to pre-established clinical and patient-related parameters by a single investigator. A non-parametric Mann-Whitney U test or Kruskal-Wallis rank test and a logistic regression model were used for the statistical analysis of the recorded data at the implant level. Results The diagnosis of peri-implant mucositis and peri-implantitis was made for 173 (41.1%) and 19 (4.5%) implants, respectively. Age (≥65 years), patient adherence (professional hygiene recalls <2/year) and the presence of plaque were associated with higher peri-implant probing-depth values and bleeding-on-probing scores. The logistic regression analysis indicated that age (P=0.001), patient adherence (P=0.03), the absence of keratinized tissue (P=0.03), implants placed in pristine bone (P=0.04), and the presence of peri-implant soft-tissue recession (P=0.000) were strongly associated with the event of peri-implantitis. Conclusions Within the limitations of this study, patients aged ≥65 years and non-adherent subjects were more prone to develop peri-implant disease. Therefore, early diagnosis and a systematic maintenance-care program are essential for maintaining peri-implant tissue health, especially in older patients. PMID:27588216

Ionized hypercalcemia in dogs: a retrospective study of 109 cases (1998-2003).

PubMed

Messinger, J S; Windham, W R; Ward, C R

2009-01-01

Serum hypercalcemia in dogs has been reported in association with a variety of diseases. Serum-ionized calcium (iCa) concentration is a more accurate measure of hypercalcemia than total serum calcium or corrected serum calcium concentrations. The severity of hypercalcemia has been utilized to suggest the most likely differential diagnosis for the hypercalcemia. Diseases causing ionized hypercalcemia may be different than those that cause increases in total or corrected serum calcium concentrations. The severity of ionized hypercalcemia in specific diseases cannot be used to determine the most likely differential diagnosis for ionized hypercalcemia. One-hundred and nine client-owned dogs with a definitive cause for their ionized hypercalcemia evaluated between 1998 and 2003 were included in this study. Retrospective, medical records review. Neoplasia, specifically lymphosarcoma, followed by renal failure, hyperparathyroidism, and hypoadrenocorticism were the most common causes of ionized hypercalcemia. Dogs with lymphoma and anal sac adenocarcinoma have higher serum iCa concentrations than those with renal failure, hypoadrenocorticism, and other types of neoplasia. The magnitude of serum-ionized hypercalcemia did not predict specific disease states. Serum-ionized hypercalcemia was most commonly associated with neoplasia, specifically lymphosarcoma. Although dogs with lymphosarcoma and anal sac adenocarcinoma had higher serum iCa concentrations than dogs with other diseases, the magnitude of the serum iCa concentration could not be used to predict the cause of hypercalcemia. Total serum calcium and corrected calcium concentrations did not accurately reflect the calcium status of the dogs in this study.

Rates and reasons for blood donor deferral, Shiraz, Iran. A retrospective study.

PubMed

Kasraian, Leila; Negarestani, Neda

2015-02-01

Knowledge of the reasons for donor deferral can help in planning more efficient recruitment strategies and evaluating donor selection criteria. This study aimed to investigate the rates and reasons for donor deferral. Retrospective study at Shiraz Blood Transfusion Center, Shiraz, Iran. 141,820 volunteers were interviewed confidentially by physicians before blood donation. The rate of and reasons for donor deferral were investigated according to demographic characteristics. The data were analyzed using the comparison-of-proportions test of the MedCalc statistical software. 43,839 people (30.9%) who had come for blood donation were deferred, 1,973 (4.5%) of them permanently. The deferral rate was significantly higher among women, single individuals and first-time donors, compared with men, married individuals and those with a history of previous donation (P < 0.0001). The deferral rate was significantly higher in the 17 to 30-year-old group (P < 0.05). The reasons for deferral were divided into five categories: risk factors possibly related to HIV or hepatitis (43.6%), underlying diseases (31.9%), non-eligible conditions (13.5%), medications that interfere with blood donation (7.8%) and risk factors that may relate to bacterial or viral infections except HIV and hepatitis infections (3.2%). Effective measures are required for documenting the impact of deferral on blood availability, monitoring the effectiveness of and need for deferral, and determining the reasons and rates of deferral.

Evaluation of the Modern Era Retrospective-Analysis for Research and Applications (MERRA) Global Water and Energy Budgets

NASA Technical Reports Server (NTRS)

Bosilovich, Michael G.; Robertson, F. R.; Chen, J.

2010-01-01

The Modern Era Retrospective-analysis for Research and Applications (MERRA) reanalyses has completed 27 years of data) soon to be caught up to present. Here) we present an evaluation of those years currently available) including comparisons with the existing long reanalyses (ERA40) JRA25 and NCEP I and II) as well as with global data sets for the water and energy cycle. Time series shows that the MERRA budgets can change with some of the variations in observing systems, but that the magnitude of energy imbalance in the system is improved with more observations. We will present all terms of the budgets in MERRA including the time rates of change and analysis increments (tendency due to the analysis of observations).

The Millennium Villages Project: a retrospective, observational, endline evaluation.

PubMed

Mitchell, Shira; Gelman, Andrew; Ross, Rebecca; Chen, Joyce; Bari, Sehrish; Huynh, Uyen Kim; Harris, Matthew W; Sachs, Sonia Ehrlich; Stuart, Elizabeth A; Feller, Avi; Makela, Susanna; Zaslavsky, Alan M; McClellan, Lucy; Ohemeng-Dapaah, Seth; Namakula, Patricia; Palm, Cheryl A; Sachs, Jeffrey D

2018-05-01

The Millennium Villages Project (MVP) was a 10 year, multisector, rural development project, initiated in 2005, operating across ten sites in ten sub-Saharan African countries to achieve the Millennium Development Goals (MDGs). In this study, we aimed to estimate the project's impact, target attainment, and on-site spending. In this endline evaluation of the MVP, we retrospectively selected comparison villages that best matched the project villages on possible confounding variables. Cross-sectional survey data on 40 outcomes of interest were collected from both the project and the comparison villages in 2015. Using these data, as well as on-site spending data collected during the project, we estimated project impacts as differences in outcomes between the project and comparison villages; target attainment as differences between project outcomes and prespecified targets; and on-site spending as expenditures reported by communities, donors, governments, and the project. Spending data were not collected in the comparison villages. Averaged across the ten project sites, we found that impact estimates for 30 of 40 outcomes were significant (95% uncertainty intervals [UIs] for these outcomes excluded zero) and favoured the project villages. In particular, substantial effects were seen in agriculture and health, in which some outcomes were roughly one SD better in the project villages than in the comparison villages. The project was estimated to have no significant impact on the consumption-based measures of poverty, but a significant favourable impact on an index of asset ownership. Impacts on nutrition and education outcomes were often inconclusive (95% UIs included zero). Averaging across outcomes within categories, the project had significant favourable impacts on agriculture, nutrition, education, child health, maternal health, HIV and malaria, and water and sanitation. A third of the targets were met in the project sites. Total on-site spending decreased from US$132

[Retrospective Cytogenetic Dose Evaluation. II. Computer Data Processing in Persons Irradiated in Different Radiation Accidents].

PubMed

Nugis, V Yu; Khvostunov, I K; Goloub, E V; Kozlova, M G; Nadejinal, N M; Galstian, I A

2015-01-01

The method for retrospective dose assessment based on the analysis of cell distribution by the number of dicentrics and unstable aberrations using a special computer program was earlier developed based on the data about the persons irradiated as a result of the accident at the Chernobyl nuclear power plant. This method was applied for the same purpose for data processing of repeated cytogenetic studies of the patients exposed to γ-, γ-β- or γ-neutron radiation in various situations. As a whole, this group was followed up in more distant periods (17-50 years) after exposure than Chernobyl patients (up to 25 years). The use for retrospective dose assessment of the multiple regression equations obtained for the Chernobyl cohort showed that the equation, which includes computer recovered estimate of the dose and the time elapsed after irradiation, was generally unsatisfactory (r = 0.069 at p = 0.599). Similar equations with recovered estimate of the dose and frequency of abnormal chromosomes in a distant period or with all three parameters as variables gave better results (r = 0.686 at p = 0.000000001 and r = 0.542 at p = 0.000008, respectively).

Multi-Center Retrospective Evaluation of Screw and Polymethylmethacrylate Constructs for Atlantoaxial Fixation in Dogs.

PubMed

Stout Steele, Megan W; Hodshon, Amy W; Hopkins, Andrew L; Tracy, Gaemia M; Cohen, Noah D; Kerwin, Sharon C; Boudreau, C Elizabeth; Thomas, William B; Mankin, Joseph M; Levine, Jonathan M

2016-10-01

To evaluate outcome and adverse events following ventral stabilization of the atlantoaxial (AA) joint in dogs with clinical AA subluxation using screw/polymethymethacrylate (PMMA) constructs in a retrospective, multi-center cohort study. Historical cohort study. 35 client-owned dogs. Medical records from 3 institutions were reviewed to identify dogs with AA subluxation treated with ventral screw and PMMA constructs. Data on signalment, pre- and postoperative neurologic status, imaging performed, and adverse events were retrieved. Neurologic examination data were abstracted to generate a modified Frankel score at admission, discharge, and re-examination. Telephone interview of owners >180 days postoperative was conducted. Thirty-five dogs with AA subluxation treated with ventral screw/PMMA constructs were included. Most dogs were young (median age 1 year), small breed dogs with acute onset of neurologic signs (median duration 22.5 hours). Most dogs were non-ambulatory at the time of admission (median modified Frankel score 3). Adverse events were identified in 15/35 dogs including 9 dogs with major adverse events. Four dogs required a second surgery due to vertebral canal violation (n = 2) or implant failure (n = 2). Re-examination at 4-6 weeks postoperative reported 15/28 dogs with improved neurologic status and 19/28 dogs were ambulatory. Telephone follow-up was available for 23/35 dogs with 23/23 reported as ambulatory (median follow-up 390 days). Ventral application of screw and PMMA constructs for AA subluxation, as described here, is associated with clinical improvement in the majority of dog. Major adverse events are infrequent and the technique is considered relatively safe. © Copyright 2016 by The American College of Veterinary Surgeons.

What is the benefit of treatment with multiple lines of chemotherapy for patients with metastatic breast cancer? A retrospective cohort study.

PubMed

Bakker, J L; Wever, K; van Waesberghe, J H; Beeker, A; Meijers-Heijboer, H; Konings, I R; Verheul, H M W

2015-12-01

Despite the extensive clinical experience, it is still under debate to what extent patients with metastatic breast cancer (MBC) benefit from multiple lines of chemotherapy beyond standard first or second line treatment. Selection of patients with MBC who will benefit from treatment is crucial to improve outcome and reduce unnecessary toxicity. In this retrospective study, systemic treatment outcome for patients with metastatic MBC is being evaluated. We evaluated to what extent the clinical benefit of prior chemotherapy can predict the success of a subsequent treatment line. Ninety-one patients treated with chemotherapy for MBC between January 2005 and January 2009 were included in this study. Clinical characteristics of patients, choices of chemotherapy and response at first evaluation of every treatment line was evaluated based on radiologic and clinical data. Patients received multiple systemic cytotoxic and biological (combination) therapies. 30% of these patients received more than five consecutive systemic (combination) treatments. First line chemotherapy was mostly anthracycline-based, followed by taxanes, capecitabine and vinorelbine. The response rate (RR, complete response plus partial response according to RECIST 1.1) decreased from 20% (95% CI 11-28%) upon first line of treatment to 0% upon the fourth line. The clinical benefit rate (combining RR and stable disease) decreased from 85% (95% CI 78-93%) in the first to 54% (95% CI 26-67) upon the fourth line. 24% of the patients with clinical benefit at first evaluation did not receive a subsequent line of treatment when progressive disease occurred, while sixty-one percent of the patients with progressive disease at first evaluation of a treatment did not receive a subsequent line of chemotherapy. When applied, the efficacy of a subsequent line of treatment was similar for patients independent of previous treatment benefit. The clinical benefit at first evaluation from systemic treatment in MBC does not

A retrospective outcomes study examining the effect of interactive metronome on hand function.

PubMed

Shank, Tracy M; Harron, Wendy

2015-01-01

Interactive Metronome (IM, The Interactive Metronome Company, Sunrise, Florida, USA) is a computer-based modality marketed to rehabilitation professionals who want to improve outcomes in areas of coordination, motor skills, self-regulation behaviors, and cognitive skills. This retrospective study examined the efficacy of IM training on improving timing skills, hand function, and parental report of self-regulatory behaviors. Forty eight children with mixed motor and cognitive diagnoses completed an average of 14 one-hour training sessions over an average of 8.5 weeks in an outpatient setting. Each child was assessed before and after training with the Interactive Metronome Long Form Assessment, the Jebsen Taylor Test of Hand Function, and a parent questionnaire. All three measures improved with statistical significance despite participants having no direct skill training. These results suggest an intimate relationship between cognition and motor skills that has potential therapeutic value. Level 4, Retrospective Case Series. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Screening and evaluation of hepatitis C virus infection in pregnant women on opioid maintenance therapy: A retrospective cohort study.

PubMed

Krans, Elizabeth E; Zickmund, Susan L; Rustgi, Vinod K; Park, Seo Young; Dunn, Shannon L; Schwarz, Eleanor B

2016-01-01

The purpose of this study was to describe the delivery of prenatal care services to women with opioid use disorder (OUD) on opioid maintenance therapy at high risk for hepatitis C virus (HCV) infection. We conducted a retrospective cohort evaluation of 791 pregnant women with OUD from 2009 to 2012. HCV screening was defined as documentation of (a) an anti-HCV antibody test or (b) a provider discussion regarding a known HCV diagnosis during pregnancy. Multivariate logistic regression was used to identify predictors of HCV screening during pregnancy. Among 791 pregnant women with OUD, 611 (77.2%) were screened for HCV infection and 369/611 (60.4%) were HCV positive. In multivariable analysis, patients who were married (odds ratio [OR] = 0.52; 95% confidence interval [CI] = 0.29, 0.91), used buprenorphine (OR = 0.45; 95% CI = 0.28, 0.71), and were cared for by private practice providers (OR = 0.29; 95% CI = 0.19, 0.45) were significantly less likely to be screened. In contrast, patients who used benzodiazepines (OR = 1.72; 95% CI = 1.02, 2.92), intravenous (IV) opioids (OR = 6.15; 95% CI = 3.96, 9.56), had legal problems (OR = 2.23; 95% CI = 1.12, 4.45), had children not in their custody (OR = 1.81; 95% CI = 1.01, 3.24), and who had a partner with substance abuse history (OR = 2.38; 95% CI = 1.23, 4.59) were significantly more likely to be screened. Of 369 HCV-positive patients, a new diagnosis of HCV was made during pregnancy for 108 (29.3%) patients. Only 94 (25.5%) had HCV viral load testing, 61 (16.5%) had HCV genotype testing, and 38 (10.4%) received an immunization for hepatitis A. Although 285 (77.2%) patients were referred to hepatology, only 71 (24.9%) attended the consultation. Finally, only 6 (1.6%) patients received HCV treatment 1 year following delivery. Prenatal care approaches to HCV infection remain inconsistent, and the majority of patients diagnosed with HCV infection during pregnancy do not receive treatment after delivery.

Prevalence and Audiological Characteristics of Auditory Neuropathy Spectrum Disorder in Pediatric Population: A Retrospective Study.

PubMed

Vignesh, S S; Jaya, V; Muraleedharan, A

2016-06-01

Auditory neuropathy spectrum disorder (ANSD) is a type of hearing disorder which is challenging for assessment and rehabilitation. This disorder has been studied over a decade and prevalence of the disorder is variable. The study aimed at estimating the prevalence and audiological characteristics of ANSD in children. A retrospective study was conducted from the medical records of pediatric patients evaluated at Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai to estimate the prevalence of ANSD. Medical records of 2,624 children evaluated during the period of November 2010 to October 2012 within the age range of 6 months to 12 years were analyzed. Out of 2,624 pediatric population assessed 217 (8.26 %) of them had unilateral or bilateral sensory neural hearing loss with varying degrees. Out of 217 children with sensory neural hearing loss 5.06 % (N = 11) had ANSD. Audiological characteristics varied among the group. Children with ANSD had varied degree of hearing thresholds from normal to profound hearing impairment. All of them had 'A' type tympanogram with absent stapedial reflexes. DPOAEs or TEOAEs were observed in 54 % of population with ANSD. All of them had abnormal auditory brainstem responses (ABR). Replicable cochlear microphonics was observed in 46 % of children with ANSD. These results indicate that ANSD is not a rare condition among children and we emphasize the use of objective tests like tympanometry, Stapedial Reflex test, otoacoustic emissions and ABR in routine hearing assessment procedure for all children to identify ANSD.

Breakthrough candidemia after the introduction of broad spectrum antifungal agents: A 5-year retrospective study.

PubMed

Breda, Giovanni L; Tuon, Felipe F; Meis, Jacques F; Herkert, Patricia F; Hagen, Ferry; de Oliveira, Letícia Z; Dias, Viviane de Carvalho; da Cunha, Clóvis Arns; Queiroz-Telles, Flávio

2018-06-01

Candidemia is the main invasive fungal disease among hospitalized patients. Several breakthrough candidemia (BrC) cases have been reported, but few studies evaluate the epidemiology, risk factors, molecular characterization, antifungal susceptibility profile and outcome of those patients, especially in developing countries and including patients using broad spectrum antifungals. We conducted a retrospective study from 2011 to 2016, including patients aged 12 years or older with candidemia. Epidemiological characteristics and risk factors for candidemia were evaluated and compared with patients with BrC using univariate and multivariate analysis. Sequential Candida isolates from BrC were identified by internal transcribed spacer sequencing, genotyped with amplified fragment length polymorphism fingerprinting (AFLP), and tested for antifungal susceptibility. From 148 candidemia episodes, 27 breakthrough episodes (18%) were identified, with neutropenia and mucositis being independent risk factors for BrC. Candida non-albicans was more frequent in the BrC group (P < .001). AFLP showed high correlation with conventional methods of identification among breakthrough isolates and a high genetic similarity among isolates from the same patient was observed. C. albicans was the most susceptible species with low MIC values for all antifungal agents tested. In contrast, we found isolates of C. glabrata, C. parapsilosis and C. tropicalis resistant to triazoles and echinocandins. In conclusion, BrC occurred mainly in severely immunosuppressed patients, with neutropenia and mucositis. Mortality did not differ between the groups. Candida non-albicans species were more recovered from BrC, with C. albicans being the most susceptible to antifungals.

Evaluation of Eligibility Criteria Used to Identify Patients for Medication Therapy Management Services: A Retrospective Cohort Study in a Medicare Advantage Part D Population.

PubMed

Lee, Janet S; Yang, Jianing; Stockl, Karen M; Lew, Heidi; Solow, Brian K

2016-01-01

General eligibility criteria used by the Centers for Medicare & Medicaid Services (CMS) to identify patients for medication therapy management (MTM) services include having multiple chronic conditions, taking multiple Part D drugs, and being likely to incur annual drug costs that exceed a predetermined threshold. The performance of these criteria in identifying patients in greatest need of MTM services is unknown. Although there are numerous possible versions of MTM identification algorithms that satisfy these criteria, there are limited data that evaluate the performance of MTM services using eligibility thresholds representative of those used by the majority of Part D sponsors. To (a) evaluate the performance of the 2013 CMS MTM eligibility criteria thresholds in identifying Medicare Advantage Prescription Drug (MAPD) plan patients with at least 2 drug therapy problems (DTPs) relative to alternative criteria threshold levels and (b) identify additional patient risk factors significantly associated with the number of DTPs for consideration as potential future MTM eligibility criteria. All patients in the Medicare Advantage Part D population who had pharmacy eligibility as of December 31, 2013, were included in this retrospective cohort study. Study outcomes included 7 different types of DTPs: use of high-risk medications in the elderly, gaps in medication therapy, medication nonadherence, drug-drug interactions, duplicate therapy, drug-disease interactions, and brand-to-generic conversion opportunities. DTPs were identified for each member based on 6 months of most recent pharmacy claims data and 14 months of most recent medical claims data. Risk factors examined in this study included patient demographics and prior health care utilization in the most recent 6 months. Descriptive statistics were used to summarize patient characteristics and to evaluate unadjusted relationships between the average number of DTPs identified per patient and each risk factor. Quartile

Radiological Insertion of Denver Peritoneovenous Shunts for Malignant Refractory Ascites: A Retrospective Multicenter Study (JIVROSG-0809)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sugawara, Shunsuke, E-mail: suga_shun@hotmail.com; Sone, Miyuki; Arai, Yasuaki

Purpose: Peritoneal venous shunts (PVSs) are widely used for palliating symptoms of refractory malignant ascites and are recognized as one of the practical methods. However, reliable clinical data are insufficient because most previous reports have been small studies from single centers. We conducted a retrospective, multicenter study to evaluate the safety and efficacy of radiologically placed PVSs in patients with malignant refractory ascites. Methods: A total of 133 patients with malignant ascites refractory to medical therapies were evaluated for patient characteristics, technical success, efficacy, survival times, adverse events, and changes in laboratory data. Results: PVSs were successfully placed in allmore » patients and were effective (i.e., improvement of ascites symptoms lasting 7 days or more) in 110 (82.7%). The median duration of symptom palliation was 26 days and median survival time was 41 days. The most frequent adverse event was PVS dysfunction, which occurred in 60 (45.1%) patients, among whom function was recovered with an additional minimally invasive procedure in 9. Abnormalities in coagulation (subclinical disseminated intravascular coagulation) occurred in 37 (27.8%) patients, although only 7 (5.3%) developed clinical disseminated intravascular coagulation. Other major adverse events were gastrointestinal bleeding (9.8%), sepsis (3.8%), and acute heart failure (3.0%). PVS was least effective in patients with elevated serum creatinine, bloody ascites, or gynecologic tumor. Conclusions: Radiological PVS is a technically feasible and effective method for palliating the symptoms from refractory malignant ascites, but preoperative evaluation and monitoring the postprocedural complications are mandatory to preclude severe adverse events after PVS.« less

Secondary cancers among children with acute lymphoblastic leukaemia treated by the Tokyo Children's Cancer Study Group protocols: a retrospective cohort study.

PubMed

Ishida, Yasushi; Maeda, Miho; Urayama, Kevin Y; Kiyotani, Chikako; Aoki, Yuki; Kato, Yoko; Goto, Shoko; Sakaguchi, Sachi; Sugita, Kenichi; Tokuyama, Mika; Nakadate, Naoya; Ishii, Eizaburo; Tsuchida, Masahiro; Ohara, Akira

2014-01-01

With improvement in survival, it is important to evaluate the impact of treatment on secondary cancers in acute lymphoblastic leukaemia (ALL) survivors. A retrospective cohort study comprising 2918 children diagnosed with ALL and enrolled on Tokyo Children's Cancer Study Group (TCCSG) protocols between 1984 and 2005 was conducted to evaluate the incidence of secondary cancers and associated factors including treatment protocol, cranial irradiation and other characteristics of the primary ALL. Thirty-seven patients developed secondary cancers, including acute myeloid leukaemia (n = 11), myelodysplastic syndrome (n = 5), non-Hodgkin lymphoma (n = 2), brain tumours (n = 13) and other solid carcinomas (n = 6) within a median follow-up duration of 9·5 years. The cumulative incidence of any secondary cancers was 1·0% (95% confidence interval (CI), 0·7-1·4%) at 10 years and 2·4% (95% CI, 1·5-3·7%) at 20 years, respectively. Standardized incidence rate ratio of secondary cancers was 9·3 (95% CI, 6·5-12·8). Multivariate analyses showed an increased risk of secondary cancers associated with the recent treatment protocol and cranial irradiation. There was no evidence of a reduction in secondary cancer incidence despite marked decreases in cranial irradiation use in the recent protocols. © 2013 John Wiley & Sons Ltd.

[Alopecia areata: a retrospective study of the paediatric dermatology department (2000-2008)].

PubMed

Rocha, Joana; Ventura, Filipa; Vieira, Ana Paula; Pinheiro, Ana Raquel; Fernandes, Susana; Brito, Celeste

2011-01-01

Alopecia areata usually presents as patchy, nonscarring hair loss. It seems to be an immune mediated disease, whereas genetic predisposition, environmental and psychological triggers may be involved in its aetiology. To study the epidemiology, clinical aspects, associations, and treatment of alopecia areata in the paediatric population of Peadiatric Dermatology outpatients over a 9-year period. Some psychologic characteristics were also assessed. Descriptive and retrospective study of all newly diagnosed AA cases seen from January 2000 to December 2008 at the Hospital de São Marcos' Paediatric Dermatology Department. Fifteen patients with AA were interviewed for psycologic evaluation. Forty-eight cases (54% male/46% female) were identified. Mean age at presentation was 7.8 years. Family history of AA was reported in 10% of the cases, and in 25% there was a personal and/or family history of atopy. The majority of patients (82%) had mild disease and topical corticotherapy was the first-line treatment for limited AA. Fifty-four percent of these patients had a complete resolution of the lesions with treatment. Systemic treatment (corticosteroids and/or ciclosporin) was used in 71% of patients with extensive disease (more than 50% hair loss). Only one of these patients had a sustained clinical improvement after treatment. Twelve out of 15 respondents (80%) recalled stressful events preceding hair loss. Our findings are similar to those reported in other studies. Epidemiologic studies of AA are available in adulthood but there is a paucity of literature on children with AA. A holistic approach is important in the management of childhood AA as the disease can have a severe psychologic impact on an individual's well-being.

Evaluation of strength and conditioning measures with game success in Division I collegiate volleyball: A retrospective study.

PubMed

Bunn, Jennifer A; Ryan, Greg A; Button, Gabriel R; Zhang, S

2017-08-04

The purpose of this study was to retrospectively assess relationships between strength and conditioning (SC) measures and game performance in Division I volleyball. Five years of SC and game data were collected from one women's Division I collegiate team, n = 76. SC measures included: T-drill, 18.3 m sprint, back squat, hang clean, vertical jump, and broad jump. All game and SC stats were normalized to Z-scores. Analyses included assessing SC differences by position, and multiple stepwise regression to assess relationships between game and SC stats. There was a significant difference by position for broad jump (p =.002), 18.3 m sprint (p =.036), vertical (p <.001), and total strength (p =.019). Overall, game performance and SC measures were significantly correlated (r = .439, p <.001). Multiple regression analyses indicated significant relationships (p < .05) between SC measures and game success by position as follows: defensive specialist stats with squat and total strength; setters game stats with hang cleans, T-drill, and broad jump; pin hitter game stats with vertical, squat, and total strength; middle blockers game stats with broad jump. These data indicate that SC measures correlate well with game performance and are specific by position. These data could help SC coaches create a more precise training approach to focus on improving specific measures by position, which could then translate to improved game performance. These data could also help coaches with talent identification to determine playing time and rotations to maximize player ability and achieve success.

Teacher-Course Evaluation: A Longitudinal Study of Response Stability and Instrument Reliability.

ERIC Educational Resources Information Center

McCollester, Charles W.; And Others

The temporal context within which a teacher and course evaluation (TCE) is completed did not appear to be of crucial importance in affecting TCE responses. A sample of students was asked to evaluate, initially as freshmen and retrospectively as seniors, a specific teacher and course. Additional data on the student's academic status characteristics…

Carboxyhemoglobin levels in medical intensive care patients: a retrospective, observational study

PubMed Central

2012-01-01

Introduction Critical illness leads to increased endogenous production of carbon monoxide (CO) due to the induction of the stress-response enzyme, heme oxygenase-1 (HO-1). There is evidence for the cytoprotective and anti-inflammatory effects of CO based on animal studies. In critically ill patients after cardiothoracic surgery, low minimum and high maximum carboxyhemoglobin (COHb) levels were shown to be associated with increased mortality, which suggests that there is an 'optimal range' for HO-1 activity. Our study aimed to test whether this relationship between COHb and outcome exists in non-surgical ICU patients. Methods We conducted a retrospective, observational study in a medical ICU at a university hospital in Vienna, Austria involving 868 critically ill patients. No interventions were undertaken. Arterial COHb was measured on admission and during the course of treatment in the ICU. The association between arterial COHb levels and ICU mortality was evaluated using bivariate tests and a logistic regression model. Results Minimum COHb levels were slightly lower in non-survivors compared to survivors (0.9%, 0.7% to 1.2% versus 1.2%, 0.9% to 1.5%; P = 0.0001), and the average COHb levels were marginally lower in non-survivors compared to survivors (1.5%, 1.2% to 1.8% versus 1.6%, 1.4% to 1.9%, P = 0.003). The multivariate logistic regression analysis revealed that the association between a low minimum COHb level and increased mortality was independent of the severity of illness and the type of organ failure. Conclusions Critically ill patients surviving the admission to a medical ICU had slightly higher minimum and marginally higher average COHb levels when compared to non-survivors. Even though the observed differences are statistically significant, the minute margins would not qualify COHb as a predictive marker for ICU mortality. PMID:22236404

Carboxyhemoglobin levels in medical intensive care patients: a retrospective, observational study.

PubMed

Fazekas, Andreas S; Wewalka, Marlene; Zauner, Christian; Funk, Georg-Christian

2012-01-11

Critical illness leads to increased endogenous production of carbon monoxide (CO) due to the induction of the stress-response enzyme, heme oxygenase-1 (HO-1). There is evidence for the cytoprotective and anti-inflammatory effects of CO based on animal studies. In critically ill patients after cardiothoracic surgery, low minimum and high maximum carboxyhemoglobin (COHb) levels were shown to be associated with increased mortality, which suggests that there is an 'optimal range' for HO-1 activity. Our study aimed to test whether this relationship between COHb and outcome exists in non-surgical ICU patients. We conducted a retrospective, observational study in a medical ICU at a university hospital in Vienna, Austria involving 868 critically ill patients. No interventions were undertaken. Arterial COHb was measured on admission and during the course of treatment in the ICU. The association between arterial COHb levels and ICU mortality was evaluated using bivariate tests and a logistic regression model. Minimum COHb levels were slightly lower in non-survivors compared to survivors (0.9%, 0.7% to 1.2% versus 1.2%, 0.9% to 1.5%; P=0.0001), and the average COHb levels were marginally lower in non-survivors compared to survivors (1.5%, 1.2% to 1.8% versus 1.6%, 1.4% to 1.9%, P=0.003). The multivariate logistic regression analysis revealed that the association between a low minimum COHb level and increased mortality was independent of the severity of illness and the type of organ failure. Critically ill patients surviving the admission to a medical ICU had slightly higher minimum and marginally higher average COHb levels when compared to non-survivors. Even though the observed differences are statistically significant, the minute margins would not qualify COHb as a predictive marker for ICU mortality.

[Gluteoplasty with intramuscular silicone cohesive gel implants: a retrospective study of 50 cases].

PubMed

Horn, G

2009-10-01

For a few years, surgery of the gluteus has become more and more popular. In this retrospective study of 50 cases over a period of five years, the author presents his results, using a personal technique of gluteoplasty with intramuscular implants. After a review of the different current surgical techniques and of the different types of gluteus, the author describes his own surgical strategy.

Maxillary Four Implant-retained Overdentures via Locator® Attachment: Intermediate-term Results from a Retrospective Study.

PubMed

Wang, Feng; Monje, Alberto; Huang, Wei; Zhang, Zhiyong; Wang, Guomin; Wu, Yiqun

2016-06-01

Maxillary overdentures have been utilized to restore oral function in scenarios where limited bone structure represents a drawback for financial issues and for cases where oral hygiene is uncertain. The aim of this study was to evaluate the intermediate-term clinical outcome of four locator attachment retaining maxillary overdentures and to test their reliability. A retrospective study was conducted from January 2007 to October 2013. After the placement of four maxillary dental implants and a healing period of approximately 3 months, all the implants were restored with locator-retained overdentures with partial palatal coverage. Subjects and implant characteristics, implant position (anterior vs posterior maxilla), bone quality, and opposing dentition were recorded. Peri-implant clinical parameters and marginal bone loss (MBL) were evaluated after delivery of the final prosthesis and annually thereafter. The performance of locator components and the prosthetic restoration were also recorded at follow-up. A total of 104 implants were placed in 26 subjects (11 women, 15 men; mean age, 64 years; age range, 55-76 years). One implant failed before loading. One subject dropped out of the study during a mean follow-up period of 46 months (range: 7-73 months), achieving an overall survival rate of 95.2%. Clinical parameters revealed healthy tissues around most of the implants, with low scores of plaque and bleeding indices. At the last follow-up evaluation, the mean MBL was 1.7 ± 1.1 mm (0.4-2.6 mm). Regression model analysis indicated that MBL for implants in the posterior maxilla was significantly higher than that for implants in the anterior maxilla (p = .0487). Overall, 26 technical and prosthetic complications were reported. Within the limitations of this study, maxillary four implant-retained overdentures via Locator attachment seem to be a predictable alternative for oral rehabilitation. © 2015 Wiley Periodicals, Inc.

The association between shallow vestibular depth and peri-implant parameters: a retrospective 6 years longitudinal study.

PubMed

Halperin-Sternfeld, Michal; Zigdon-Giladi, Hadar; Machtei, Eli E

2016-03-01

The aim of this study was to retrospectively evaluate the association between shallow vestibular depth (VD) and peri-implant parameters. Peri-implant parameters were evaluated in 61 periodontal patients under regular supportive periodontal therapy. Clinical parameters included gingival index (GI), plaque index (PI), bleeding on probing (BOP), peri-implant pocket depths (PPD), mucosal recession (MR), relative attachment level (RAL), width and thickness of keratinized mucosa (KMW, KMT) and VD. Radiographic bone level (RBL) was measured on peri-apical radiographs. Sites with shallow VD (≤ 4 mm) were associated with higher MR (0.91 mm versus 0.47 mm, p ≤ 0.009), higher RAL (4.23 mm versus 3.59 mm, p ≤ 0.0001) and higher RBL (2.18 mm versus 1.7 mm, p = 0.05) when compared with adequate vestibular depth sites (VD > 4 mm). Moreover, sites with shallow VD presented lower KMW compared with sites with adequate VD (1.24 mm versus 2.38 mm, respectively, p ≤ 0.0001). Slightly greater BOP, and GI were recorded for the shallow VD compared with adequate sites. According to multivariate analysis, factors that could predict RAL included: VD, GI, age, supporting periodontal therapy, implant type and design. Based on this study, inadequate vestibular depth around dental implants may be associated with increased peri-implant bone loss and mucosal recession. Further prospective and intervention studies will be required to fully understand this phenomenon. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Echocardiographic findings in infants with presumed congenital Zika syndrome: Retrospective case series study

PubMed Central

Santos, Cleusa C.; Feitosa, Fabiana G.; Ribeiro, Maria C.; Menge, Paulo; Lira, Izabelle M.

2017-01-01

Objective To report the echocardiographic evaluation of 103 infants with presumed congenital Zika syndrome. Methods An observational retrospective study was performed at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil. 103 infants with presumed congenital Zika syndrome. All infants had microcephaly and head computed tomography findings compatible with congenital Zika syndrome. Zika IgM antibody was detected in cerebrospinal fluid samples of 23 infants. In 80 infants, the test was not performed because it was not available at that time. All infants had negative serology for HIV, syphilis, rubella, cytomegalovirus and toxoplasmosis. A complete transthoracic two-dimensional, M-mode, continuous wave and pulsed wave Doppler and color Doppler echocardiographic (PHILIPS HD11XE or HD15) examination was performed on all infants. Results 14/103 (13.5%) echocardiograms were compatible with congenital heart disease: 5 with an ostium secundum atrial septal defect, 8 had a hemodynamically insignificant small apical muscular ventricular septal defect and one infant with dyspnea had a large membranous ventricular septal defect. The echocardiograms considered normal included 45 infants with a persistent foramen ovale and 16 with a minimum patent ductus arteriosus. Conclusions Preliminarily this study suggests that congenital Zika syndrome may be associated with an increase prevalence of congenital heart disease. However the types of defects noted were septal defects, a proportion of which would not be hemodynamically significant. PMID:28426680

Early Stage Blood Purification for Paraquat Poisoning: A Multicenter Retrospective Study.

PubMed

Li, An; Li, Wenxiong; Hao, Fengtong; Wang, Haishi

2016-01-01

To evaluate the efficacy of conservative treatment vs. hemoperfusion (HP) vs. HP + continuous veno-venous hemofiltration (CVVH) for acute Paraquat (PQ) poisoning. This was a multicenter retrospective study of patients with PQ poisoning between January 2013 and June 2014. Clinical data and PQ serum levels were collected at baseline and after 24, 48, and 72 h of treatment. Seventy-five, 65, and 43 underwent conservative treatment only (conservative treatment group), conservative treatment + HP (HP group), and conservative treatment + HP + CVVH (HP + CVVH group), respectively. PQ serum levels decreased in all groups after 72 h of treatment (p < 0.001); meanwhile, these values decreased faster in the HP and HP + CVVH groups compared with the conservative treatment group. More importantly, PQ blood levels were significantly lower in the HP + CVVH group compared with the HP group at 24 h (p < 0.05). Sequential organ failure assessment (ΔSOFA) values in the HP and HP + CVVH groups were significantly lower compared with that obtained for the conservative treatment group (p < 0.05). The 60-day survival rates were 21.3, 43.1 and 46.5%, respectively. Multivariate analysis indicated that age, PQ dose, admission PQ levels, and admission SOFA score were independently associated with mortality. HP and HP + CVVH were protective factors. Early HP or HP + CVVH after PQ poisoning could decrease PQ blood levels, alleviate organ damage, and increase survival. © 2016 S. Karger AG, Basel.

Isolated v-lesion represents a benign phenotype of vascular rejection of the kidney allograft- a retrospective study.

PubMed

Novotny, Marek; Hruba, Petra; Vichova, Petra; Maluskova, Jana; Honsova, Eva; Viklicky, Ondrej; Wohlfahrtova, Mariana

2018-05-31

While the detrimental impact of the humoral acute vascular rejection (AVR) phenotype is recognized, the prognostic significance of isolated v-lesion (IV) remains unclear. In this retrospective single-centre study, AVR was found in 98 out of 1015 patients (9.7%) who had undergone kidney transplantation in 2010-2014, with donor-specific antibodies (DSA) evaluated in all of them. The outcome of four AVR phenotypes was evaluated during median follow-up of 59 months; in 25 patients with IV, 18 with T cell-mediated vascular rejection (TCMRV), 19 with antibody-mediated vascular rejection (AMRV) and 36 with suspected antibody-mediated rejection (sAMRV). AVR was diagnosed mainly by for-cause biopsy (81%) early after transplantation (median 19 POD) and appeared as mild grade intimal arteritis. IV occurred in low sensitized patients after the first transplantation (96%) in the absence of DSA. IV responded satisfactorily to treatment (88%), showed no persistence of rejection in surveillance biopsy, had stable graft function, minimal proteinuria and excellent DCGS (96%). Contrary to that, Kaplan-Meier estimate of 3-year DCGS of AMRV was 66% (log rank=0.0004). Early IV represents a benign phenotype of AVR with a favourable outcome. This study prompts further research to evaluate the nature of IV before considering any change in the classification and management. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Beach-goer behavior during a retrospectively detected algal ...

EPA Pesticide Factsheets

Algal blooms occur among nutrient rich, warm surface waters and may adversely impact recreational beaches. During July – September 2003, a prospective study of beachgoers was conducted on weekends at a public beach on a Great Lake in the United States. We measured each beachgoer’s activity at the start and end of their beach visit and the environmental factors: water and air temperature, wind speed and wave height at the study site each day. At the time, there was no notification of algal blooms; we retrospectively evaluated the presence of algal blooms using MERIS data from the Envisat-1 satellite. A total of 2840 people participated in the study over 16 study days. The majority (55%) were female, and 751 (26%) were < 18 years of age. An algal bloom was detected retrospectively by remotely sensed satellite imagery during August 16 – 24. This peak bloom period (PB) included 4 study days. During PB study days, more study participants 226/742 (31%) reported body contact with the water compared to contact 531/2098 (25%) on non-peak days. During the 4 PB days, of the environmental factors, only mean water temperature was significantly different, 250 C vs. 230 C (p<0.05) from other days.These results suggest that beachgoer body contact with water was not deterred by the presence of an algal bloom, and that interventions to actively discourage water contact during a bloom are needed to reduce exposure to blooms. This is an abstract of a proposed presentation and

Clinical examination of leucite-reinforced glass-ceramic crowns (Empress) in general practice: a retrospective study.

PubMed

Sjögren, G; Lantto, R; Granberg, A; Sundström, B O; Tillberg, A

1999-01-01

The purpose of this study was to retrospectively evaluate leucite reinforced-glass ceramic crowns (Empress) placed in patients who regularly visit general practices. One hundred ten Empress crowns, placed in 29 patients who visited a general practice on a regular basis, were evaluated according to the California Dental Association's (CDA) quality evaluation system. In addition, the occurrence of plaque and certain gingival conditions was evaluated. All crowns were luted with resin composite cement. The mean and median years in function for the crowns were 3.6 and 3.9 years, respectively. Based on the CDA criteria, 92% of the 110 crowns were rated "satisfactory." Eighty-six percent were given the CDA rating "excellent" for margin integrity. Fracture was registered in 6% of the 110 crowns. Of the remaining 103 crowns, the CDA rating excellent was given to 74% for anatomic form, 86% for color, and 90% for surface. No significant differences (P > 0.05) were observed regarding fracture rates between anterior and posterior crowns. With regard to the occurrence of plaque and bleeding on probing, no significant differences (P > 0.05) were observed between the Empress crowns and the controls. Most of the fractured crowns had been placed on molars or premolars. Although the difference between anterior and posterior teeth was not statistically significant with respect to the fracture rates obtained, the number of fractured crowns placed on posterior teeth exceeded that of those placed on anterior teeth. The difference between the fracture rates may have clinical significance, and the risk of fracture has to be taken into consideration when placing crowns on teeth that are likely to be subjected to high stress levels.

[Childhood in sex offenders; A retrospective study].

PubMed

Hadi, G; Linkowski, P; Leistedt, S

2016-01-01

This retrospective and observational study is based on the hypothesis that sex offenders have experienced trauma and/or educational dysfunction which have a responsibility in theirs crimes of sexual type. The purpose of this study is to highlight these disturbances, develop a typology of sex offenders and offer a reflection on elements which allowed their acting out. Two groups were selected. A group of 31 patients having committed criminal offences or murders and having been determined as mentally irresponsibles of their act (" Défense Sociale " in Belgium). This group was compared to a group of 31 patients consulting a general practitioner. A survey and a personal interview were used. Most of this questions came from Thomas Achenbach's Child Behavior Checklist (this questionnaire highlight psychiatric disorders or pathological behaviors in childhood). The inclusion criteria were: male patients major in social defense; single or series rape(s) (accompanied or not by murder); incest; pedophilia; intelligence quotient greater than or equal to 80 (determined by the scale WAIS). The anova test results showed a statistically significant difference between the two groups (p ⟨ 0,00063). Several different profiles of rapists were established. Indeed, patient group shows more trauma such as sexual abuse (9.8 times more) and physical abuse (3.1 times more) than the control group. Three factors were identified as a condition to an achieved rape: a pathological family dynamic, impaired impulse control and an empathic deficit.

Retrospective clinicopathological study of 418 odontogenic cysts.

PubMed

Nuñez-Urrutia, Sergio; Figueiredo, Rui; Gay-Escoda, Cosme

2010-09-01

To determine the relative incidence of odontogenic cysts and to identify the main clinicopathological features among patients treated in the Oral Surgery Department of the Dental Clinic of the University of Barcelona (Spain). A retrospective observational study was made of 418 odontogenic cysts diagnosed in 380 patients included in the database of 1235 histopathological diagnoses. The subjects were treated in the Master degree program of Oral Surgery and Implantology of the University of Barcelona in the period 1997-2006. The following variables were recorded: gender, age, clinical characteristics of the lesions (size and location), radiological features, duration, treatment, complications and relapses. A descriptive analysis was made of the study variables, using the SPSS version 15.0. The incidence of odontogenic cysts was 33.8%. The mean patient age at appearance of the lesion was 42 years (range 7-83). The cysts were slightly more prevalent in males (58.4%). The lesion size ranged from 2-60 mm, with a mean size of 18.4 mm. The most frequent diagnosis was radicular cyst (50.2%). The most common location of the odontogenic cysts was in the mandible (61.5%), particularly the lower third molar region (36.8%). The most frequently diagnosed lesion was the radicular cyst. Odontogenic cysts were seen to be slightly more prevalent in males, and showed a high mandibular incidence. Knowledge of the biological and histological behavior of odontogenic cysts and their frequency are key aspects for ensuring early detection and adequate treatment.

Alveolar ridge keratosis - a retrospective clinicopathological study

PubMed Central

2013-01-01

Background Alveolar ridge keratosis (ARK) is a distinct, benign clinicopathological entity, characterized by a hyperkeratotic plaque or patch that occurs on the alveolar edentulous ridge or on the retromolar trigone, considered to be caused by chronic frictional trauma. The aim of this retrospective study is to present the clinicopathological features of 23 consecutive cases of ARK. Material and methods The 23 biopsy samples of ARK were selected and pathological features were revised (keratosis, acanthosis, surface architecture, and inflammation). Factors such as the patient’s gender, age, anatomical location, tobacco and alcohol use were analyzed. Results Sixteen out of the 23 cases studied were men and 7 women with a mean age of 55.05 (age ranged from 17 to 88 years). Thirteen cases had a history of tobacco habit, amongst whom, 4 also presented alcohol consumption. All the cases presented only unilateral lesions. Nineteen cases involved the retromolar trigone while 4 cases involved edentulous alveolar ridges. When observed microscopically, the lesions were mainly characterized by moderate to important hyperorthokeratosis. Inflammation was scanty or absent. In four of the cases, the presence of melanin pigment in the superficial corium or in the cytoplasm of macrophages was detected. None of the cases showed any features of dysplasia. Conclusion Our results reveal that ARK is a benign lesion. However, the high prevalence of smokers amongst the patients might suggest that some potentially malignant disorders such as tobacco associated leukoplakia may clinically mimic ARK. PMID:23587097

Alveolar ridge keratosis--a retrospective clinicopathological study.

PubMed

Bellato, Lorenzo; Martinelli-Kläy, Carla P; Martinelli, Celso R; Lombardi, Tommaso

2013-04-16

Alveolar ridge keratosis (ARK) is a distinct, benign clinicopathological entity, characterized by a hyperkeratotic plaque or patch that occurs on the alveolar edentulous ridge or on the retromolar trigone, considered to be caused by chronic frictional trauma. The aim of this retrospective study is to present the clinicopathological features of 23 consecutive cases of ARK. The 23 biopsy samples of ARK were selected and pathological features were revised (keratosis, acanthosis, surface architecture, and inflammation). Factors such as the patient's gender, age, anatomical location, tobacco and alcohol use were analyzed. Sixteen out of the 23 cases studied were men and 7 women with a mean age of 55.05 (age ranged from 17 to 88 years). Thirteen cases had a history of tobacco habit, amongst whom, 4 also presented alcohol consumption. All the cases presented only unilateral lesions. Nineteen cases involved the retromolar trigone while 4 cases involved edentulous alveolar ridges. When observed microscopically, the lesions were mainly characterized by moderate to important hyperorthokeratosis. Inflammation was scanty or absent. In four of the cases, the presence of melanin pigment in the superficial corium or in the cytoplasm of macrophages was detected. None of the cases showed any features of dysplasia. Our results reveal that ARK is a benign lesion. However, the high prevalence of smokers amongst the patients might suggest that some potentially malignant disorders such as tobacco associated leukoplakia may clinically mimic ARK.

Laser-assisted corneal welding in cataract surgery: retrospective study.

PubMed

Menabuoni, Luca; Pini, Roberto; Rossi, Francesca; Lenzetti, Ivo; Yoo, Sonia H; Parel, Jean-Marie

2007-09-01

To evaluate the efficacy of laser welding to close corneal wounds in cataract surgery. Department of Ophthalmology, Hospital of Misericordia e Dolce, Prato, Italy. This retrospective nonrandomized interventional case series included 20 eyes of 20 patients. All eyes had cataract with visual acuity worse than 20/200. Ten patients had phacoemulsification surgery, and 10 had extracapsular cataract extraction (ECCE). Surgeries were followed by laser-assisted closure of the corneal wounds by diode laser welding of the stroma using a technique established in animal models. Preoperative and postoperative (1, 3, 7, 30, and 90 days) astigmatism, level of inflammation, Seidel testing, and endothelial cell counts were obtained. There were minor differences in preoperative and postoperative astigmatism except in 1 eye in the ECCE group. The Seidel test showed no wound leakage during the follow-up examinations, and endothelial cell loss was similar to that published for standard surgical cataract procedures. No collateral effects of the laser welding were detected, nor was postoperative inflammation. Astigmatism was slightly affected by the use of laser welding for corneal wound closure after phacoemulsification and ECCE. The laser-assisted corneal sealing procedure was rapid and safe and could serve as an alternative to corneal suturing, with significant potential applications for the closure of longer incisions, such as those used in penetrating keratoplasty.

Pelvic floor physical therapy for lifelong vaginismus: a retrospective chart review and interview study.

PubMed

Reissing, Elke D; Armstrong, Heather L; Allen, Caroline

2013-01-01

Pelvic floor physical therapy is used in the treatment of sexual pain disorders; however, women with lifelong vaginismus have not yet been included in treatment studies or have not been differentiated from women with acquired vaginismus and/or dyspareunia. This retrospective chart review and interview study was intended to obtain initial information on physical therapy interventions, course, and outcome in women who have never been able to experience vaginal intercourse. The files of 53 women, consecutively treated at one physical therapy clinic, were included in the chart review; 13 of these women volunteered to be interviewed. The chart review revealed significant pelvic floor pathology and an average treatment course of 29 sessions. Internal manual techniques were found to be most effective, followed by patient education, dilatation exercises, and home exercises. Although participants were very satisfied with the physical therapy, some symptoms, such as pain, anxiety/fear, and pelvic floor tension remained and scores on the Female Sexual Distress Scale and Female Sexual Function Index indicated clinical levels of sexual distress and impaired sexual function after treatment. Although there appears to be no linear relation between symptom reduction and healthy sexual function, this initial information suggests that physical therapy may be a promising treatment option for some women with lifelong vaginismus and merits further evaluation.

An evaluation system for electronic retrospective analyses in radiation oncology: implemented exemplarily for pancreatic cancer

NASA Astrophysics Data System (ADS)

Kessel, Kerstin A.; Jäger, Andreas; Bohn, Christian; Habermehl, Daniel; Zhang, Lanlan; Engelmann, Uwe; Bougatf, Nina; Bendl, Rolf; Debus, Jürgen; Combs, Stephanie E.

2013-03-01

To date, conducting retrospective clinical analyses is rather difficult and time consuming. Especially in radiation oncology, handling voluminous datasets from various information systems and different documentation styles efficiently is crucial for patient care and research. With the example of patients with pancreatic cancer treated with radio-chemotherapy, we performed a therapy evaluation by using analysis tools connected with a documentation system. A total number of 783 patients have been documented into a professional, web-based documentation system. Information about radiation therapy, diagnostic images and dose distributions have been imported. For patients with disease progression after neoadjuvant chemoradiation, we designed and established an analysis workflow. After automatic registration of the radiation plans with the follow-up images, the recurrence volumes are segmented manually. Based on these volumes the DVH (dose-volume histogram) statistic is calculated, followed by the determination of the dose applied to the region of recurrence. All results are stored in the database and included in statistical calculations. The main goal of using an automatic evaluation system is to reduce time and effort conducting clinical analyses, especially with large patient groups. We showed a first approach and use of some existing tools, however manual interaction is still necessary. Further steps need to be taken to enhance automation. Already, it has become apparent that the benefits of digital data management and analysis lie in the central storage of data and reusability of the results. Therefore, we intend to adapt the evaluation system to other types of tumors in radiation oncology.

Retrospective Case Study in the Raton Basin, Colorado, Study of hte Potential Impacts of Hydraulic Fracturing on Drinking Water Resources.

EPA Science Inventory

This report describes the retrospective case study that was conducted in the Colorado portion of the Raton Basin, located within Las Animas and Huerfano counties. These locations are the focus of unconventional gas production of coalbed methane (CBM) from several coal-bearing st...

Retrospective study of management of uterine sarcomas at Oxford 1990-1998: role of adjuvant treatment.

PubMed

Riddle, P J; Echeta, C B; Manek, S; Lavery, B A; Charnock, F M L; Mackenzie, I; Ganesan, T S

2002-02-01

We report a retrospective study of 47 consecutive patients with uterine sarcoma treated at the Churchill Hospital in Oxford between 1990-1998. The mainstay of treatment was surgery with adjuvant chemotherapy and radiotherapy reserved for selected patients with early stage disease. Overall 1 and 2 year survival was 49% and 30% respectively compared with 73% and 55% in the group who received adjuvant chemotherapy/radiotherapy. Median survival was 11 months for the group as a whole compared to 32.9 months in the adjuvant therapy group. This is a retrospective review with small numbers and considerable selection bias, however, given the poor survival of patients with this disease, adjuvant treatment should be considered in future trials of patients with uterine sarcoma.

Is Statin Use Associated With Tendon Rupture? A Population-Based Retrospective Cohort Analysis.

PubMed

Contractor, Tahmeed; Beri, Abhimanyu; Gardiner, Joseph C; Tang, Xiaoqin; Dwamena, Francesca C

2015-01-01

Previous case reports and small studies have suggested that 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors (HMG-CoA-Is) may increase the risk of tendon rupture. We conducted a population-based retrospective cohort evaluation to better assess this relationship. From approximately 800,000 enrollees of a private insurance database, those who were aged ≤64 years with at least 1 year of continuous enrollment were selected. Exposure was defined as initiation of HMG-CoA-I after the beginning of the study period. Each exposed person was matched with 2 controls of similar age and gender. Baseline characteristics, including known risk factors for tendon rupture, were compared between exposed and control cohorts with fidelity to the study's matched design. After adjusting for differences in follow-up and baseline characteristics, incidence rate ratios for tendon rupture was assessed in HMG-CoA-I users and nonusers. A total of 34,749 exposed patients were matched with 69,498 controls. There was no difference in the occurrence of tendon ruptures in HMG-CoA-I users versus nonusers. The results remained unchanged after adjustment for age and gender. In conclusion, this population-based retrospective cohort evaluation suggests that use of HMG-CoA-Is as a group are not associated with tendon rupture.

Retrospective Cohort Study of Hydrotherapy in Labor.

PubMed

Vanderlaan, Jennifer

To describe the use of hydrotherapy for pain management in labor. This was a retrospective cohort study. Hospital labor and delivery unit in the Northwestern United States, 2006 through 2013. Women in a nurse-midwifery-managed practice who were eligible to use hydrotherapy during labor. Descriptive statistics were used to report the proportion of participants who initiated and discontinued hydrotherapy and duration of hydrotherapy use. Logistic regression was used to provide adjusted odds ratios for characteristics associated with hydrotherapy use. Of the 327 participants included, 268 (82%) initiated hydrotherapy. Of those, 80 (29.9%) were removed from the water because they met medical exclusion criteria, and 24 (9%) progressed to pharmacologic pain management. The mean duration of tub use was 156.3 minutes (standard deviation = 122.7). Induction of labor was associated with declining the offer of hydrotherapy, and nulliparity was associated with medical removal from hydrotherapy. In a hospital that promoted hydrotherapy for pain management in labor, most women who were eligible initiated hydrotherapy. Hospital staff can estimate demand for hydrotherapy by being aware that hydrotherapy use is associated with nulliparity. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

[A retrospective study of orthodontic treatment of children with clefts].

PubMed

Brin, I; Bar-Abudi, R; Abed, Y; Ben-Bassat, Y; Harari, D; Zilberman, Y

2003-04-01

To evaluate the population of cleft patients treated in a Department of Orthodontics and the types of treatment modalities provided. Demographic, cleft related and treatment related data existing in the patients' files were supplemented by questionnaires. Comparisons were conducted among 3 cleft groups: cleft lip (CL), cleft lip and palate (CLP) and cleft palate (CP). The response rate was 36% (n = 152). The distribution of the patients in the 3 cleft groups, the sidedness, the male predominance and association with additional anomalies were similar to the reports in the literature. Most of the patients were the 3rd born (or more) and were of normal birth weight. Consanguity in the cleft families was at least 2.5 times more prevalent than that of the Israeli population and 30% reported on additional cleft in the family. Low birth weight and additional anomalies were found mainly in the CP group. Orthodontic involvement spanned 3 developmental periods: immediate postnatal presurgical treatment, phase I between the ages 6-8 years and full orthodontic treatment at a later age. Up to the age of 5 years only one lip operation was performed for 60% of the lip-affected children and one palate operation for 65% of the palate affected patients. 1. The distribution of the various cleft-related parameters in this retrospective study was similar to the findings in the literature. 2. The high prevalence of additional anomalies found emphasizes the need for a thorough examination of the cleft babies. 3. Orthodontic treatment was rendered in one and two phase protocols in addition to immediate postnatal pre-surgical intervention.

Recurrent Urinary Tract Infection After Midurethral Sling: A Retrospective Study.

PubMed

Hammett, Jessica; Lukman, Revana; Oakes, Megan; Whitcomb, Emily L

Our primary objective was to estimate the proportion of patients with culture-proven urinary tract infection (UTI) and recurrent UTI after midurethral sling (MUS), as well as to evaluate their risk factors. Our secondary objective was to characterize the difference in the proportion of patients with recurrent UTI before and after MUS. We conducted a retrospective study of patients who underwent MUS from 2009 to 2012 within a large health maintenance organization and subsequently had documentation of at least 1 positive urine culture (>100 K CFU/mL) within 1 year. Validated procedural and diagnostic codes were used to identify patients undergoing MUS and the diagnosis of UTI, respectively. Of the 7461 MUS performed, 883 (12%) patients had at least 1 culture-proven UTI and 258 (3.5%) patients met the definition of recurrent UTI postoperatively. Of those 883 patients, 89 (10%) patients met the definition of recurrent UTI before, and 258 (29%) patients after, MUS. McNemar χ test revealed that patients were more likely to have recurrent UTI after MUS compared with before (P < 0.0001). In multivariate logistic regression, Caucasian (odds ratio [OR], 1.60, 95% confidence interval [95% CI], 1.12-2.29; P = 0.01) and African-American (OR, 3.42; 95% CI, 1.42-8.29; P = 0.01) ethnicity, older age (OR, 1.02; 95% CI, 1.00-1.04; P = 0.03), and a history of recurrent UTI (OR 3.79, 95% CI 1.88-7.93, P = 0.0003) were risk factors for postoperative recurrent UTI. In this population, preoperative recurrent UTI was the only modifiable risk factor associated with an increased risk of postoperative recurrent UTI.

[Cytomegalovirus retinitis in HIV negative patients - retrospective study].

PubMed

Beňová, A; Brichová, M; Svozílková, P; Kousal, B; Jeníčková, D; Heissigerová, J; Ríhová, E

2013-12-01

To evaluate own experience with the diagnosis and treatment of cytomegalovirus (CMV) retinitis in HIV negative patients with immunodeficiency. Retrospective study and case reports. In the Centre for diagnosis and treatment of Uveitis 1869 patients with uveitis we have examined from June 2003 to June 2012. CMV retinitis was diagnosed in 7 patients (1 woman and 6 men) according to the typical clinical findings and history of immunodeficiency. In 2 atypical findings was the diagnosis confirmed by determination of DNA pathogen in vitreous sample (a patient with non-Hodgkin lymphoma) or by positive serology (CMV in leukocytes - indolent form of CMV retinitis in a patient with systemic lupus erythematosus). In 8 cases we found fulminant form, in 1 case indolent form of CMV retinitis. The average age of patients was 39,1 years (18-51 years old), ratio of men to women 6 : 3. In 6 of 9 cases we noticed bilateral retinitis. The average period of observation in our study was 15,8 months (1-48 months). Five of our patients underwent bone marrow transplantation, 2 patients were treated with systemic immunosuppressive drugs (colitis ulcerosa, systemic lupus erythematosus) and 2 patients had chemotherapy for lymphoma. The initiation or modification of treatment (gancyklovir p.o./i.v., foscarnet i.v.) was consulted and coordinated with others specialists. After initiation of treatment we followed-up 7 patients. In 4 eyes of 3 patients (31 %) the improvement of visual acuity was documented, in 5 eyes of 5 patients (38 %) the visual acuity was stabilized. The worsening of vision in 4 eyes of 3 patients (31 %) was caused by complications without any connection to virostatic therapy. All of our patients, who underwent bone marrow transplantation, died within 12 months since the diagnosis of CMV retinitis was determined. The diagnosis of CMV retinitis only in 9 cases (0,48% of all uveitic patients) confirms the rare occurrence of this retinitis. The important tool to the diagnosis of

Hypopigmented mycosis fungoides: a retrospective clinicohistopathologic study.

PubMed

Rodney, I J; Kindred, C; Angra, K; Qutub, O N; Villanueva, A R; Halder, R M

2017-05-01

Hypopigmented mycosis fungoides is a rare variant of mycosis fungoides with limited published clinicohistopathologic data available. To characterize our patient group, to provide additional information and insight into this malignancy. A 16-year retrospective medical records review (from 1992 to 2009) was conducted of patients with a diagnosis of hypopigmented mycosis fungoides. All patients were seen in the department of dermatology at Howard University Hospital, an outpatient clinic in an urban academic institution. The review comprised of 20 patients. Inclusion required presence of hypopigmented skin lesions and a skin biopsy diagnostic for hypopigmented mycosis fungoides. Treatment modalities, including oral psoralen with UVA, narrow-band UVB and/or topical medications such as nitrogen mustard and topical corticosteroids were employed. Patients ranged from 4 to 57 years old. Fifteen were African American, three African, one Afro-Caribbean and one Hispanic. The interval from disease onset to diagnosis ranged from 7 months to 24 years. Patients presented at Stage 1A or 1B. Treatment included phototherapy and topical medications. In four patients with pre- and post-treatment biopsies, the original histological diagnosis of hypopigmented mycosis fungoides and the subsequent complete resolution were shown. There was no associated mortality in the patients studied. Hypopigmented mycosis fungoides affected skin of colour patients in this study. This variant differs from classic mycosis fungoides: younger population, slower progression and the majority of patients remaining in Stage I with treatment. We observed that any repigmentation of lesions suggests an effective treatment regimen, complete repigmentation correlates with clinical and histopathologic resolution, and new hypopigmented lesions during remission suggest relapse. A limitation of this study is the small sample size. This is the first study to correlate the histological resolution of hypopigmented mycosis

Utilizing public health clinics for service-learning rotations in dental hygiene: a four-year retrospective study.

PubMed

Aston-Brown, Roberta E; Branson, Bonnie; Gadbury-Amyot, Cynthia C; Bray, Kimberly Krust

2009-03-01

National reports outlining disparities in oral health care in the United States have focused attention on ways to encourage health care providers to become more involved in the public health arena. Utilization of service-learning in professional health education programs is one method being explored. The purpose of this study was to conduct a retrospective review of a service-learning rotation within a dental hygiene public health course. The study utilized data sources generated by students as part of a course evaluation. These sources included student journals (qualitative/quantitative) and Likert-scaled (quantitative) and open-ended (qualitative) student satisfaction survey items. Mixed methodology data analysis techniques were used to analyze and triangulate data in order to form conclusions related to the effectiveness of service-learning as a teaching strategy in dental hygiene. This investigation suggests that service-learning is an effective learning strategy for increasing student awareness of underserved populations, cultural diversity, and ethical patient care. The study also suggests that service-learning helped students to determine their level of interest in public health as a career choice by giving them a real-world experience in public health patient care.

Excess morbidity and mortality in patients with craniopharyngioma: a hospital-based retrospective cohort study.

PubMed

Wijnen, Mark; Olsson, Daniel S; van den Heuvel-Eibrink, Marry M; Hammarstrand, Casper; Janssen, Joseph A M J L; van der Lely, Aart J; Johannsson, Gudmundur; Neggers, Sebastian J C M M

2018-01-01

Most studies in patients with craniopharyngioma did not investigate morbidity and mortality relative to the general population nor evaluated risk factors for excess morbidity and mortality. Therefore, the objective of this study was to examine excess morbidity and mortality, as well as their determinants in patients with craniopharyngioma. Hospital-based retrospective cohort study conducted between 1987 and 2014. We included 144 Dutch and 80 Swedish patients with craniopharyngioma identified by a computer-based search in the medical records (105 females (47%), 112 patients with childhood-onset craniopharyngioma (50%), 3153 person-years of follow-up). Excess morbidity and mortality were analysed using standardized incidence and mortality ratios (SIRs and SMRs). Risk factors were evaluated univariably by comparing SIRs and SMRs between non-overlapping subgroups. Patients with craniopharyngioma experienced excess morbidity due to type 2 diabetes mellitus (T2DM) (SIR: 4.4, 95% confidence interval (CI): 2.8-6.8) and cerebral infarction (SIR: 4.9, 95% CI: 3.1-8.0) compared to the general population. Risks for malignant neoplasms, myocardial infarctions and fractures were not increased. Patients with craniopharyngioma also had excessive total mortality (SMR: 2.7, 95% CI: 2.0-3.8), and mortality due to circulatory (SMR: 2.3, 95% CI: 1.1-4.5) and respiratory (SMR: 6.0, 95% CI: 2.5-14.5) diseases. Female sex, childhood-onset craniopharyngioma, hydrocephalus and tumour recurrence were identified as risk factors for excess T2DM, cerebral infarction and total mortality. Patients with craniopharyngioma are at an increased risk for T2DM, cerebral infarction, total mortality and mortality due to circulatory and respiratory diseases. Female sex, childhood-onset craniopharyngioma, hydrocephalus and tumour recurrence are important risk factors. © 2018 European Society of Endocrinology.

Endoscopic dacryocystorhinostomy with and without silicone intubation: 4 years retrospective study.

PubMed

Longari, F; Dehgani Mobaraki, P; Ricci, A L; Lapenna, R; Cagini, C; Ricci, G

2016-08-01

The objective of this study is to assess different outcomes between endoscopic dacryocystorhinostomy (En-DCR) with and without silicone intubation. We retrospectively analyzed 84 patients (89 procedures), suffering from chronic epiphora for primary acquired nasolacrimal duct obstruction, treated with En-DCR and divided into two groups depending on silicone stent intubation. The surgical outcomes were evaluated at 7 post-operative controls using Munk's score criteria. Functional success was defined as absence of epiphora, no further episodes of dacryocystitis, and a patent ostium after fluorescein irrigation. 45 En-DCR with stent and 44 En-DCR without stent were performed. Success rate after 18 months follow-up were, respectively, 82.2 % in the stent group and 88.6 % in the non-stent group (OR 0.59) with no statistical differences. The ostial size reduction has been reported in higher percentage in the stent group, mainly due to peristomal granuloma (OR 3.64), scar tissue formation (OR 2.25), and turbinoseptal synaechia (OR 1.76). The benefits of non-intubation are less patient discomfort, reduced surgical time and costs, simpler follow-up regimen and less intubation-associated complications. En-DCR without silicone stent intubation should be the first choice of procedure, stent intubation should be reserved in selected cases with poor local conditions pre and intra-operatively assessed.

The lasting memory enhancements of retrospective attention

PubMed Central

Reaves, Sarah; Strunk, Jonathan; Phillips, Shekinah; Verhaeghen, Paul; Duarte, Audrey

2016-01-01

Behavioral research has shown that spatial cues that orient attention toward task relevant items being maintained in visual short-term memory (VSTM) enhance item memory accuracy. However, it is unknown if these retrospective attentional cues (“retro-cues”) enhance memory beyond typical short-term memory delays. It is also unknown whether retro-cues affect the spatial information associated with VSTM representations. Emerging evidence suggests that processes that affect short-term memory maintenance may also affect long-term memory (LTM) but little work has investigated the role of attention in LTM. In the current event-related potential (ERP) study, we investigated the duration of retrospective attention effects and the impact of retrospective attention manipulations on VSTM representations. Results revealed that retro-cueing improved both VSTM and LTM memory accuracy and that posterior maximal ERPs observed during VSTM maintenance predicted subsequent LTM performance. N2pc ERPs associated with attentional selection were attenuated by retro-cueing suggesting that retrospective attention may disrupt maintenance of spatial configural information in VSTM. Collectively, these findings suggest that retrospective attention can alter the structure of memory representations, which impacts memory performance beyond short-term memory delays. PMID:27038756

The lasting memory enhancements of retrospective attention.

PubMed

Reaves, Sarah; Strunk, Jonathan; Phillips, Shekinah; Verhaeghen, Paul; Duarte, Audrey

2016-07-01

Behavioral research has shown that spatial cues that orient attention toward task relevant items being maintained in visual short-term memory (VSTM) enhance item memory accuracy. However, it is unknown if these retrospective attentional cues ("retro-cues") enhance memory beyond typical short-term memory delays. It is also unknown whether retro-cues affect the spatial information associated with VSTM representations. Emerging evidence suggests that processes that affect short-term memory maintenance may also affect long-term memory (LTM) but little work has investigated the role of attention in LTM. In the current event-related potential (ERP) study, we investigated the duration of retrospective attention effects and the impact of retrospective attention manipulations on VSTM representations. Results revealed that retro-cueing improved both VSTM and LTM memory accuracy and that posterior maximal ERPs observed during VSTM maintenance predicted subsequent LTM performance. N2pc ERPs associated with attentional selection were attenuated by retro-cueing suggesting that retrospective attention may disrupt maintenance of spatial configural information in VSTM. Collectively, these findings suggest that retrospective attention can alter the structure of memory representations, which impacts memory performance beyond short-term memory delays. Copyright © 2016 Elsevier B.V. All rights reserved.

[Retrospective study regarding the contribution of Italian nurses to the debate on the Englaro case: between paradigms of catholic and non-religious bioethics].

PubMed

Sansoni, Julita; Minnella, Giuseppe; Mitello, Lucia

2010-01-01

This study presents the results of a retrospective study evaluating the contribution of Italian nurses to the public debate on the Englaro case, analysing the articles published by two major daily newspapers during a precise period. The data collected testify to the intensity of the debate that involved the whole nation in which many diverse social and professional categories took part. The nursing category was principally represented by the Sisters of Mercy who, at the insistence of the media, gave their own opinion although their role in this context was more as personal assistants to Eluana Englaro rather than representatives of a professional category expressing a bioethical opinion.

Add-on lacosamide: a retrospective study on the relationship between serum concentration, dosage, and adverse events.

PubMed

Hillenbrand, Barbara; Wisniewski, Ilona; Jürges, Uta; Steinhoff, Bernhard J

2011-11-01

We performed a retrospective study in patients with poorly controlled epilepsy treated with add-on lacosamide (LCM) to investigate the relationship of LCM-related adverse events with LCM serum concentration and weight-dependent dosage. We collected serum concentrations, weight-related dosages, and occurrences of the seven most frequent adverse events according to the randomized double-blind, placebo-controlled trials. Seventy of 131 patients could be sufficiently evaluated. LCM serum concentrations and weight-related dosages in patients with and without typical adverse events did not differ significantly. Closer analysis of the data suggested that dizziness as the leading adverse event occurred significantly more often if LCM was combined with classic sodium channel blockers. There was a significant correlation between LCM serum concentrations and co-medication, so there is still evidence for dependent variables that might have a relevant impact in individual cases. However, our data do not allow definition of a safety range for LCM. Copyright © 2011 Elsevier Inc. All rights reserved.

Sinonasal mucosal melanoma: retrospective survival study of 25 patients.

PubMed

Vandenhende, C; Leroy, X; Chevalier, D; Mortuaire, G

2012-02-01

To determine potential prognostic factors for survival in patients with mucosal malignant melanoma of the sinonasal tract. Patients managed between 1991 and 2008 were assessed retrospectively. The seventh edition Union for International Cancer Control (7th UICC) tumour-node-metastasis classification was used for tumour staging. Kaplan-Meier and log rank tests were used for survival analysis. Twenty-five patients were studied (six were tumour stage three, eight tumour stage four(a) and 11 tumour stage four(b)). Surgery was performed on 23 patients (92 per cent). Fifteen received post-operative radiotherapy. Mean follow up was 31.3 months (range, two to 99 months). Three-year disease-free survival was improved in patients with stage four tumour arising from the nasal fossa, versus other sites, and in those with stage four tumour treated with surgery plus adjuvant radiotherapy, versus other treatments. Patients with melanoma of the nasal cavity have very poor survival rates. Treatment is still based on adequate surgical resection with safe margins. In this study, post-operative radiotherapy improved local control only for stage four tumours.

Retrospective study of primary reconstruction of facial traumatic events.

PubMed

Chen, Baoguo; Song, Huifeng; Gao, Quanwen; Xu, Minghuo; Chai, Jiake

2017-02-01

Facial traumatic events are commonly encountered in plastic and reconstructive surgery. Primary reconstruction is a reliable procedure with function and aesthetic considerations. We conduct a retrospective study of the experience of reconstructing facial traumatic defects in the first stage. One hundred and thirty-two cases (aged 18-65) with facial traumatic events were recruited in the study from 2008 to 2014. Facial traumatic events included injured soft tissue, maxillofacial fractures and facial nerve rupture, which were repaired primarily. After primary reconstruction, encouraging functional and aesthetic outcomes were attained. Ten cases were re-operated to reconstruct partial nasal defect. Four patients who had trouble with disabled occluding relations sought help from dentists. Inconspicuous scar and function restoration were presented. Facial wounds should be reconstructed in the first stage as far as possible. Then, satisfactory functional and aesthetic results can be achieved. However, combined injury should be carefully considered in those traumatic cases before we carry out the reconstructive surgery on the face. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Preoperative Biometric Parameters Predict the Vault after ICL Implantation: A Retrospective Clinical Study.

PubMed

Zheng, Qian-Yin; Xu, Wen; Liang, Guan-Lu; Wu, Jing; Shi, Jun-Ting

2016-01-01

To investigate the correlation between the preoperative biometric parameters of the anterior segment and the vault after implantable Collamer lens (ICL) implantation via this retrospective study. Retrospective clinical study. A total of 78 eyes from 41 patients who underwent ICL implantation surgery were included in this study. Preoperative biometric parameters, including white-to-white (WTW) diameter, central corneal thickness, keratometer, pupil diameter, anterior chamber depth, sulcus-to-sulcus diameter, anterior chamber area (ACA) and central curvature radius of the anterior surface of the lens (Lenscur), were measured. Lenscur and ACA were measured with Rhinoceros 5.0 software on the image scanned with ultrasound biomicroscopy (UBM). The vault was assessed by UBM 3 months after surgery. Multiple stepwise regression analysis was employed to identify the variables that were correlated with the vault. The results showed that the vault was correlated with 3 variables: ACA (22.4 ± 4.25 mm2), WTW (11.36 ± 0.29 mm) and Lenscur (9.15 ± 1.21 mm). The regressive equation was: vault (mm) = 1.785 + 0.017 × ACA + 0.051 × Lenscur - 0.203 × WTW. Biometric parameters of the anterior segment (ACA, WTW and Lenscur) can predict the vault after ICL implantation using a new regression equation. © 2016 The Author(s) Published by S. Karger AG, Basel.

Comparison of expert and job-exposure matrix-based retrospective exposure assessment of occupational carcinogens in The Netherlands Cohort Study.

PubMed

Offermans, Nadine S M; Vermeulen, Roel; Burdorf, Alex; Peters, Susan; Goldbohm, R Alexandra; Koeman, Tom; van Tongeren, Martie; Kauppinen, T; Kant, Ijmert; Kromhout, Hans; van den Brandt, Piet A

2012-10-01

Reliable retrospective exposure assessment continues to be a challenge in most population-based studies. Several methodologies exist for estimating exposures retrospectively, of which case-by-case expert assessment and job-exposure matrices (JEMs) are commonly used. This study evaluated the reliability of exposure estimates for selected carcinogens obtained through three JEMs by comparing the estimates with case-by-case expert assessment within the Netherlands Cohort Study (NLCS). The NLCS includes 58,279 men aged 55-69 years at enrolment in 1986. For a subcohort of these men (n=1630), expert assessment is available for exposure to asbestos, polycyclic aromatic hydrocarbons (PAHs) and welding fumes. Reliability of the different JEMs (DOMJEM (asbestos, PAHs), FINJEM (asbestos, PAHs and welding fumes) and Asbestos JEM (asbestos) was determined by assessing the agreement between these JEMs and the expert assessment. Expert assessment revealed the lowest prevalence of exposure for all three exposures (asbestos 9.3%; PAHs 5.3%; welding fumes 11.7%). The DOMJEM showed the highest level of agreement with the expert assessment for asbestos and PAHs (κs=0.29 and 0.42, respectively), closely followed by the FINJEM. For welding fumes, concordance between the expert assessment and FINJEM was high (κ=0.70). The Asbestos JEM showed poor agreement with the expert asbestos assessment (κ=0.10). This study shows case-by-case expert assessment to result in the lowest prevalence of occupational exposure in the NLCS. Furthermore, the DOMJEM and FINJEM proved to be rather similar in agreement when compared with the expert assessment. The Asbestos JEM appeared to be less appropriate for use in the NLCS.

Study of constraints in using household NaCl salt for retrospective dosimetry

NASA Astrophysics Data System (ADS)

Elashmawy, M.

2018-05-01

Thermoluminescence (TL) characteristics of 5 different household NaCl salts and one analytical salt were determined to investigate the possible factors that affect the reliability of using household salt for retrospective dosimetry. Salts' TL sensitivities were found to be particle-size dependent and approached saturation at the largest size, whereas for salts that have the same particle size, the TL sensitivity depended on their origin. TL dependence on the particle size interprets significant variations in TL response reported in the literature for the same salt patch. The first TL readout indicated that all salts have similar glow curves with one distinctive peak. Typical second TL readout at two different doses showed a dramatic decrease in TL sensitivity associated with a significant change in the glow curve structure possessing two prominent peaks. Glow curve deconvolution (GCD) of the first TL readout for all salts yielded 6 individual glow peaks of first-order kinetics, whereas in GCD of second TL readouts, 5 individual glow peaks of second-order kinetics were obtained. Similarities in the glow curve structures of the first and second TL readouts suggest that additives such as KIO3 and MgCO3 have no effect on the TL process. Fading effect was evaluated for the salt of highest TL sensitivity, and it was found that the integral TL intensity decreased gradually and lost 40% of its initial value over 2 weeks, after which it remained constant. Results conclude that a household salt cannot be used for retrospective dosimetry without considering certain constraints such as the salt's origin and particle size. Furthermore, preparedness for radiological accidents and accurate dose reconstructions require that most of the commonly distributed household salt brands should be calibrated in advance and stored in a repository to be recalled in case of accidents.

Psychotropic Drug Prescription in Adolescents: A Retrospective Study in a Swiss Psychiatric University Hospital.

PubMed

Ansermot, Nicolas; Jordanov, Véronique; Smogur, Michal; Holzer, Laurent; Eap, Chin B

2018-04-01

This retrospective study aims to evaluate off-label prescriptions and administrations of psychotropic medications in adolescents in a university psychiatric hospital in Switzerland. Data were collected during the entire stays from the electronic database for 76 inpatients in 2008 and 76 inpatients in 2014. Data collected included gender, age, psychiatric diagnosis, duration of hospitalization, and psychotropic drug prescriptions and administrations. A total of 224 psychotropic drugs (mean 2.9 drugs/patient) were prescribed in 2008 and 268 (mean 3.5 drugs/patient) in 2014. Due to the prescriptions of some drugs as required, only 76% of the prescriptions were actually administered in 2008 (mean 2.3 drugs/patient) and 55% in 2014 (mean 1.9 drugs/patient). Antipsychotics were the most frequently prescribed drugs in 2008 (74% of patients) and 2014 (86% of patients). Anxiolytics were also highly prescribed in 2008 (54% of patients) and 2014 (66% of patients), as well as antidepressants in 2008 (30% of patients), but less in 2014 (13% of patients). Overall, 69% of prescriptions were found to be off label in 2008 and 68% in 2014, according to age, diagnosis, dose, or formulation as approved by Swissmedic. The medication classes with the highest rate of off-label prescriptions were antidepressants (100% for both years), antipsychotics (94% in 2008 and 92% in 2014), and hypnotics (67% in 2008 and 100% in 2014). For both study periods, at least one off-label psychotropic drug prescription and administration was recorded in 96% and 79% of the patients, respectively. The high rate of off-label psychotropic drug use strengthens the need for clinical trials to better evaluate the efficacy and safety of these treatments in adolescents.

Retrospective study of 68 implants placed in the pterygomaxillary region using drills and osteotomes.

PubMed

Peñarrocha, Miguel; Carrillo, Celia; Boronat, Araceli; Peñarrocha, Maria

2009-01-01

The aim of this study was to evaluate the success rate of implants placed in the pterygomaxillary region using drills and osteotomes with a minimum of 12 months' follow-up. Bone loss after 1 year of loading and patient satisfaction with the prosthesis were evaluated. A retrospective case study was made. The sample was composed of patients rehabilitated with pterygoid implants between January 2000 and January 2006. The inclusion criteria were patients in good general health with severe atrophy of the posterior maxilla who had been rehabilitated with one or two pterygoid implants inserted using drills and osteotomes and had been followed for 12 months after implant loading. Implant success was defined according to the criteria of Albrektsson et al. Bone loss was measured on panoramic radiographs on the mesial and distal of each implant, and the largest value (whether mesial or distal) was selected as the bone loss for the implant in question. Subjects indicated satisfaction with the new prosthesis on a visual analogue scale. Forty-five patients were treated with 268 implants (200 anterior and 68 pterygoid). The success rate of pterygoid implants was 97.05%. The mean bone loss around implants in the pterygomaxillary region after 1 year of loading was 0.71 mm (range, 0 to 3.20). All prostheses were stable at the end of the observation period. Patients were satisfied with comfort and stability, ability to speak, ease of cleaning, and esthetics and functionality of the prosthesis. Placement of implants in the posterior pterygomaxillary region using drills and osteotomes is a viable alternative treatment modality for rehabilitation of atrophic posterior maxilla. Patients were satisfied with a prosthesis supported by pterygoid implants.

A retrospective study of 370 patients with oral lichen planus in Turkey

PubMed Central

2013-01-01

Objectives: Although several detailed studies concerning the patient profile and clinical features of oral lichen planus have been undertaken all over the world in different populations, a similar study has not yet been conducted in a Turkish population. The purpose of this retrospective study was to describe the demographic and clinical characteristics of a group of patients with oral lichen planus in Turkey. Study Design: Charts of 370 patients, from the archive of Oral Diagnosis and Radiology Department of Marmara University Faculty of Dentistry (Istanbul, Turkey), with histologically confirmed clinical diagnosis of oral lichen planus in the period 1990-2010 were retrospectively reviewed. Results: Of the 370 patients, 260 (70.3%) were women and 110 (29.7%) were men. The mean age was 49.84±13.41 years (range of 16-83). The lesions were asymptomatic in 63 patients (17%). Nearly half of the patients (47.6%) had multiple sites of involvement. Predominantly red forms were the most frequent, affecting 60.5% of patients. Approximately 17% of the patients had symptoms of possible extraoral involvement. No evidence suggesting a connection between oral lichen planus and tobacco or alcohol use was found. Only one out of the 370 cases had histologically proven malignant transformation. Conclusions: The patient profile and clinical features of oral lichen planus in Turkey were generally similar to those described in other populations. The preponderance of the red forms and also the fact that majority of patients referred themselves to our clinic highlighted the lack of awareness among Turkish health care providers about lichen planus. Key words:Oral lichen planus, clinical features, patient profile. PMID:23524413

Retrospective clinical evaluation of gauze-based negative pressure wound therapy.

PubMed

Campbell, Penny E; Smith, Gary S; Smith, Jennifer M

2008-06-01

Negative pressure wound therapy (NPWT) is an established modality in the treatment of challenging wounds. However, most existing clinical evidence is derived from the use of open-cell polyurethane foam at -125 mmHg. Alternative negative pressure systems are becoming available, which use gauze at a pressure of -80 mmHg. This study describes clinical results from a retrospective non comparative analysis of 30 patients treated with Chariker-Jeter gauze-based negative pressure systems (V1STA, Versatile-1 and EZ-Care; Smith & Nephew, Inc.) in a long-term care setting. The mean age of the patients was 72 years. The wounds consisted of chronic (n = 11), surgical dehiscence (n = 11) and surgical incision (n = 8). Wound volume and area were recorded at commencement and at the cessation of therapy. Discontinuation of therapy was instigated upon closure through secondary intention or when size and exudate were sufficiently reduced that the wounds could be managed by conventional wound dressing (median 41 days). An overall median reduction in wound volume of 88.0% (P < 0.001) and a 68.0% reduction in area (P < 0.001) compared with baseline were observed over the course of NPWT. The overall rate of volume reduction (15.1% per week) compares favourably with published data from foam-based systems.

[Lens luxation in dogs: a retrospective study of 134 dogs (2000-2011)].

PubMed

Betschart; Hässig; Spiess

2014-03-01

This retrospective study evaluated cases of lens luxation in dogs that were documented at the University of Zurich Veterinary Teaching Hospital between 2000 and 2011. A total 134 dogs were included in the study. This population of dogs with lens luxation represents 0.41 % of all dogs presented to the Zurich Veterinary Teaching Hospital (32'523) and 3.02 % of all dogs presented to the ophthalmology service during the same time period. The 134 dogs represented over 40 different breeds, including mixed breeds. 63 of the dogs were male, 71 were female. The 134 dogs were divided in primary lens luxation (86 of the 134 dogs, 64 %) and secondary lens luxation (48 dogs, 36 %). The most frequent causes for secondary lens luxation were glaucoma (58 %), cataract (19 %) and trauma (17 %). This study shows the predisposition for primary lens luxations in terrier breeds, Chinese Crested dogs, Pinscher and Spitz. In contrast, Siberian Huskies, Basset Hounds, Bearded Collies, Cairn Terriers, mixed breed dogs, Bolonka Zwetna, Boston Terriers, Borzoi, Doberman, Eurasian, Leonberg, Luzerner Niederlaufhund and Weimaraner suffered significantly more often from secondary lens luxation. There was no sex predilection for primary or secondary lens luxation. Dogs with primary lens luxation were on average 7.39 ± 3.02 years old, which is significantly younger than the dogs with secondary lens luxation (9.12 ± 3.38 years). Dogs with primary lens luxation showed a significantly higher rate of a bilateral development than those with secondary lens luxation (85.5 % of the dogs with primary lens luxation and only 14.5 % of the dogs with secondary lens luxation showed it in both their eyes).

Sodium polystyrene sulfonate for the treatment of acute hyperkalemia: a retrospective study.

PubMed

Hagan, Amanda E; Farrington, Crystal A; Wall, Geoffrey C; Belz, Mark M

2016-01-01

Hyperkalemia is a common problem in hospitalized patients, especially those with underlying chronic kidney disease, but evidence-based guidelines for its treatment are lacking. Sodium polystyrene sulfonate (SPS), a cation exchange resin first approved by the FDA for the treatment of hyperkalemia in 1958, is frequently used alone or in conjunction with other medical therapies to lower serum potassium. Recently, the safety and efficacy of SPS have come into question based on multiple reported cases of bowel necrosis associated with SPS administration. The primary objective of this study was to evaluate the use of SPS for the treatment of hyperkalemia, at a large tertiary community teaching hospital, to determine its effectiveness and the incidence of related adverse side effects. A retrospective chart review was performed on all adult inpatients receiving single-dose SPS at a 466-bed tertiary community teaching hospital over a 3-year period. 501 patients received SPS for the treatment of hyperkalemia during their index hospital stay. Serum potassium levels decreased by 0.93 mEq/L on average at first recheck after SPS administration, with or without additional medical treatments. Our study identified 10 cases of hypernatremia (greater than 145 mEq/L), 31 cases of hypokalemia (less than 3.5 mEq/L), and 2 cases of bowel necrosis related to the administration of SPS. Our results suggest a serum potassium reduction of less than 1 mEq/L after administration of SPS for the treatment of acute hyperkalemia. Additionally, this study offers some evidence that the use of SPS may be associated with harm. We further note the need for standardized guidelines for the treatment of hyperkalemia at our institution.

Alveolar Ridge Reconstruction with Titanium Meshes and Simultaneous Implant Placement: A Retrospective, Multicenter Clinical Study

PubMed Central

Paraud Freixas, Andres; Han, Chang-Hun; Bechara, Sohueil; Tawil, Isaac

2016-01-01

Objective. To evaluate horizontal bone gain and implant survival and complication rates in patients treated with titanium meshes placed simultaneously with dental implants and fixed over them. Methods. Twenty-five patients treated with 40 implants and simultaneous guided bone regeneration with titanium meshes (i–Gen®, MegaGen, Gyeongbuk, Republic of Korea) were selected for inclusion in the present retrospective multicenter study. Primary outcomes were horizontal bone gain and implant survival; secondary outcomes were biological and prosthetic complications. Results. After the removal of titanium meshes, the CBCT evaluation revealed a mean horizontal bone gain of 3.67 mm (±0.89). The most frequent complications were mild postoperative edema (12/25 patients: 48%) and discomfort after surgery (10/25 patients: 40%); these complications were resolved within one week. Titanium mesh exposure occurred in 6 patients (6/25 : 24%): one of these suffered partial loss of the graft and another experienced complete graft loss and implant failure. An implant survival rate of 97.5% (implant-based) and a peri-implant marginal bone loss of 0.43 mm (±0.15) were recorded after 1 year. Conclusions. The horizontal ridge reconstruction with titanium meshes placed simultaneously with dental implants achieved predictable satisfactory results. Prospective randomized controlled trials on a larger sample of patients are required to validate these positive outcomes. PMID:27999799

Association of Torsion With Testicular Cancer: A Retrospective Study.

PubMed

Uguz, Sami; Yilmaz, Sercan; Guragac, Ali; Topuz, Bahadır; Aydur, Emin

2016-02-01

Testicular torsion is a medical emergency that usually requires surgical exploration. However, testicular malignancy has been anecdotally reported with the association of torsion in surgical specimens, and the published data remain scant on the association of torsion with testicular tumors. By retrospective medical record review, we identified 32 patients who had been diagnosed with testicular torsion, 20 of whom had undergone orchiectomy. Of these 20 patients, 2 were diagnosed with a malignancy. Our study, the largest case series to date, has shown an association between testicular torsion and testicular cancer of 6.4%. Testicular torsion is a medical emergency that usually requires surgical exploration. However, testicular malignancy has been anecdotally reported in association with torsion in surgical specimens. However, the published data remain scant on the association between torsion and the presence of testicular tumors. The present retrospective study explored the association between torsion and testicular cancer in patients with testicular torsion undergoing orchiectomy during scrotal exploration. A medical record review was performed of patients who had had a diagnosis of testicular torsion from January 2003 to February 2015. The clinicopathologic characteristics of the patients were recorded. A total of 32 patients were identified. Their mean age was 21.1 years (range, 7-39 years). All the patients had unilateral testicular torsion, which affected the left side in 17 and the right side in 15. Manual detorsion was successful in 6 patients, and 26 patients underwent emergency surgery with testicular detorsion (6 fixation surgery and 20 orchiectomy). The type of incision was scrotal in 6, inguinal in 10, and unspecified in 4. Pathologic examination of the orchiectomy specimens showed malignancy in 2 cases (seminoma and malign mixed germ cell tumor). To the best of our knowledge, the present single-center case series is the largest case series to date of

Retrospective population cohort study on hip fracture risk associated with zolpidem medication.

PubMed

Lin, Fang-Yu; Chen, Pei-Chun; Liao, Chun Hui; Hsieh, Yow-Wen; Sung, Fung-Chang

2014-04-01

Few studies have evaluated the hip fracture risk for zolpidem users. We assessed the risk for subjects taking zolpidem. Population-based retrospective cohort study using claims data of a universal insurance system. We identified 6,978 patients newly prescribed for zolpidem in 2000-2001 age 18 y and older, and 27,848 nonusers frequency matched with sex, age, and date visiting a clinic. Both cohorts were followed up to the end of 2008 to measure the hip fracture incidence and risk, which considered factors such as sex, age, occupation, days of drug use, and osteoporosis status. The zolpidem users had a 2.23-fold higher hip fracture incidence than nonusers (3.10 versus 1.39 per 1,000 person-y). The risk increased with age for both cohorts. The elderly users had a 21-fold higher incidence than the younger users, or twofold higher than the elderly nonusers. Among 33 patients (20.4%) with hip fracture occurring during presumed medication days, which was accountable for an incidence of 1,083.0 per 1,000 person-y. Those taking the medicine for 8 days or longer had a moderately higher fracture rate than those taking it for less days (6.02 versus 4.48 per 100 person-times) with a ratio of 1.34 (95% confidence interval 0.42-4.56). Subjects with blue collar occupations were at a higher fracture risk. The hip fracture risk of zolpidem users is higher than that of nonusers. Fracture prevention awareness should be disseminated to the users.

Denture-induced fibrous inflammatory hyperplasia: a retrospective study in a school of dentistry.

PubMed

Coelho, C M; Zucoloto, S; Lopes, R A

2000-01-01

The aim of this study was to investigate the denture-induced fibrous inflammatory hyperplasia (FIH) that occurs around the borders of an ill-fitting denture, in relation to frequency of the lesion, age and sex distribution, length of denture use, and frequency of dysplasia. A comprehensive review of FIH diagnosed in patients wearing dentures by the oral pathology diagnostic service at the University of São Paulo over 26 years (1971 to 1996) was undertaken, based on retrospective analysis of the oral histopathologic files. The frequency of FIH was 15% of the total number of pathologies diagnosed at the service of oral pathology in that period. The disorder occurred predominantly in the fifth and sixth decades of life and more often among females, at a proportion of 5:1. The frequency of FIH was higher for a length of denture use of between 1 and 10 years. Dysplasia was found in 4% of cases. The knowledge of some aspects of FIH, especially the possible histologic alteration of dysplasia, supports the importance of the diagnosis and treatment of the lesion and suggests that any excised tissue should be submitted to histopathologic evaluation. Education and regular review of patients who have worn dentures are essential if the development of FIH is to be prevented.

Gall bladder mucoceles and their association with endocrinopathies in dogs: a retrospective case-control study.

PubMed

Mesich, M L L; Mayhew, P D; Paek, M; Holt, D E; Brown, D C

2009-12-01

To investigate the relationship between endocrinopathies and diagnosis of gall bladder mucocele in dogs via a retrospective case-control study. Records of 78 dogs with a surgical or ultrasonographic diagnosis of gall bladder mucocele were examined for the presence or absence of hyperadrenocorticism, hypothyroidism and diabetes mellitus. Two age- and breed-matched controls for each gall bladder mucocele dog (156 total control dogs) were examined for the same concurrent diseases. A matched case-control analysis was performed using conditional logistic regression. The odds of mucocele in dogs with hyperadrenocorticism were 29 times that of dogs without hyperadrenocorticism (P=0.001; 95 per cent CI 3.8, 219.9). No difference was found between dogs with and without diabetes mellitus. Although a significant association was found between gall bladder mucocele and hypothyroidism, potential observation bias was also identifi ed. Hyperadrenocorticoid dogs that were presented for acute illness with laboratory evidence of hepatobiliary disease should undergo evaluation for the presence of a biliary mucocele. Dogs diagnosed with a gall bladder mucocele should be screened for concurrent hyperadrenocorticism if clinical suspicion exists.

Prevalence of oral lichen planus in Iranian children and adolescents: a 12-year retrospective study.

PubMed

Bakhtiari, S; Taheri, J B; Toossi, P; Azimi, S; Kawosi Nezhad, Sh

2017-12-01

To investigate the prevalence of oral lichen planus in patients younger than 18 years, referred to a dermatology centre in Iran during 2002-2014. Lichen planus is a chronic inflammatory, immune-mediated disease that could affect the oral mucosa and is a pre-cancerous condition. The disease usually develops in middle age with female predominance and is rare in children. In this retrospective study, cases with definitive histopathologic diagnosis of lichen planus, over a 12-year period from 2002 to 2014 from a dermatologic hospital archive were evaluated. The prevalence of both cutaneous and oral lichen planus, the male:female ratio and site of involvement were calculated using SPSS version 21. Thirty-six of 564 patients younger than 18 years old diagnosed with lichen planus. Two females (0.4%) had oral lichen planus. One patient had erosive, and one had bullous, oral lichen planus. Oral lichen planus had a very low frequency in Iranian population younger than 18 years old, identifying these patients is recommended for long-term follow-up.

Systemic amyloidosis in inflammatory bowel disease: retrospective study on its prevalence, clinical presentation, and outcome.

PubMed

Serra, Isabel; Oller, Blanca; Mañosa, Míriam; Naves, Juan E; Zabana, Yamile; Cabré, Eduard; Domènech, Eugeni

2010-09-01

Systemic amyloidosis is a rare but life-threatening complication of inflammatory bowel disease (IBD), most cases being reported among Crohn's disease (CD) patients. The only two available retrospective studies showed a prevalence ranging from 0.9% to 3% among CD patients. To evaluate the prevalence of secondary systemic amyloidosis in a large IBD cohort of a referral centre, and to describe its clinical characteristics and outcome. Patients diagnosed with amyloidosis were identified among 1006 IBD patients included in the IBD database of our centre, and their medical records were carefully reviewed. Among a total of 1006 IBD patients, 5 cases of amyloidosis were identified, all of them with CD, resulting in a prevalence of 0.5% for IBD and 1% for CD. Two patients died after developing renal failure. Two patients were treated with anti-TNF agents, showing a clinical improvement of their amyloidosis. Secondary amyloidosis occurs mainly in long-lasting, complicated, Crohn's disease and seems to be as prevalent among IBD patients as previously reported. Copyright © 2009 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Neighborhood socioeconomic disadvantage and 30-day rehospitalization: a retrospective cohort study.

PubMed

Kind, Amy J H; Jencks, Steve; Brock, Jane; Yu, Menggang; Bartels, Christie; Ehlenbach, William; Greenberg, Caprice; Smith, Maureen

2014-12-02

Measures of socioeconomic disadvantage may enable improved targeting of programs to prevent rehospitalizations, but obtaining such information directly from patients can be difficult. Measures of U.S. neighborhood socioeconomic disadvantage are more readily available but are rarely used clinically. To evaluate the association between neighborhood socioeconomic disadvantage at the census block group level, as measured by the Singh validated area deprivation index (ADI), and 30-day rehospitalization. Retrospective cohort study. United States. Random 5% national sample of Medicare patients discharged with congestive heart failure, pneumonia, or myocardial infarction between 2004 and 2009 (n = 255,744). Medicare data were linked to 2000 census data to construct an ADI for each patient's census block group, which were then sorted into percentiles by increasing ADI. Relationships between neighborhood ADI grouping and 30-day rehospitalization were evaluated using multivariate logistic regression models, controlling for patient sociodemographic characteristics, comorbid conditions and severity, and index hospital characteristics. The 30-day rehospitalization rate did not vary significantly across the least disadvantaged 85% of neighborhoods, which had an average rehospitalization rate of 21%. However, within the most disadvantaged 15% of neighborhoods, rehospitalization rates increased from 22% to 27% with worsening ADI. This relationship persisted after full adjustment, with the most disadvantaged neighborhoods having a rehospitalization risk (adjusted risk ratio, 1.09 [95% CI, 1.05 to 1.12]) similar to that of chronic pulmonary disease (adjusted risk ratio, 1.06 [CI, 1.04 to 1.08]) and greater than that of uncomplicated diabetes (adjusted risk ratio, 0.95 [CI, 0.94 to 0.97]). No direct markers of care quality or access. Residence within a disadvantaged U.S. neighborhood is a rehospitalization predictor of magnitude similar to chronic pulmonary disease. Measures of

Trends in Early Aspirin Use Among Patients With Acute Myocardial Infarction in China, 2001–2011: The China PEACE‐Retrospective AMI Study

PubMed Central

Gao, Yan; Masoudi, Frederick A.; Hu, Shuang; Li, Jing; Zhang, Haibo; Li, Xi; Desai, Nihar R.; Krumholz, Harlan M.; Jiang, Lixin

2014-01-01

Background Aspirin is an effective, safe, and inexpensive early treatment of acute myocardial infarction (AMI) with few barriers to administration, even in countries with limited healthcare resources. However, the rates and recent trends of aspirin use for the early treatment of AMI in China are unknown. Methods and Results Using data from the China Patient‐centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction (China PEACE‐Retrospective AMI Study), we identified a cohort of 14 041 patients with AMI eligible for early aspirin therapy. Early use of aspirin for AMI increased over time (78.4% in 2001, 86.5% in 2006, and 90.0% in 2011). However, about 15% of hospitals had a rate of use of <80% in 2011. Treatment was less likely in patients who were older, presented with cardiogenic shock at admission, presented without chest discomfort, had a final diagnosis of non‐ST‐segment elevation acute myocardial infarction, or did not receive reperfusion therapy. Hospitalization in rural regions was also associated with aspirin underuse. Conclusions Despite improvements in early use of aspirin for AMI in China, there remains marked variation in practice and opportunities for improvement that are concentrated in some hospitals and patient groups. Clinical Trial Registration URL: ClinicalTrials.gov Unique identifier: NCT01624883. PMID:25304853

Phrenic nerve injury after radiofrequency ablation of lung tumors: retrospective evaluation of the incidence and risk factors.

PubMed

Matsui, Yusuke; Hiraki, Takao; Gobara, Hideo; Uka, Mayu; Masaoka, Yoshihisa; Tada, Akihiro; Toyooka, Shinichi; Mitsuhashi, Toshiharu; Mimura, Hidefumi; Kanazawa, Susumu

2012-06-01

To retrospectively investigate the incidence of and risk factors for phrenic nerve injury after radiofrequency (RF) ablation of lung tumors. The study included 814 RF ablation procedures of lung tumors. To evaluate the development of phrenic nerve injury, chest radiographs obtained before and after the procedure were examined. Phrenic nerve injury was assumed to have developed if the diaphragmatic level was elevated after the procedure. To identify risk factors for phrenic nerve injury, multiple variables were compared between cases of phrenic nerve injury and randomly selected controls by using univariate analyses. Multivariate analysis was then performed to identify independent risk factors. Evaluation of phrenic nerve injury from chest radiographs was possible after 786 procedures. Evidence of phrenic nerve injury developed after 10 cases (1.3%). Univariate analysis revealed that larger tumor size (≥ 20 mm; P = .014), proximity of the phrenic nerve to the tumor (< 10 mm; P < .001), the use of larger electrodes (array diameter or noninsulated tip length ≥ 3 cm; P = .001), and higher maximum power applied during ablation (≥ 100 W; P < .001) were significantly associated with the development of phrenic nerve injury. Multivariate analysis demonstrated that the proximity of the phrenic nerve to the tumor (< 10 mm; P < .001) was a significant independent risk factor. The incidence of phrenic nerve injury after RF ablation was 1.3%. The proximity of the phrenic nerve to the tumor was an independent risk factor for phrenic nerve injury. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

Efficacy of low-dose radiotherapy in painful gonarthritis: experiences from a retrospective East German bicenter study

PubMed Central

2013-01-01

Purpose To evaluate the efficacy of low-dose radiotherapy in painful gonarthritis. Methods We assessed the medical records of 1037 patients with painful gonarthritis who had undergone low-dose radiotherapy between 1981 and 2008. The subjective patient perception of the response to irradiation as graded immediately or up to two months after the completion of a radiotherapy series was evaluated and correlated with age, gender, radiological grading and the duration of symptoms before radiotherapy. Moreover, we performed a mail survey to obtain additional long-term follow-up information and received one hundred and six evaluable questionnaires. Results We assessed 1659 series of radiotherapy in 1037 patients. In 79.3% of the cases the patients experienced a slight, marked or complete pain relief immediately or up to two months after the completion of radiotherapy. Gender, age and the duration of pain before radiotherapy did not have a significant influence on the response to irradiation. In contrast, severe signs of osteoarthritis were associated with more effective pain relief. In more than 50% of the patients who reported a positive response to irradiation a sustained period of symptomatic improvement was observed. Conclusions Our results confirm that low-dose radiotherapy is an effective treatment for painful osteoarthritis of the knee. In contrast to an earlier retrospective study, severe signs of osteoarthritis constituted a positive prognostic factor for the response to irradiation. A randomized trial is urgently required to compare radiotherapy with other treatment modalities. PMID:23369282

A retrospective cohort study of suspected child maltreatment cases resulting in hospitalization.

PubMed

Friedman, Lee S; Sheppard, Shirley; Friedman, Daniel

2012-11-01

Although the incidence and risk factors of child abuse have been well researched, there continues to be a need for large studies that provide information regarding the process of recognizing children whose health and lives are most seriously threatened by abuse and neglect, in particular children requiring hospitalization as a result of child abuse. The purpose of this study was to (1) describe differences in the type of injuries and illnesses of children hospitalized for abuse and neglect and (2) assess the relationship between in-hospital mortality and child maltreatment. For this retrospective cohort study, child maltreatment cases were identified using medical record databases of patients treated in all hospitals and trauma units in Illinois. A comparison group of children not suffering from suspected maltreatment were randomly selected and matched by age and data source to the suspected maltreatment cases. 2656 children under the age of 13 years suspected of suffering maltreatment who were admitted to any hospital in Illinois between 2000 and 2009. The analysis showed distinct patterns in injury, physical illness and psychological disorders for each subgroup of maltreatment cases. Among the cases of maltreatment 75.6% were discharged home, 2.9% into child protective services and 15.8% to an intermediate care facility. In the final multivariable conditional logistic regression model, children suffering maltreatment continued to have a higher odds of dying during hospitalization (adjusted OR=2.99; CI95%: 1.63, 5.45; p<0.001). There were distinct diagnostic patterns and outcomes among suspected cases of child maltreatment admitted to Illinois hospitals over a 10-year period. This large retrospective cohort study confirms findings reported in many smaller studies and larger national cross-sectional surveys. Copyright © 2012 Elsevier Ltd. All rights reserved.

Recurrence of cystic echinococcosis in an endemic area: a retrospective study.

PubMed

Velasco-Tirado, Virginia; Romero-Alegría, Ángela; Belhassen-García, Moncef; Alonso-Sardón, Montserrat; Esteban-Velasco, Carmen; López-Bernús, Amparo; Carpio-Perez, Adela; Jimenez López, Marcelo Fernando; Muñoz Bellido, Juan Luis; Muro, Antonio; Cordero-Sanchez, Miguel; Pardo-Lledias, Javier; Muñoz-Bellvis, Luis

2017-06-27

Cystic echinococcosis (CE) is a chronic, complex and neglected zoonotic disease. CE occurs worldwide. In humans, it may result in a wide spectrum of clinical manifestations, ranging from asymptomatic infection to fatal disease. Clinical management procedures have evolved over decades without adequate evaluation. Despite advances in surgical techniques and the use of chemotherapy, recurrence remains one of the major problems in the management of hydatid disease. The aim of this study was to determine the frequency of CE recurrence and the risk factors involved in recurrence. A descriptive longitudinal-retrospective study was designed. We reviewed all patients diagnosed with CE according to ICD-9 (code 122-0 to 122-9) criteria admitted at Complejo Asistencial Universitario de Salamanca, Spain, between January 1998 and December 2015. Among the 217 patients studied, 25 (11.5%) had a hydatid recurrence after curative intention treatment. Median duration of recurrence's diagnosis was 12.35 years (SD: ±9.31). The likelihood of recurrence was higher [OR = 2.7; 95% CI, 1.1-7.1; p < 0.05] when the cyst was located in organs other than liver and lung, 22.6% (7/31) vs 14.2% (31/217) in the cohort. We detected a chance of recurrence [OR = 2.3; 95% CI, 1.4-6.5; p > 0.05] that was two times higher in those patients treated with a combination of antihelminthic treatments and surgical intervention (20/141, 14.2%) than in patients treated with surgical intervention alone (5/76, 6.6%). Despite advances in diagnosis and therapeutic techniques in hydatid disease, recurrence remains one of the major problems in the management of hydatid disease. The current management and treatment of recurrences is still largely based on expert opinion and moderate-to-poor quality of evidence. Consequently, large prospective and multicenter studies will be needed to provide definitive recommendations for its clinical management.

Guiding the Design of Evaluations of Innovations in Health Informatics: a Framework and a Case Study of the SMArt SHARP Evaluation

PubMed Central

Ramly, Edmond; Brennan, Patricia Flatley

2012-01-01

Development of health information systems innovations is necessary to create a better future for health and health care, but evaluating them is challenging. This paper examines the problem of evaluating health IT projects in which innovation is agile, adaptive, and emergent, and in which innovation diffusion and production are interlinked. We introduce a typology of mindsets for evaluation design that are typically used in health informatics: optimality, contingency, and usefulness, and make the case for a modularity mindset. We propose a model that shifts the unit of analysis from an evaluation as a whole, to specific modules of an evaluation, such as purpose, target, and methods. We then use retrospective participant observation to illustrate the approach using a case study: the ONC SHARP Harvard project developing the SMArt platform (smartplaforms.org). We find that the proposed modular approach to evaluation design provides a balanced alternative to standard archetypical designs on the one hand, and fully custom-made designs, on the other hand. PMID:23304417

A retrospective evaluation of coral snake envenomation in dogs and cats: 20 cases (1996-2011).

PubMed

Pérez, Mayrim L; Fox, Karlie; Schaer, Michael

2012-12-01

To describe the clinical signs, treatment, and outcomes of dogs and cats following envenomation by the eastern coral snake and to report our clinical experience with the use of Coralmyn. Retrospective study (1996-2011). University teaching hospital. Sixteen dogs and 4 cats with eastern coral snake envenomation. Medical records meeting the study inclusion criteria were reviewed and evaluated for signalment, date and time of the snake encounter, elapsed time between encounter and hospital examination, initial physical examination findings, antivenom type, length of hospitalization, and outcome. Initial physical examination findings included: quiet mentation, tetraparesis, ptyalism, tachypnea, abdominal breathing, shallow breathing, decreased to absent gag reflex, ataxia, muscle fasciculations, and decreased spinal reflexes. Laboratory findings in dogs included proteinuria, bilirubinuria, hemeproteinuria, increased aspartate aminotransferase activity, increased alanine aminotransferase activity, and hemolysis. Four dogs and 2 cats received Coralmyn and 4 dogs received North American Coral Snake Antivenom. Adverse reaction to antivenom was suspected in 1 dog that received North American Coral Snake Antivenom. Eight of 11 envenomated dogs survived with a median length of hospitalization of 4.5 days. Two of 3 envenomated cats survived with a median length of hospitalization of 4 days. Two dogs were euthanized, 1 dog suffered acute respiratory arrest, and 1 cat developed tachycardia that progressed to pulseless electrical activity. Five dogs and 1 cat in the encounter group survived to discharge. Diagnosis of eastern coral snake envenomation is likely in the dog that has concomitant lower motor neuron neuropathy, bulbar palsy, and hemolysis. Early diagnosis is crucial as antivenom administration can reduce morbidity. Prognosis is considered good with 71% of the envenomated patients in this study surviving to discharge. Supportive care that may include ventilator

REOX: Evaluation of the Efficacy of Retreatment With an Oxaliplatin-containing Regimen in Metastatic Colorectal Cancer: A Retrospective Single-center Study.

PubMed

Costa, Talita; Nuñez, Jose; Felismino, Tiago; Boente, Leonardo; Mello, Celso

2017-12-01

Treatment of metastatic colorectal adenocarcinoma (mCRC) has evolved, and survival is over 30 months in contemporary trials. Nevertheless, there is a paucity of effective regimes after the first or second-line treatment. Thus, reexposure to previously used drugs has become a treatment strategy for some patients. We aimed to evaluate the efficacy of retreatment with an oxaliplatin-containing regimen in mCRC and correlate this with clinicopathologic features. We retrospectively analyzed 83 patients with mCRC who underwent reexposure to oxaliplatin (REOX). REOX was defined as a second trial of an oxaliplatin-containing regimen after a previous failure. Primary endpoint was time to treatment failure (TTF). The median age was 53.5 years, and the female/male ratio was 51.8%/48.2%. The site of the primary tumor was colon (67.5%) and rectal (32.5%). KRAS was mutated in 39.8%. Liver-limited metastasis was found in 19.3% of patients. The main regimen was 5-fluorouracil, levoleucovorin, and oxaliplatin (mFOLFOX6) (84.3%). Bevacizumab and cetuximab were used in 42.2% and 6% of patients, respectively. REOX was used in the third and fourth lines in 48.2% and 25.3% of patients, respectively. The median TTF after REOX was 6.04 months. Overall survival (OS) was 10.04 months. Disease control (complete response + partial response + stable disease) was observed in 56.6%, whereas 42.2% had progressive disease. Partial response + complete response to previous oxaliplatin was predictive of prolonged OS. Patients who attained disease control had better median OS compared with those with progressive disease (14.5 vs. 6.24 months; P < .0001). In the setting of heavily pretreated patients with mCRC, REOX was an effective treatment, with mTTF of 6.04 months in our cohort. Selection of patients with the longest time since previous oxaliplatin can translate in better outcome. Further studies should be conducted to confirm our data. Copyright © 2017 Elsevier Inc. All rights reserved.

Critical evaluation of lung scintigraphy in cystic fibrosis: study of 113 patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Piepsz, A.; Wetzburger, C.; Spehl, M.

1980-10-01

A long-term study has been performed on 285 lung perfusion scintigrams obtained from 113 patients with cystic fibrosis. Transverse and longitudinal comparisons with clinical and radiological scores, as well as retrospective analysis of the deceased patients, were the methods used in order to evaluate the importance of the scintigraphic images. It appears that lung scintigraphy is the best index of the regional lung impairment, and contributes, as does a chest radiograph, to the early detection of lung lesions, the two methods being complementary.

Implementation of Venous Thromboembolism Prophylaxis Guidelines in Clinical Practice: A Retrospective Study in Two Croatian Hospitals.

PubMed

Marušić, Srećko; Knežević, Aleksandar; Bačić Vrca, Vesna; Marinović, Ivana; Bačić, Julija; Obreli Neto, Paulo Roque; Amidžić Klarić, Daniela; Diklić, Dijaneta

2017-12-01

The aim of this study was to evaluate the implementation of the 9th edition of the American College of Chest Physicians (ACCP9) guidelines for prevention of venous thromboembolism in nonsurgical patients in clinical practice in one university and one general Croatian hospital. A retrospective study was conducted at Zadar General Hospital from Zadar and Dubrava University Hospital from Zagreb. Medical charts of all patients admitted to Medical Departments in two periods, before and after implementation of the ACCP9 guidelines, were analyzed. The ACCP9 guidelines were made available to all physicians through the hospital electronic information system immediately after the publication. The Hospital Drug Committees promoted implementation of the guidelines during their periodical clinical visits. Overall, 850 patients were included in the study in two periods. There was no statistically significant difference in the number of high-risk patients receiving thromboprophylaxis after the guidelines implementation in either hospital. In both periods, a signifi-cantly higher number of high-risk patients received thromboprophylaxis in Dubrava University Hos-pital in comparison with Zadar General Hospital (31.7% vs. 3.8% and 40.3% vs. 7.3%, respectively; p<0.001). This study revealed insufficient implementation of evidence-based thromboprophylaxis guidelines in clinical practice in two Croatian hospitals.

Occupational rhinitis in the Slovak Republic--a long-term retrospective study.

PubMed

Perečinský, Slavomir; Legáth, L'ubomír; Varga, Marek; Javorský, Martin; Bátora, Igor; Klimentová, Gabriela

2014-12-01

Allergic and non-allergic rhinitis ranks among the common occupational health problems. However, data on the incidence of occupational rhinitis are lacking, since comprehensive studies are rare. The study includes a group of patients in the Slovak Republic who were reported as having occupational rhinitis in the years 1990-2011. The following parameters were tracked in the investigated sample: age, gender, number of cases by individual years, occupations, causative factors and the length of exposure to the given agent. Possible progression of rhinitis to bronchial asthma was evaluated as well. The diagnostic algorithm was also analysed retrospectively, which included skin tests, the examination of specific IgE antibodies and nasal provocation tests. A total of 70 cases of occupational rhinitis were reported. The disease most often occurred in food industry workers (50% of cases). The most common aetiological factor was flour. Among other relatively common allergens were synthetic textile, wool, cotton and different types of moulds. Significant agents were also different chemical factors causing allergic and irritant rhinitis. The average length of exposure was 14.8 years. Exposure was shorter in men than in women (11 years vs. 16 years) (p = 0.04). Bronchial asthma as a comorbidity was diagnosed in 13 patients (19.7%). The critical diagnostic method on the basis of which the causal association between rhinitis and work environments was confirmed in 59% of cases was skin test; confirmation of the occupational cause using nasal provocation test was less frequent (18%). Food industry, textile industry and agriculture were the most risky occupational environments. Workers in these sectors require preventive intervention. In case of showing rhinitis symptoms it is necessary to confirm the occupational aetiology of the disease by the objective diagnostic methods. Since occupational rhinitis mostly precedes the occupational asthma, the elimination from the workplace is

Methotrexate use in allergic contact dermatitis: a retrospective study.

PubMed

Patel, Ashaki; Burns, Erin; Burkemper, Nicole M

2018-03-01

Methotrexate, a folate antimetabolite, is used to treat atopic dermatitis and psoriasis. Although methotrexate's therapeutic efficacy has been noted in the literature, there are few data on the efficacy of methotrexate treatment for allergic contact dermatitis. To evaluate the efficacy and tolerability of methotrexate in treating allergic contact dermatitis at a single institution, and also to assess methotrexate efficacy in patients with chronic, unavoidable allergen exposure. We performed a retrospective chart review of 32 patients diagnosed with allergic contact dermatitis by positive patch test reactions, and who received treatment with methotrexate from November 2010 to November 2014. Demographic and treatment-associated data were collected from electronic medical records. Ten patients were identified as allergen non-avoiders secondary to their occupation, and were subgrouped as such. Seventy-eight per cent (25/32) of patients showed either a partial or a complete response. Methotrexate had a comparable efficacy rate in the allergen non-avoiders subset, at 10 of 10. Of the 32 patients, 23% (5/22) had complete clearance of their dermatitis, and 1/10 of allergen non-avoiders had complete clearance of their dermatitis. Methotrexate is a well-tolerated and effective treatment for allergic contact dermatitis, and shows comparable efficacy to immunomodulatory agents such as cyclosporine and azathioprine, with robust efficacy despite persistent allergen exposure in patients with allergic contact dermatitis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Serum Liver Fibrosis Markers for Predicting the Presence of Gastroesophageal Varices in Liver Cirrhosis: A Retrospective Cross-Sectional Study

PubMed Central

Li, Hongyu; Chen, Jiang; Xia, Chunlian; Peng, Ying; Dai, Junna; Hou, Yue; Deng, Han; Li, Jing; Guo, Xiaozhong

2015-01-01

Background and Aims. A retrospective cross-sectional study was conducted to evaluate the role of hyaluronic acid (HA), laminin (LN), amino-terminal propeptide of type III procollagen (PIIINP), and collagen IV (CIV) in predicting the presence of gastroesophageal varices (GEVs) in patients with liver cirrhosis. Methods. We enrolled 118 patients with liver cirrhosis who underwent the tests for the four serum liver fibrosis markers and upper gastrointestinal endoscopy at the same admissions. The predictive values of the four serum liver fibrosis markers were evaluated by the areas under the receiving operator characteristics curves (AUROCs) with 95% confidence intervals (CIs). Results. The prevalence of GEVs was 88% (104/118). The AUROCs for HA, LN, PIIINP, and CIV levels in predicting the presence of GEVs were 0.553 (95% CI: 0.458 to 0.644, P = 0.5668), 0.490 (95% CI: 0.397 to 0.584, P = 0.9065), 0.622 (95% CI: 0.528 to 0.710, P = 0.1099), and 0.560 (95% CI: 0.466 to 0.652, P = 0.4909). The PIIINP level at a cut-off value of 31.25 had a sensitivity of 73.1% and a specificity of 57.1%. Conclusions. The present study did not recommend HA, LN, PIIINP, and CIV levels to evaluate the presence of GEVs in liver cirrhosis. PMID:26770190

Patients' Characteristics, Histopathological Findings, and Tumor Stage in Different Types of Malignant Melanoma: A Retrospective Multicenter Study.

PubMed

Farahmand, Ali-Mohammad; Ehsani, Amir-Hoshang; Mirzaei, Mojtaba; Mohsenian, Maryam; Ghanadan, Alireza

2017-05-01

Cutaneous malignant melanoma (CMM) is currently the most fatal of skin cancers accounting for 50000 deaths annually. Five distinct melanomas are described histopathologically: superficial spreading, lentigo maligna, nodular, acral lentiginous and mucosal melanoma. The aim of this study was to investigate the characteristics of patients with various types of malignant melanoma and evaluate histopathological findings. In this retrospective study, we obtained our data from the records of 111 patients with melanoma. Biopsied specimens were collected and re-evaluated. Demographic information and histopathological findings were noted. SPSS 16 was used for analyzing data. Chi-square and one-way ANOVA was conducted for comparing categorical and numerical variables respectively. The mean age of patients was 59.33±14.68 years old. Most common melanoma type was acral lentiginous (40.5%), followed by nodular (35.1%) and mucosal (10.8%). The highest tumor thickness was viewed in nodular melanoma followed by mucosal melanoma. The highest rate of metastasis, microsatellitosis, perineural invasion and Clark level of the invasion were reported in nodular and acral lentiginous respectively. The most frequent rate of ulceration and vascular invasion was reported in mucosal melanoma. Distribution of melanoma types varies largely in different regions. Lack of classic presentations in some types necessitate specific public education about warning signs. Histopathological and pathological characteristics in melanoma can aid in better staging and management of the tumor.

Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study.

PubMed

Marschalek, Marie-Louise; Worda, Christof; Kuessel, Lorenz; Koelbl, Heinz; Oberaigner, Willi; Leitner, Hermann; Marschalek, Julian; Husslein, Heinrich

2018-03-14

In view of the reported increase in obstetric anal sphincter injuries, the objective of this study was to evaluate the incidence of such injuries over time and the associated risk and protective factors. This was a retrospective cohort study from a national database of 168 137 primiparous women with term, singleton, cephalic, vaginal delivery between 2008 and 2014. The main outcome measure was obstetric anal sphincter injury. A multivariate regression model was used to identify risk and protective factors. Age >19 years, birthweight >4000 g, and operative vaginal delivery were independent risk factors for obstetric anal sphincter injuries. Mediolateral episiotomy increased the risk for obstetric anal sphincter injuries in spontaneous vaginal birth (number needed to harm 333), whereas it was protective in vacuum delivery (number needed to treat 50). From 2008 to 2014, there was an increase in the rate of obstetric anal sphincter injuries (2.1% vs 3.1%, P < .01), vacuum deliveries (12.1% vs 12.8%, P < .01), and cesarean delivery after labor (17.1% vs 19.4%, P < .01), while forceps deliveries (0.4% vs 0.1%, P < .01) and episiotomy rate decreased (35.9% vs 26.4%, P < .01). Episiotomy may be a risk or protective factor depending on the type of episiotomy and the clinical setting in which it is used. Our study supports a restrictive use of mediolateral episiotomy in spontaneous vaginal deliveries. In vacuum deliveries mediolateral episiotomy may help prevent obstetric anal sphincter injuries. © 2018 the Authors. Birth published by Wiley Periodicals, Inc.

Applied Pharmacokinetics: Course Description and Retrospective Evaluation.

ERIC Educational Resources Information Center

Beck, Diane E.

1984-01-01

An applied course designed to allow students to formulate pharmacokinetic recommendations individually for actual patient data and compare their recommendations to those of a pharmacokinetic consulting service is described and evaluated, and an objective student evaluation method is outlined. (MSE)

A retrospective study of chiropractic treatment of 276 danish infants with infantile colic.

PubMed

Wiberg, Karin R; Wiberg, Jesper M M

2010-09-01

The aim of this study was to investigate if the outcome of excessively crying infants treated with chiropractic manipulation (1) was associated with age and/or (2), at least partially, can be explained by age according to the natural decline in crying. This was a retrospective evaluation of clinical records of 749 infants from a private Danish chiropractic practice. All of the infants were healthy, thriving infants born to term within the age of 0 to 3 months who fulfilled the diagnostic criteria for excessively crying infants (infantile colic), whose parents sought chiropractic treatment. The infants were treated using chiropractic management as decided by the treating doctor of chiropractic, and changes in crying based upon the parents' report were noted as improved, uncertain, or nonrecovered. Age predictor groups were cross-tabulated against the outcome variables, and difference between classification groups was tested with χ(2) tables and confidence intervals. Slightly older age was found to be linked to excessively crying infants who experienced clinical improvement. However, no apparent link between the clinical effect of chiropractic treatment and a natural decline in crying was found for this group of infants. The findings of this study do not support the assumption that effect of chiropractic treatment of infantile colic is a reflection of the normal cessation of this disorder. Copyright © 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

How international is bioethics? A quantitative retrospective study.

PubMed

Borry, Pascal; Schotsmans, Paul; Dierickx, Kris

2006-01-13

Studying the contribution of individual countries to leading journals in a specific discipline can highlight which countries have the most impact on that discipline and whether a geographic bias exists. This article aims to examine the international distribution of publications in the field of bioethics. Retrospective quantitative study of nine peer reviewed journals in the field of bioethics and medical ethics (Bioethics, Cambridge Quarterly of Healthcare Ethics, Hastings Center Report, Journal of Clinical Ethics, Journal of Medical Ethics, Kennedy Institute of Ethics Journal, Nursing Ethics, Christian Bioethics, and Theoretical Medicine and Bioethics). In total, 4,029 articles published between 1990 and 2003 were retrieved from the nine bioethical journals under study. The United States (59.3%, n = 2390), the United Kingdom (13.5%, n = 544), Canada (4%, n = 160) and Australia (3.8%, n = 154) had the highest number of publications in terms of absolute number of publications. When normalized to population size, smaller affluent countries, such as New Zealand, Finland and Sweden were more productive than the United States. The number of studies originating from the USA was decreasing in the period between 1990 and 2003. While a lot of peer reviewed journals in the field of bioethics profile themselves as international journals, they certainly do not live up to what one would expect from an "international" journal. The fact that English speaking countries, and to a larger extent American authors, dominate the international journals in the field of bioethics is a clear geographic bias towards the bioethical discussions that are going on in these journals.

IgG4 related disease - a retrospective descriptive study highlighting Canadian experiences in diagnosis and management.

PubMed

Patel, Harshna; Khalili, Korosh; Kyoung, Kim Tae; Yazdi, Leyla; Lee, Eric; May, Gary; Kortan, Paul; Coltescu, Catalina; Hirschfield, Gideon M

2013-12-09

Appreciating the utility of published diagnostic criteria for autoimmune pancreatitis, when compared to the characteristics of patients clinically managed as having disease, informs and refines ongoing clinical practice. Comparative retrospective descriptive evaluation of patients with autoimmune pancreatitis including dedicated radiology review. 66 subjects with radiographic OR clinical features of autoimmune pancreatitis were initially identifiable (Male: n = 50), with 55 confirmed for evaluation. The most common presentation included pain (67%), weight loss (65%), and jaundice (62%). Diffuse enlargement of the pancreas was evident in 38%, whilst multifocal, focal, or atrophic changes were seen in 7%, 33% and 9% respectively. 13% had no pancreatic parenchymal involvement. Peripheral rim enhancement was seen in 23 patients (42%). Where discernible, disease was a) Sclerosing pancreatitis and cholangitis, n = 21; b) Sclerosing cholangitis, n = 9; c) Sclerosing pancreatitis, n = 4; d) Sclerosing pancreatitis and cholangitis with pancreatic pseudotumour, n = 7; e) Sclerosing cholangitis with hepatic pseudotumour, n = 3; f) Sclerosing pancreatitis with pancreatic pseudotumour, n = 1. 56% of the patients had systemic manifestations and the median serum IgG4 at diagnosis was 5.12 g/L. The Korean criteria identified most patients (82%) compared to HISORt (55%) or the Japan Pancreas Society (56%). The majority (HISORt 60%; Japan Pancreas Society 55%; Korean 58%) met diagnostic criterion by radiological findings and elevated serum IgG4. Treatment and response did not differ when stratified by diagnostic criteria. Our descriptive and retrospective dataset confirms that in non-expert practice settings, autoimmune pancreatitis scoring systems with a focus on radiology and serology capture most patients who are clinically felt to have disease.

Medical comorbidities in patients with lichen planopilaris, a retrospective case-control study.

PubMed

Fertig, Raymond M; Hu, Shasa; Maddy, Austin J; Balaban, Alexandra; Aleid, Nouf; Aldahan, Adam; Tosti, Antonella

2018-04-16

Lichen planopilaris (LPP) is a rare inflammatory lymphocyte-mediated disease of the scalp considered to have an autoimmune pathogenesis. To identify the prevalence of medical comorbidities in patients with classic LPP (CLPP) and frontal fibrosing alopecia (FFA). The medical records of 206 LPP patients and 323 control patients were retrospectively reviewed for existing comorbidities. The control group consisted of 257 patients with androgenetic alopecia (ICD 9 = 704.0 or ICD 10 = L64.9) and 66 patients with actinic keratosis (ICD 9 = 702.0 or ICD 10 = L57.0). Systemic lupus erythematosus (SLE) was found in 4.37% of all patients with LPP (including CLPP and the FFA subtype) and in 0.31% of controls. Female patients with the FFA subtype were more likely to have SLE than controls (OR 31.034, 95% CI 2.405-400.382, P = 0.0085). This study is limited in that it is a retrospective chart review. Female patients with FFA are significantly more likely to have SLE. Patients with LPP (including CLPP and the FFA subtype) are less likely to have diabetes. Patients with CLPP excluding FFA are less likely to have hypertension, heart disease, and hypothyroidism. © 2018 The International Society of Dermatology.

(Self-)Portrait of Prof. R. C.: A Retrospective

ERIC Educational Resources Information Center

Morris, Charles E., III

2010-01-01

This essay offers a retrospective on the four special issues of this journal (1957, 1980, 1990, 2001) dedicated to the "state of the art" of rhetorical criticism. Drawing on Oscar Wilde's "The Portrait of Mr. W. H." as allegory, the essay also functions to queer this retrospective in an ongoing effort to queer rhetorical studies. The essay closes…

The retrospective binning method improves the consistency of phase binning in respiratory-gated PET/CT

NASA Astrophysics Data System (ADS)

Didierlaurent, D.; Ribes, S.; Batatia, H.; Jaudet, C.; Dierickx, L. O.; Zerdoud, S.; Brillouet, S.; Caselles, O.; Courbon, F.

2012-12-01

This study assesses the accuracy of prospective phase-gated PET/CT data binning and presents a retrospective data binning method that improves image quality and consistency. Respiratory signals from 17 patients who underwent 4D PET/CT were analysed to evaluate the reproducibility of temporal triggers used for the standard phase-based gating method. Breathing signals were reprocessed to implement retrospective PET data binning. The mean and standard deviation of time lags between automatic triggers provided by the Real-time Position Management (RPM, Varian) gating device and inhalation peaks derived from respiratory curves were computed for each patient. The total number of respiratory cycles available for 4D PET/CT according to the binning mode (prospective versus retrospective) was compared. The maximum standardized uptake value (SUVmax), biological tumour volume (BTV) and tumour trajectory measures were determined from the PET/CT images of five patients. Compared to retrospective binning (RB), prospective gating approach led to (i) a significant loss in breathing cycles (15%) and (ii) the inconsistency of data binning due to temporal dispersion of triggers (average 396 ms). Consequently, tumour characterization could be impacted. In retrospective mode, SUVmax was up to 27% higher, where no significant difference appeared in BTV. In addition, prospective mode gave an inconsistent spatial location of the tumour throughout the bins. Improved consistency with breathing patterns and greater motion amplitude of the tumour centroid were observed with retrospective mode. The detection of the tumour motion and trajectory was improved also for small temporal dispersion of triggers. This study shows that the binning mode could have a significant impact on 4D PET images. The consistency of triggers with breathing signals should be checked before clinical use of gated PET/CT images, and our RB method improves 4D PET/CT image quantification.

[Radiotherapy of primary breast sarcomas: Retrospective study].

PubMed

Chellakhi, M; Benchakroun, N; Bouchbika, Z; Jouhadi, H; Tawfiq, N; Sahraoui, S; Benider, A

2018-04-18

Primary breast sarcomas are heterogeneous tumours derived from non-epithelial mammary gland structures. Although they represent a rare entity, their incidence may increase in the coming years owing to conservative approach considered in the treatment of breast cancer. The aim of this work was to highlight the effect of postoperative irradiation in the treatment of these tumours. This is a retrospective study conducted at the Mohammed-VI centre for cancer treatment between 2004 and 2011. Survival rates were calculated by the Kaplan-Meier method. Fifteen cases were collected. The median age was 41.9years. Phyllode sarcoma accounted for 66% of this series. Surgical treatment was performed in 93% of the patients with negative margins in 33.33% of the cases. Neoadjuvant chemotherapy was indicated in 46% of the patients with locally advanced tumours and 66% of the patients received postoperative radiotherapy for positive or close margins. Five years overall survival and relapse free survival was not significantly different with the use of adjuvant radiotherapy. Due to the rarity of this entity and the absence of randomized trials, evidence based management is still lacking. However, a multidisciplinary approach is to be required including surgical excision followed by radiotherapy, depending on the tumour characteristics. Copyright © 2018 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

A comparison of propensity score-based approaches to health service evaluation: a case study of a preoperative physician-led clinic for high-risk surgical patients.

PubMed

Pham, Clarabelle T; Gibb, Catherine L; Mittinty, Murthy N; Fitridge, Robert A; Marshall, Villis R; Karnon, Jonathan D

2016-10-01

A physician-led clinic for the preoperative optimization and management of high-risk surgical patients was implemented in a South Australian public hospital in 2008. This study aimed to estimate the costs and effects of the clinic using a mixed retrospective and prospective observational study design. Alternative propensity score estimation methods were applied to retrospective routinely collected administrative and clinical data, using weighted and matched cohorts. Supplementary survey-based prospective data were collected to inform the analysis of the retrospective data and reduce potential unmeasured confounding. Using weighted cohorts, clinic patients had a significantly longer mean length of stay and higher mean cost. With the matched cohorts, reducing the calliper width resulted in a shorter mean length of stay in the clinic group, but the costs remained significantly higher. The prospective data indicated potential unmeasured confounding in all analyses other than in the most tightly matched cohorts. The application of alternative propensity-based approaches to a large sample of retrospective data, supplemented with a smaller sample of prospective data, informed a pragmatic approach to reducing potential observed and unmeasured confounding in an evaluation of a physician-led preoperative clinic. The need to generate tightly matched cohorts to reduce the potential for unmeasured confounding indicates that significant uncertainty remains around the effects of the clinic. This study illustrates the value of mixed retrospective and prospective observational study designs but also underlines the need to prospectively plan for the evaluation of costs and effects alongside the implementation of significant service innovations. © 2016 John Wiley & Sons, Ltd.

Reconstruction of organ dose for external radiotherapy patients in retrospective epidemiologic studies

NASA Astrophysics Data System (ADS)

Lee, Choonik; Jung, Jae Won; Pelletier, Christopher; Pyakuryal, Anil; Lamart, Stephanie; Kim, Jong Oh; Lee, Choonsik

2015-03-01

Organ dose estimation for retrospective epidemiological studies of late effects in radiotherapy patients involves two challenges: radiological images to represent patient anatomy are not usually available for patient cohorts who were treated years ago, and efficient dose reconstruction methods for large-scale patient cohorts are not well established. In the current study, we developed methods to reconstruct organ doses for radiotherapy patients by using a series of computational human phantoms coupled with a commercial treatment planning system (TPS) and a radiotherapy-dedicated Monte Carlo transport code, and performed illustrative dose calculations. First, we developed methods to convert the anatomy and organ contours of the pediatric and adult hybrid computational phantom series to Digital Imaging and Communications in Medicine (DICOM)-image and DICOM-structure files, respectively. The resulting DICOM files were imported to a commercial TPS for simulating radiotherapy and dose calculation for in-field organs. The conversion process was validated by comparing electron densities relative to water and organ volumes between the hybrid phantoms and the DICOM files imported in TPS, which showed agreements within 0.1 and 2%, respectively. Second, we developed a procedure to transfer DICOM-RT files generated from the TPS directly to a Monte Carlo transport code, x-ray Voxel Monte Carlo (XVMC) for more accurate dose calculations. Third, to illustrate the performance of the established methods, we simulated a whole brain treatment for the 10 year-old male phantom and a prostate treatment for the adult male phantom. Radiation doses to selected organs were calculated using the TPS and XVMC, and compared to each other. Organ average doses from the two methods matched within 7%, whereas maximum and minimum point doses differed up to 45%. The dosimetry methods and procedures established in this study will be useful for the reconstruction of organ dose to support

A retrospective study on the management of patients with rituximab refractory follicular lymphoma.

PubMed

Solal-Céligny, Philippe; Leconte, Pierre; Bardet, Aurélie; Hernandez, Juana; Troussard, Xavier

2018-01-01

Given that there are currently no clear recommendations regarding therapeutic options for rituximab refractory/relapsed follicular lymphoma patients, this study aimed to describe the real-life management of patients with refractory follicular lymphoma after systemic rituximab-containing regimens (rFL), and rFL patient characteristics. In this retrospective, national, multicentre study, descriptive analyses were mainly performed according to rituximab-containing regimen at rFL diagnosis [rituximab monotherapy (R-MONO), rituximab + chemotherapy (R-COMBO), and ongoing rituximab maintenance (R-MAINTAIN)]. The 459 analysed patients experienced rituximab-refractoriness between October 2013 and September 2015: R-MONO: 58 (13%), R-COMBO: 197 (43%), R-MAINTAIN: 204 (44%). Post-refractoriness strategies were heterogeneous: idelalisib ± rituximab (22%), without anti-lymphoma treatment (21%), rituximab-chemotherapy (21%) and stem cell transplantation (18%). Rituximab was continued in combination in 41% of cases. Chosen strategies varied according to patient age (without anti-lymphoma treatment: 28% of patients if ≥65 years vs. 12% if <65 years old; stem-cell transplantation: 4% vs. 38%), treatment line at rFL, FL International Prognostic Index score and prior treatment. This French retrospective study, the first one conducted in a large cohort of rFL patients, showed that further strategies were highly heterogeneous, depending notably on patient characteristics and previous treatment. These data are the basis for a better understanding of rFL management and for the design of clinical trials in these patients. © 2017 John Wiley & Sons Ltd.

Stiffness after total knee arthroplasty: does component alignment differ in knees requiring manipulation? A retrospective cohort study of 281 patients.

PubMed

Harvie, Paul; Larkin, James; Scaddan, Matt; Longstaff, Lee M; Sloan, Karen; Beaver, Richard J

2013-01-01

This study aims to evaluate component alignment in a large cohort of total knee arthroplasties (TKAs) and ascertain whether alignment in TKAs undergoing postoperative manipulation under anesthetic is significantly different from those achieving good function. A retrospective review of 281 consecutive primary TKAs was performed. All TKAs underwent computed tomographic scanning (Perth computed tomography knee protocol). Of 281 TKAs, 21 (7.4%) underwent manipulation, performed at a mean of 8.1 weeks (range, 3-14 weeks) after surgery. No statistically significant difference was seen between groups for any of 12 parameters of alignment. Postoperative stiffness with the need for manipulation under anesthetic is multifactorial in origin. This study found insufficient evidence to support the theory that component alignment contributes significantly to the etiology of this difficult problem. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Retrospective study of CMV retinitis in patients with AIDS.

PubMed

Pauriah, M; Ong, E L

2000-01-01

To study the characteristics of clinical presentations and treatment outcome of patients with HIV infection who developed cytomegalovirus(CMV) retinitis. A retrospective study for the period 1986-97 at the regional Unit of Infectious Diseases, Newcastle General Hospital; a teaching hospital in the north-east of England. Twenty-seven patients with advanced HIV disease and clinically confirmed CMV retinitis were studied. The mean age was 40.8 years, standard deviation +/-6.3 years. The male : female ratio was 25 : 2. Twenty-six of the patients were white Caucasians and one was of Afro-Caribbean origin. The median time between the first AIDS-defining diagnosis and development of CMV retinitis was 1.5 years and the CD4+ cell count at the time of diagnosis of CMV retinitis was 7/mm3. After 14 months of treatment. 80% of patients on mono antiretroviral therapy had impairment of sight (visual acuity 3/60) versus 30% for those on triple antiretroviral therapy. In the same period, the survival rate was 18 versus 70% for mono versus triple antiretroviral therapy, respectively. The outcome for patients with CMV retinitis was significantly better for those who were on triple than for those on mono antiretroviral therapy.

Pregnancy outcomes in women with type 1 and type 2 diabetes mellitus in a retrospective multi-institutional study in Japan.

PubMed

Sato, Takahiro; Sugiyama, Takashi; Kurakata, Michiyo; Saito, Masatoshi; Sugawara, Junichi; Yaegashi, Nobuo; Sagawa, Norimasa; Sanaka, Mayumi; Akazawa, Shoichi; Anazawa, Sonoko; Waguri, Masako; Sameshima, Hiroshi; Hiramatsu, Yuji; Toyoda, Nagayasu

2014-01-01

The present study was performed to evaluate pregnancy outcomes in women with type 1 and type 2 diabetes mellitus (DM) in Japan. This multi-institutional retrospective study was conducted in 40 general hospitals in Japan during 2003-2009. We evaluated 369 and 579 pregnant women with type 1 and type 2 DM, respectively, and compared pregnancy outcomes between the two groups. Glycosylated hemoglobin levels in the first trimester did not differ significantly between the studied groups. Gestational weight gain was lower in type 2 DM than in type 1 DM. Although there were no significant differences in perinatal outcomes between the groups, the primary cesarean section rate was higher in type 2 DM than in type 1 DM. Multiple logistic regression analysis revealed that primigravida status, pre-gestational body mass index (BMI), gestational weight gain, chronic hypertension, and microvascular disease including diabetic retinopathy or nephropathy were associated with onset of pregnancy-induced hypertension. Further, pre-gestational BMI was associated with the need for primary cesarean section. This study demonstrated that no differences were observed in the rates of perinatal mortality and congenital malformation between pregnant women with type 1 DM and type 2 DM; however, women with type 2 DM displayed a higher risk of primary cesarean section.

Case study of evaluations that go beyond clinical outcomes to assess quality improvement diabetes programmes using the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE)

PubMed Central

Harris, Stewart B.; Naqshbandi Hayward, Mariam; Tompkins, Jordan W.

2016-01-01

Abstract Rationale, aims and objectives Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real‐world evaluation. Method Using a critical and positivist approach, this intrinsic and collective case study retrospectively examines two naturalistic evaluations to demonstrate how DEFINE could be used when conducting real‐world comprehensive evaluations in health care settings. Results The variability between the cases and the evaluation designs are described and aligned to the DEFINE goals, steps and sub‐steps. The majority of the theoretical steps of DEFINE were exemplified in both cases, although limited for knowledge translation efforts. Application of DEFINE to evaluate diverse programmes that target various chronic diseases is needed to further test the inclusivity and built‐in flexibility of DEFINE and its role in encouraging more comprehensive knowledge translation. Conclusions This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale‐up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases. PMID:26804339

Self-expandable metal stents for malignant colonic obstruction: data from a retrospective regional SIED-AIGO study.

PubMed

Di Mitri, Roberto; Mocciaro, Filippo; Traina, Mario; Montalbano, Luigi Maria; Familiari, Luigi; D'Amore, Fabio; Raimondo, Dario; Virgilio, Clara; Tarantino, Ilaria; Barresi, Luca; Giunta, Marco; Borina, Eleonora; Borruto, Antonino; Marino, Antonino

2014-03-01

Self-expandable metal stents are a non-surgical option for the treatment of symptomatic malignant colorectal obstruction as palliative treatment or as a bridge to surgery. To report data from a regional study on self-expandable metal stent (SEMS) placement for malignant colorectal obstruction. Two hundred and four patients (male 54.9%, mean age of 69.5 ± 14.2) were retrospectively evaluated and data on technical and clinical success, and complications, were analyzed. Technical and clinical success rates were 99% and 94.6% respectively, with 36.7% treated on an emergency basis and 63.3% electively. Palliative treatment was administered to 70.1%, and as a bridge to surgery for 29.9%. Complications were 17 neoplastic ingrowths, 10 stent migrations, and 4 perforations. Palliative treatment was associated with a higher risk of stent ingrowth (p=0.003), and chemotherapy with a lower risk of stent ingrowth (p=0.009). This regional study, although it has certain limitations, confirms the positive role of self-expandable metal stents in the treatment of symptomatic malignant colorectal obstruction, and that chemotherapy decreases the risk of ingrowth. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Complications of the retromandibular transparotid approach for low condylar neck and subcondylar fractures: a retrospective study

PubMed Central

2018-01-01

Objectives The goal of this study was to evaluate the rates of complications, morbidity, and safety with the transparotid approach. Materials and Methods A retrospective study was conducted and consisted of 53 surgically treated patients in the past five years for low condylar neck and subcondylar fractures. Only patients with malocclusion and who underwent open reduction with internal fixation with the retromandibular transparotid approach were included. The examined parameters were postoperative suboptimal occlusion, deflection, saliva fistula, and facial nerve weakness. Results Fifty-three patients had an open reduction with internal fixation on 55 sides (41 males, 77.4%; mean age, 42 years [range, 18–72 years]). Four patients (7.5%) experienced transient facial nerve weakness of the marginal mandibular branch, but none was permanent. Four patients had a salivary fistula, and 5 patients showed postoperative malocclusion, where one needed repeat surgery after one year. One patient showed long-term deflection. No other complications were observed. Conclusion The retromandibular transparotid approach is a safe procedure for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications. PMID:29732312

Breast cancer mammographic diagnosis performance in a public health institution: a retrospective cohort study.

PubMed

Mello, Juliana M R B; Bittelbrunn, Fernando P; Rockenbach, Marcio A B C; May, Guilherme G; Vedolin, Leonardo M; Kruger, Marilia S; Soldatelli, Matheus D; Zwetsch, Guilherme; de Miranda, Gabriel T F; Teixeira, Saone I P; Arruda, Bruna S

2017-12-01

To evaluate the quality assurance of mammography results at a reference institution for the diagnosis and treatment of breast cancer in southern Brazil, based on the BIRADS (Breast Imaging Reporting and Data System) 5th edition recommendations for auditing purposes. Retrospective cohort and cross-sectional study with 4502 patients (9668 mammographies)) who underwent at least one or both breast mammographies throughout 2013 at a regional public hospital, linked to a federal public university. The results were followed until 31 December 2014, including true positives (TPs), true negatives (TNs), false positives (FPs), false negatives (FNs), positive predictive values (PPVs), negative predictive value (NPV), sensitivity and specificity, with a confidence interval of 95%. The study showed high quality assurance, particularly regarding sensitivity (90.22%) and specificity (92.31%). The overall positive predictive value (PPV) was 65.35%, and the negative predictive value (NPV) was 98.32%. The abnormal interpretation rate (recall rate) was 12.26%. The results are appropriate when compared to the values proposed by the BIRADS 5th edition. Additionally, the study provided self-reflection considering our radiological practice, which is essential for improvements and collaboration regarding breast cancer detection. It may stimulate better radiological practice performance and continuing education, despite possible infrastructure and facility limitations. • Accurate quality performance rates are possible despite financial and governmental limitations. • Low-income institutions should develop standardised teamwork to improve radiological practice. • Regular mammography audits may help to increase the quality of public health systems.

Somatization in Post-Concussion Syndrome: A Retrospective Study

PubMed Central

Gibaldi, James C

2016-01-01

This is a retrospective study of concussion patient data conducted to analyze the prevalence of somatization in patients presenting with post-concussion symptoms. Patient records from June 2010 to December 2015 were examined for concussion history, psychosocial history, neuropsychological test results, validity scores, and a symptom severity scale. Records meeting inclusion criteria from 33 males and 27 females were located. The sample had an age range of 11–78 years with a mean age of 33.40 (SD +/- 7.5 years). A clinically significant number of patients (55%) were found to be somaticizing their symptoms and a significant majority (78%) of somaticizing patients reported no loss of consciousness, retrograde amnesia, or post-traumatic amnesia but their symptom validity scales were significantly exaggerated. Caution should be exercised by clinicians to ensure that the obtained results of neuropsychological testing are reliable and valid. It is very important for the clinician to take into account the entire patient history, including psychosocial factors (such as pre-existing psychological traits or conditions) and social influences (such as stressors in family dynamics or work/school activities that may be affecting the patient's complaints). PMID:27766190

Hysteroscopic sterilization: 10-year retrospective analysis of worldwide pregnancy reports.

PubMed

Munro, M G; Nichols, J E; Levy, B; Vleugels, M P H; Veersema, S

2014-01-01

To identify factors that might contribute to pregnancies reported after hysteroscopic sterilization worldwide. Retrospective review of commercial data compiled from the MAUDE database, medical literature, and manufacturer reports received during commercial distribution of hysteroscopic sterilization micro-inserts from 2001 through 2010 (Canadian Taskforce classification III descriptive study). From 2001 through 2010, 497 305 hysteroscopic sterilization kits were distributed worldwide, and 748 pregnancies were reported, i.e., 0.15% of the estimated user population based on the number of distributed kits. The data were sufficient to enable analysis of 508 pregnancies for potential contributing factors and showed most to be associated with patient or physician noncompliance (n = 264) or misinterpreted confirmation tests (n = 212). Conceptions deemed to have occurred within 2 weeks of the procedure and therefore too early for detection were identified in 32 cases. Although there are limitations to the dataset and the study design is retrospective, it represents the largest body of cumulative hysteroscopic sterilization data available to date. Of the 748 pregnancies reported, it is apparent that some might have been prevented with greater patient and clinician attention to interim contraceptive use and counseling and with more rigorous evaluation and informed interpretation of the procedure confirmation tests. Although the estimated pregnancy rate based on such a dataset is likely an underestimation, it does suggest that the evaluable field performance of hysteroscopic sterilization micro-inserts is consistent with the labeled age-adjusted effectiveness of 99.74% at 5 years. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

Association between infection and fever in terminations of pregnancy using misoprostol: a retrospective cohort study.

PubMed

Nijman, Tobias A J; Voogdt, Kevin G J A; Teunissen, Pim W; van der Voorn, Patrick J Jp; de Groot, Christianne J M; Bakker, Petra C A M

2017-01-05

Fever is a well-known side effect of misoprostol, but clinically difficult to distinguish from an intra uterine infection. The aim of this study was to determine the incidence of fever in terminations of pregnancy (TOP) using misoprostol and to evaluate fever as indication of intra uterine infection. A retrospective cohort study was performed. Consecutive second trimester TOP with misoprostol between January 2008 and October 2012 were selected. We included 403 cases and determined the incidence of fever. To examine intra uterine infection as plausible cause of fever, pathological examination reports of placentas were reviewed for signs of infections. The incidence of fever was 42%. Logistic regression showed a dose dependent association between dosage misoprostol and degree of fever (OR 1.86; 95% CI: 1.3-2.7). There was no association between fever and epidural analgesia. Fever has a sensitivity of 55% and a specificity of 58% as a marker of intra uterine infection. The positive predictive value of fever for an intra uterine infection is 4% and the negative predictive value is 98%. Administration of misoprostol for the indication TOP is strongly associated with fever during labor. Fever is a poor predictor of intra uterine infection in the context of TOP.

Subclassification of the "grey zone" of thyroid cytology; a retrospective descriptive study with clinical, cytological, and histological correlation.

PubMed

Bonzanini, Mariella; Amadori, Pierluigi; Morelli, Luca; Fasanella, Silvia; Pertile, Riccardo; Mattiuzzi, Angela; Marini, Giorgio; Niccolini, Mauro; Tirone, Giuseppe; Rigamonti, Marco; Dalla Palma, Paolo

2011-01-01

Undetermined thyroid cytology precludes any definitive distinction between malignant and benign lesions. Recently several classifications have been proposed to split this category into two or more cytological subcategories related to different malignancy risk rates. The current study was performed retrospectively to investigate the results obtained separating "undetermined" cytologic reports into two categories: "follicular lesion" (FL) and "atypia of undetermined significance" (AUS). Biochemical, clinical, and echographic features of each category were also retrospectively analyzed. Altogether, 316 undetermined fine-needle aspirated cytologies (FNACs) were reclassified as 74 FL and 242 AUS. Histological control leads to a diagnosis of carcinomas, adenomas, and nonneoplastic lesions, respectively, in 42.2%, 20%, and 37.8% of AUS and in 8.3%, 69.4%, and 22.2% of FL. Among biochemical, clinical, cytological, and echographic outcomes, altered thyroid autoantibodies, multiple versus single nodule, AUS versus FL, and presence of intranodular vascular flow were statistically significant to differentiate adenoma from carcinoma and from nonneoplastic lesions, whereas no significant differences were found between carcinomas and nonneoplastic lesions for these parameters. The results of this retrospective study show that undetermined FNAC category can further be subclassified in AUS and FL, the former showing higher malignancy rate. Further prospective studies are needed to confirm our results.

Retrospective dosimetry analyses of reactor vessel cladding samples

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greenwood, L. R.; Soderquist, C. Z.; Fero, A. H.

2011-07-01

Reactor pressure vessel cladding samples for Ringhals Units 3 and 4 in Sweden were analyzed using retrospective reactor dosimetry techniques. The objective was to provide the best estimates of the neutron fluence for comparison with neutron transport calculations. A total of 51 stainless steel samples consisting of chips weighing approximately 100 to 200 mg were removed from selected locations around the pressure vessel and were sent to Pacific Northwest National Laboratory for analysis. The samples were fully characterized and analyzed for radioactive isotopes, with special interest in the presence of Nb-93m. The RPV cladding retrospective dosimetry results will be combinedmore » with a re-evaluation of the surveillance capsule dosimetry and with ex-vessel neutron dosimetry results to form a comprehensive 3D comparison of measurements to calculations performed with 3D deterministic transport code. (authors)« less

Retrospective epidemiological study of Latin American patients with transfusional hemosiderosis: the first Latin American epidemiological study in iron overload--the RELATH study.

PubMed

Lobo, Clarisse; Angulo, Ivan L; Aparicio, Lidia R; Drelichman, Guillermo I; Zanichelli, Maria A; Cancado, Rodolfo

2011-09-01

The retrospective epidemiological study of Latin Americans with transfusional hemosiderosis is the first regional patient registry to gather data regarding the burden of transfusional hemosiderosis and patterns of care in these patients. Retrospective and cross-sectional data were collected on patients ≥2 years with selected chronic anemias and minimum 20 transfusions. In the 960 patients analyzed, sickle-cell disease (48·3%) and thalassemias (24·0%) were the most frequent underlying diagnoses. The registry enrolled 355 pediatric patients (187 with sickle-cell disease/94 with thalassemia). Serum ferritin was the most frequent method used to detect iron overload. Complications from transfusional hemosiderosis were reported in ~80% of patients; hepatic (65·3%), endocrine (27·5%), and cardiac (18·2%) being the most frequent. These data indicate that hemoglobinopathies and complications due to transfusional hemosiderosis are a significant clinical problem in the Latin American population with iron overload. Chelation therapy is used insufficiently and has a high rate of discontinuation.

Variability in early height growth rate of forest trees: implications for retrospective studies of stand dynamics

Treesearch

Brain J. Palik; Kurt S. Pregitzer

1995-01-01

Retrospective studies of forest stand dynamics may rely on estimates of tree ages. In some of these studies, trees are aged near the stem base, while in other studies trees may be aged at breast height. An age correction may be added to breast-height ages in an attempt to account for average time to reach breast height and thus provide better estimates of total ages....

A retrospective study on related factors affecting the survival rate of dental implants

PubMed Central

Kang, Jeong-Kyung; Lee, Ki; Lee, Yong-Sang; Park, Pil-Kyoo

2011-01-01

PURPOSE The aim of this retrospective study is to analyze the relationship between local factors and survival rate of dental implant which had been installed and restored in Seoul Veterans Hospital dental center for past 10 years. And when the relationship is found out, it could be helpful to predict the prognosis of dental implants. MATERIALS AND METHODS A retrospective study of patients receiving root-shaped screw-type dental implants placed from January 2000 to December 2009 was conducted. 6385 implants were placed in 3755 patients. The following data were collected from the dental records and radiographs: patient's age, gender, implant type and surface, length, diameter, location of implant placement, bone quality, prosthesis type. The correlations between these data and survival rate were analyzed. Statistical analysis was performed with the use of Kaplan-Meier analysis, Chi-square test and odds ratio. RESULTS In all, 6385 implants were placed in 3755 patients (3120 male, 635 female; mean age 65 ± 10.58 years). 108 implants failed and the cumulative survival rate was 96.33%. There were significant differences in age, implant type and surface, length, location and prosthesis type (P<.05). No significant differences were found in relation to the following factors: gender, diameter and bone quality (P>.05). CONCLUSION Related factors such as age, implant type, length, location and prosthesis type had a significant effect on the implant survival. PMID:22259704

Retrospective study of the physical therapy modalities applied in head and neck l ymphedema treatment.

PubMed

Tacani, Pascale Mutti; Franceschini, Juliana Pereira; Tacani, Rogério Eduardo; Machado, Aline Fernanda Perez; Montezello, Débora; Góes, João Carlos Guedes Sampaio; Marx, Angela

2016-02-01

Secondary lymphedema after head and neck cancer treatment is a serious complication and its management can be a challenge. The purpose of this study was to verify which physical therapy modalities were applied in the treatment of head and neck lymphedema through a retrospective analysis. A retrospective study was developed, based on the analysis of medical records of 32 patients treated in the physiotherapy outpatient department of the Brazilian Institute of Cancer Control (IBCC). The physiotherapy included manual lymphatic drainage, massage, exercises, patient education, and compression therapy with an average of 23.9 ± 14.8 sessions. Measurement results showed a significant reduction of face and neck lymphedema (p < .05) and pain (from 7.8 ± 2.2 to 3.6 ± 1.6; p < .001). The physical therapy modalities based on strategic manual lymphatic drainage, shoulder girdle massage, facial, tongue and neck exercises, compressive therapy at home, and patient education showed reduction of the lymphedema and pain, both of them secondary to head and neck cancer treatment. © 2014 Wiley Periodicals, Inc.

Bathtub drowning: An 11-year retrospective study in the state of Maryland.

PubMed

Okuda, Takahisa; Wang, Zhuo; Lapan, Sheldon; Fowler, David R

2015-08-01

A bathtub drowning is one of the leading causes of death in a bathtub. The purpose of this study was to evaluate how reliable the drowning-related signs could be for identifying a bathtub drowning in the cases of death in the bathtub. Performing a retrospective review of 92 deaths in the bathtub in Maryland, 71.7 percent were the presence of bathtub drowning and 28.3 percent were the absence of bathtub drowning. Three leading contributory causes of death were cardiovascular disease, drug/alcohol-related death, and seizure disorder in both groups. There was a statistically significant difference between the groups in relation to a history of recovery from the water (95.5% and 38.4%, p<0.001), foam in the air way (33.3% and 15.4%, p<0.05), watery fluid in the sphenoid sinuses (81.8% and 11.5%, p<0.05), hyperinflated lungs (36.4% and 3.8%, p<0.01), and watery fluid in the stomach contents (40.9% and 3.8%, p<0.01). More than triple overlapped drowning-related signs could be beneficial for the diagnosis of a bathtub drowning. A comprehensive investigation incorporating a thorough scene investigation, gathering of the victim's medical and psychosocial history, and a meticulous full autopsy is necessary to elucidate both the cause and manner of death in these cases of death in the bathtub. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Neuroprotective effect of ethanol in acute carbon monoxide intoxication: A retrospective study.

PubMed

Kim, Hyuk-Hoon; Choi, Sang Chun; Chae, Minjung Kathy; Min, Young-Gi

2018-01-01

In acute carbon monoxide (CO) intoxication, treatment of neurologic injury and prevention of neurological sequelae are primary concerns. Ethanol is the one of the frequent substances which is co-ingested in intentional CO poisoning. Neuroprotective effect of ethanol was highlighted and demonstrated in isolated brain injury recently. We assessed the neuroprotective effect of ethanol in acute CO intoxication using magnetic resonance imaging (MRI).We retrospectively reviewed medical records for patients who visited an emergency medical center of a university-affiliated hospital during a period of 73 months, from March 2009 to April 2015. Enrolled patients were divided into 2 groups, patients with or without abnormal brain lesion in brain MRI. Multivariate logistic regression analysis was performed to assess the factors associated with brain injury in MRI.A total of 109 patients with acute CO intoxication were evaluated of which 66 (60.55%) tested positive in brain MRI. MRI lesion-positive patients were more likely to have electrocardiogram change, elevation of serum troponin I and s100 protein level and lower serum ethanol level. Serum ethanol positivity was an independent factor for prevalence of brain injury in MRI in acute CO poisoning.This study revealed that ethanol which is co-ingested in acute CO intoxication may work the neuroprotective effect and could consequence more favorable neurological outcome in acute CO intoxication. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Clinic research on the treatment for humeral shaft fracture with minimal invasive plate osteosynthesis: a retrospective study of 128 cases.

PubMed

Chen, H; Hu, X; Yang, G; Xiang, M

2017-04-01

Minimal invasive plate osteosynthesis (MIPO) is one of the most important techniques in the treatment for humeral shaft fractures. This study was performed to evaluate the efficacy of MIPO technique for the treatment for humeral shaft fractures. We retrospectively evaluated 128 cases with humeral shaft fractures that were treated with MIPO technique from March 2005 to August 2008. All the patients were followed up by routine radiological imaging and clinical examinations. Constant-Murley score and HSS elbow joint score were used to evaluate the treatment outcome. The average duration of the surgery was 60 min (range 40-95 min) without blood transfusion. All fractures healed without infection. All cases recovered carrying angle except four cases with 10°-15° cubitus varus. After the average follow-up of 23 (13-38) months, satisfactory function was achieved according to Constant-Murley score and HSS elbow joint score. Constant-Murley score was 80 on average (range 68-91). According to HSS elbow joint score, there were 123 cases of excellent clinical outcome and five cases of effective outcome. It seems to be a safe and effective method for managing humeral shaft fractures with MIPO technique.

Exploring associations between prenatal solvent exposures and teenage drug and alcohol use: a retrospective cohort study.

PubMed

Gallagher, Lisa G; Webster, Thomas F; Aschengrau, Ann

2017-03-11

Investigating the effects of prenatal and childhood exposures on behavioral health outcomes in adolescence is challenging given the lengthy period between the exposure and outcomes. We conducted a retrospective cohort study in Cape Cod, Massachusetts to evaluate the impact of prenatal and early childhood exposure to tetrachloroethylene (PCE)-contaminated drinking water on the occurrence of risk-taking behaviors as a teenager. An increased occurrence of risk-taking behaviors, particularly illicit drug use, was observed in those highly exposed to PCE. We hypothesized that there may be other sources of prenatal solvent exposure such as maternal consumption of alcoholic beverages during pregnancy which might modify the previously observed associations between PCE and risk-taking behaviors and so we conducted an exploratory analysis using available cohort data. The current report presents the results of these analyses and describes the difficulties in conducting research on long-term behavioral effects of early life exposures. The exploratory analysis compared a referent group of subjects with no early life exposure to PCE or alcohol (n = 242) to subjects with only alcohol exposure (n = 201), subjects with only PCE exposure (n = 361), and subjects with exposure to both PCE and alcohol (n = 302). Surveys completed by the subject's mother included questions on prenatal alcoholic beverage consumption and available confounding variables such as cigarette smoking and marijuana use. Surveys completed by the subjects included questions on risk-taking behaviors such as alcoholic beverage consumption and illicit drug use as a teenager and available confounding variables. PCE exposure was modeled using a leaching and transport algorithm embedded in water distribution system modeling software that estimated the amount of PCE delivered to a subject's residence during gestation and early childhood. Subjects with early life exposure to both PCE and alcohol had an

Clinical Evidence of OsseoSpeed EV Implants: A Retrospective Study and Characterization of the Newly Introduced System.

PubMed

Toia, Marco; Galli, Silvia; Cecchinato, Denis; Wennerberg, Ann; Jimbo, Ryo

2017-08-23

This retrospective study sought to compare a new implant (Astra Tech OsseoSpeed EV) with its predecessor (Astra Tech OsseoSpeed TX) by scanning electron microscopy and interferometry. Radiographic data from 19 patients who underwent implant restoration with EV (n = 49) with a median follow-up of 16 months were evaluated for mean bone level (MBL) changes from delivery of the definitive prosthesis. EV and TX did not differ in surface roughness, and both systems had a tight seal at the implant-abutment interface. The median MBL change of the EV was -0.02 mm mesiodistally after a median follow-up period of 16 months. Greater maintenance of MBL was found in the screw-retained restorations (n = 17) compared to cemented (0.35 ± 0.33 mm and -0.38 ± 0.76 mm, respectively; P = .03). The data suggest that EV shows minimal levels of bone loss and high implant survival.