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Sample records for clinical retrospective study

  1. Clinical rehabilitation of the amputee : A retrospective study

    NARCIS (Netherlands)

    Rommers, GM; Vos, LDW; Groothoff, JW; Eisma, WH

    1996-01-01

    The aim of this study was to determine the rehabilitation outcome of lower limb amputee patients after clinical rehabilitation. Altogether 183 amputee patients admitted for clinical rehabilitation in the years 1987-1991 were reviewed by retrospective analysis of medical record data. Three groups of

  2. CLINICAL STUDY OF ACUTE POISONING: A RETROSPECTIVE STUDY

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    Praveen

    2014-11-01

    Full Text Available : OBJECTIVES: To determine the common agents, clinical features and outcomes of acute poisoning. MATERIALS AND METHODS: A retrospective study of patients of acute poisoning of more than 14 years age admitted through emergency with a history of intentional, self-inflicted and suicidal poisoning in SRMS-IMS from Jan 2010 to Dec 2012. RESULTS: A total of 58 cases were included with a common age of affection 16 to 25 years and male to female ratio 1.63: 1. Poisoning cases occur throughout the year with maximum prevalence in May and minimum in June. Organophosphorus was the most common poison followed by aluminium phosphide. Vomiting was the most common symptoms followed by altered sensorium. 70.68% patients were discharged, 20.68% expired and 8.62% left against medical advice. Aluminium phosphide was the most common toxin consumed by dead patients. CONCLUSION: Acute poisoning is commonly affecting young population and is caused by variety of toxin. High mortality is associated with aluminum phosphide.

  3. Clinical value of acoustic voice measures: a retrospective study.

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    Werth, Katrin; Voigt, Daniel; Döllinger, Michael; Eysholdt, Ulrich; Lohscheller, Jörg

    2010-08-01

    Within this study a retrospective analysis of clinical voice perturbation measures, Dysphonia Severity Index and subjective perceived hoarseness was performed to determine their value under clinical aspects. The study included the data of 580 healthy and 1,700 pathologic voices, which were investigated under the following aspects. The relevant parameters were identified and their interrelation determined. Group differences between healthy and pathologic voices were figured out and investigated if voice quality measures allowed an automatic diagnosis of voice disorders. The analysis revealed significant changes between the clinical groups, which indicate the diagnostic relevance of voice quality measures. However, an individual diagnosis of the underlying voice disorder failed due to a vast spread of the parameter values within the respective groups. Classification accuracies of 75-90% were achieved. The high misclassification rate of up to 25% implied that in voice disorder diagnosis, the individual interpretation of the parameter values has to be done carefully.

  4. Incidence and clinical outcome of renal amyloidosis: A retrospective study

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    Emad Abdallah

    2013-01-01

    Full Text Available The kidneys are affected in almost all patients with amyloid A in secondary amyloidosis (AA amyloidosis but less frequently in immunoglobulin light chains in primary systemic amyloidosis (AL amyloidosis. In this study, we present the incidence, etiology, clinical manifestations, biochemical features and clinical course of renal amyloidosis. We conducted a retrospective study on a group of 40 cases with renal biopsy-proven amyloidosis. They constituted 2.5% of the total cases of renal biopsies performed in the Theodor Bilharz Research Institute, Cairo, Egypt, during the period from February 2003 to May 2009. The mean age (30 males, ten females was 36.51 ± 10.32 years. Thirty-two of the cases had secondary AA amyloidosis and eight cases had primary AL amyloidosis. The causes of secondary amyloidosis were as follows: 12 (30% familial Mediterranean fever (FMF, eight (20% pulmonary tuberculosis, four (10% chronic osteomyelitis, four (10% bronchiectasis, three (7% rheumatoid arthritis and one (2% rheumatic heart disease. The eight cases of primary AL amyloidosis comprised of five cases that were associated with myloma (13% and three (8% cases that were idiopathic. Among the 23 patients with AA amyloidosis, after six months of treatment with colchicine, the proteinuria improved, serum albumin level increased and edema disappeared in 13 patients. In four cases of AA amyloidosis who were clinically and biochemically normal after cholchicine therapy, a second renal biopsy disclosed decreased amyloid deposition compared with the first biopsy. In the three renal transplanted patients who had amyloidosis secondary to FMF and were treated with colchicines, AA amyloidosis did not recur in the transplanted kidney. It might be possible that in AL amyloidosis, treatment with methotrexate, melphalan and prednisolone may improve survival. The incidence of renal amyloidosis is increasing and colchicine can be used in secondary amyloidosis as it may have an effect

  5. "Hardware breakage in spine surgery (A retrospective clinical study "

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    "Sadat MM

    2001-11-01

    Full Text Available This was a retrospective review of a consecutive series of patients with spinal disease in year 2000, who underwent posterior fusion and instrumentation with Harrington distraction and Cotrel-Dobousset system to evaluate causes of hardware failure. Many cases of clinical failure has been observed in spinal instrumentation used in spinal disorder like spondylolisthesis, fractures, deformities, … . Thirty six cases that were operated because of spinal disorders like spondylolisthesis, fractures, deformities, …, were included in this study. Seventeen of this cases had breakage of device. Factors like age at surgery, type of instrumentation, angles before and after surgery and …, were compared in two groups of patients. The most common instrument breakage was pedicle screw breakage. Pseudoarthrosis was the main factor that was presented in failure group (P value<0.001. Other important causes were, age of patient at surgery (P value=0.04, pedicle screw placement off center in the sagittal or coronal plane of the pedicle (P value=0.04. Instrumentation loads increased significantly as a direct result of variations in surgical technique that produce pseudoarthrosis, pedicle screw placement off center in the sagittal plane of the pedicle, or using less than 6 mm diameter screw. This factor can be prevented with meticulous surgical technique and using proper devices.

  6. MYRINGOPLASTY IN CHILDREN - RETROSPECTIVE ANALYSIS: A CLINICAL STUDY

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    Shankar

    2015-06-01

    Full Text Available Myringoplasty is the surgical closure of the perforation of pars tensa of the tympanic membrane. Perforation of the tympanic membrane in children can cause significant disability. It is a simple and effective procedure that results in the success ful closure of the perforation in most cases. This retrospective study was conducted in our hospital, for 06 years. Myringoplasty is a beneficial procedure in the pediatric population in the hands of a skilled and experienced surgeon. This paper will discu ss the success rate of perforation closure, improvement in hearing and complications during surgery and postoperative period in pediatric age group.

  7. Clinical and microbiological features of maternal sepsis: a retrospective study.

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    Abir, G; Akdagli, S; Butwick, A; Carvalho, B

    2017-02-01

    Identifying pregnant women with sepsis is challenging because diagnostic clinical and laboratory criteria overlap with normal pregnant physiologic indices. Our primary study aim was to describe clinical and laboratory characteristics of women diagnosed with sepsis, severe sepsis and septic shock. Our secondary aim was to determine positive predictive values for International Classification of Disease (ICD)-9 billing codes for sepsis, severe sepsis, and septic shock. After gaining Institutional Review Board approval, we identified women with ICD-9 codes for sepsis, severe sepsis and septic shock who were admitted to a single tertiary obstetric center from 2007-2013. Diagnoses were confirmed using criteria from the International Sepsis Definitions Conference report. Demographic, obstetric, vital signs and laboratory data were abstracted by medical chart review. We identified 190 women with sepsis-related ICD-9 codes: of these, 35 (18%) women met the criteria for a clinical diagnosis of sepsis, severe sepsis or septic shock. Twenty (57%) women had a sepsis-related diagnosis after cesarean delivery. Twenty-one (60%) women had one or more pre-existing medical conditions and 19 (54%) women had one or more obstetric-related conditions. The genital tract was the most common site of infection. We observed considerable heterogeneity in maternal vital signs and laboratory indices for women with ICD-9 codes for sepsis, severe sepsis, and septic shock. The positive predictive value for each sepsis-related ICD-9 code was low: 16% (95% CI 10 to 24%) for sepsis, 10% (95% CI 3 to 25%) for severe sepsis and 24% (95% CI 10 to 46%) for septic shock. We identified marked heterogeneity in patient characteristics, clinical features, laboratory indices and microbiological findings among cohorts of women diagnosed with maternal sepsis, severe sepsis or septic shock. Based on our findings, the incidence of maternal sepsis using ICD-9 codes may be significantly overestimated. Copyright

  8. Safety of bevacizumab in clinical practice for recurrent ovarian cancer: A retrospective cohort study

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    SELLE, FRÉDÉRIC; EMILE, GEORGE; PAUTIER, PATRICIA; ASMANE, IRÈNE; SOARES, DANIELE G.; KHALIL, AHMED; ALEXANDRE, JEROME; LHOMMÉ, CATHERINE; RAY-COQUARD, ISABELLE; LOTZ, JEAN-PIERRE; GOLDWASSER, FRANÇOIS; TAZI, YOUSSEF; HEUDEL, PIERRE; PUJADE-LAURAINE, ERIC; GOUY, SÉBASTIEN; TREDAN, OLIVIER; BARBAZA, MARIE O.; ADY-VAGO, NORA; DUBOT, CORALINE

    2016-01-01

    The poor outcome of patients with recurrent ovarian cancer constitutes a continuous challenge for decision-making in clinical practice. In this setting, molecular targets have recently been identified, and novel compounds are now available. Bevacizumab has been introduced for the treatment of patients with ovarian cancer and is, to date, the most extensively investigated targeted therapy in this setting. However, potential toxicities are associated with the use of this monoclonal antibody. These toxicities have been reported in clinical trials, and can also be observed outside of trials. As limited data is currently available regarding the safety of bevacizumab treatment in daily clinical practice, the current retrospective study was designed to evaluate this. Data from 156 patients with recurrent ovarian cancer who had received bevacizumab treatment between January 2006 and June 2009 were retrospectively identified from the institutional records of five French centers. In contrast to clinical trials, the patients in the present study were not selected and had a heterogeneous profile according to their prior medical history, lines of treatment prior to bevacizumab introduction and number of relapses. The results first confirm the effect of heavy pretreatment on the occurrence of serious and fatal adverse events in clinical practice, as previously reported for clinical trials and for other retrospective cohort studies. Importantly, the data also demonstrates, for the first time, that medical history of hypertension is an independent predictive risk factor for the development of high-grade hypertension during bevacizumab treatment. These results thus suggest that treating physicians must consider all risk factors for managing bevacizumab toxicity prior to its introduction. Such risk factors include the time of bevacizumab introduction, a patient's history of hypertension and a low incidence of pre-existing obstructive disease. PMID:26998090

  9. Clinical application of echocardiography in detection of foetal arrhythmia:a retrospective study of 451 foetuses

    Institute of Scientific and Technical Information of China (English)

    赵博文; 张松英; 潘美; 徐海珊; 寿金朵; 吕江红; 汤富刚; 范妙英; 范晓明; 林莎

    2004-01-01

    @@Foetal arrhythmia is defined as any irregular foetal cardiac rhythm or regular rhythm at a rate outside the reference range of 120 to 160 beats/minute. Foetal echocardiography permits accurate determination of the structural characteristics and the nature of the arrhythmia in foetuses. It is particularly indicated for mothers from high-risk groups. Management of diagnosed heart disease, including foetal arrhythmia, leads either to the termination of pregnancy or to optimal postnatal care of baby and mother. This retrospective study examined the application of foetal echocardiography in the diagnosis of foetal arrhythmia and its clinical significance.

  10. Retrospective, Single Center Study of Clinical, Paraclinical and Natural Course of Infantile-Onset Pompe Disease

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    Noormohammad Noori

    2015-01-01

    Full Text Available Background: Infantile-onset Pompe disease is a rare genetic and lethal disorder which is caused by the lack of acid alpha-glucosidase activity (GAA. The aim of our study was to identify the demographic and clinical characteristics, and natural history of these patients. Materials and Methods: In this retrospective study, clinical file of 15 patients diagnosed with infantile-onset Pompe disease whose symptoms started before the age of 12 months were studied. Diagnosis was based on clinical history, physical examination and diagnostic parameters in chest X-ray, echocardiogram, electrocardiogram and biochemical tests after rule out the other metabolic and neuromuscular disorders. Results: Sixty percent of the patients were male and 40% were female. The mean age at the onset of symptoms was 78 days (range: 3-150 days. Most frequent clinical and paraclinical symptoms were cardiomegaly, hypotonia, hyporeflexia, macroglossia, failure to thrive, hepatomegaly, and feeding problems, respectively. The mean age at the time of death was 5.96 months (range: 4-8 months, and all patients died before one year of age. Muscle enzymes including AST, ALT, LDH, and CPK were elevated in all patients. Due to the lack of availability, enzyme replacement therapy was not possible for any patient. Conclusion: The study showed that despite the supportive measures and no specific treatment, the clinical course is not significantly different with similar studies and the overall prognosis of this form of disease is very poor and disappointing.

  11. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study

    DEFF Research Database (Denmark)

    Jensen, Anders Torp; Jensen, Simon Storgård; Worsaae, Nils

    2016-01-01

    PURPOSE: This retrospective clinical study aims to evaluate complications after augmentation of localized bone defects of the alveolar ridge. METHODS: From standardized registrations, the following complications related to bone augmentation procedures were recorded: soft tissue dehiscence, infect...

  12. Clinical and Breed Characteristics of Idiopathic Head Tremor Syndrome in 291 Dogs: A Retrospective Study

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    Linda G. Shell

    2015-01-01

    Full Text Available Objective. To establish signalment and phenomenology of canine idiopathic head tremor syndrome (IHTS, an episodic head movement disorder of undetermined pathogenesis. Design. Retrospective case series. Animals. 291 dogs with IHTS diagnosed between 1999 and 2013. Procedures. Clinical information was obtained from an online community of veterinary information aggregation and exchange (Veterinary Information Network, 777 W Covell Boulevard, Davis, CA 95616 and conducted with their approval. Information on breed, sex, age of onset, tremor description, mentation during the event, effect of distractions and drugs, diagnostics, presence of other problems, and outcome was analyzed. Results. IHTS was found in 24 pure breeds. Bulldogs, Labrador Retrievers, Boxers, and Doberman Pinschers comprised 69%; mixed breeds comprised 17%. Average onset age was 29 months (range: 3 months to 12 years. First episode occurred before 48 months of age in 88%. Vertical (35%, horizontal (50%, and rotational (15% movements were documented. Possible trigger events were found in 21%. Mentation was normal in 93%. Distractions abated the tremor in 87%. Most dogs did not respond to antiepileptic drugs. Conclusions and Clinical Relevance. This retrospective study documents IHTS in many breeds including Labrador Retrievers, Boxers, and mixed breeds.

  13. [Emphysematous pyelonephritis. Epidemiological, clinical, biological, bacteriological, radiological, therapeutic and prognostic features. Retrospective study of 30 cases].

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    Cherif, Mohamed; Kerkeni, Walid; Bouzouita, Abderrazak; Selmi, Mohamed Slim; Derouiche, Amine; Ben Slama, Mohamed Riadh; Chebil, Mohamed

    2012-10-01

    Emphysematous pyelonephritis is an uncommon, necrotizing bacterial infection of the kidney. It is a severe, life threatening affection. To study the epidemiological, clinical, biological, bacteriological and radiological features of this affection, and to describe its therapeutic management and prognostic characteristics. We conducted a retrospective study including 30 patients who were treated for an emphysematous pyelonephritis, in Charles Nicolle hospital department of urology, from 1987 to 2009. Emphysematous pyelonephritis generally affects adults. It is especially favored by diabetes and urinary tract obstruction. Escherichia coli is the main causative agent. Uroscan is the key of diagnosis. It is both medical and surgical emergency; the treatment combines intensive care with appropriate antibiotics and often drainage. Nephrectomy may be necessary from the outset, or after drainage failure. Prognosis is poor, with a high mortality rate (23 %), in our series. Management of emphysematous pyelonephritis poses real problems. This affection is still threatening, despite of advances in intensive care.

  14. Clinical Effect of Rebound Hyperthermia After Cooling Postcardiac Arrest: A Retrospective Cohort Study.

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    Makker, Parth; Shimada, Yuichi J; Misra, Deepika; Kanei, Yumiko

    2016-10-26

    Therapeutic hypothermia is used in select patients after out-of-hospital cardiac arrest (OHCA) to improve neurologic outcome. Rebound hyperthermia (RH) is commonly observed post-treatment. Previous studies analyzing the association of RH with clinical outcome have reported conflicting results. The purpose of this study is to examine the impact of RH after completion of therapeutic hypothermia in patients postcardiac arrest. We analyzed a retrospective cohort from our institution. All adults who underwent therapeutic hypothermia post-OHCA were divided into two cohorts depending on the presence/absence of fever (T > 38°C) within 24 hours of completing hypothermia protocol. Clinical outcomes were analyzed at hospital discharge or death. Among 306 patients admitted with OHCA, 117 underwent hypothermia, 97 survived 24 hours postrewarming. Twenty-seven patients (50%) with RH died compared with 20 (47%) without RH (OR, 1.15; 95% CI, 0.52-2.57). Twenty-six patients (67%) with RH had a poor neurologic outcome compared with 27 (63%) without RH (OR 1.19, 95% CI, 0.51-2.74). RH is common after completion of therapeutic hypothermia in comatose patients due to cardiac arrest and is associated with poor neurologic outcomes. We found no significant clinical impact of rebound hypothermia on neurologic outcome or mortality, but our study was underpowered to reveal such impact if it exists.

  15. The clinical and radiological spectrum of posterior reversible encephalopathy syndrome: the retrospective Berlin PRES study.

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    Liman, T G; Bohner, G; Heuschmann, P U; Endres, M; Siebert, E

    2012-01-01

    The aim of the study was to characterize the clinical and radiological spectrum of posterior reversible encephalopathy syndrome (PRES) in a large cohort. The radiological report data bases of the authors' university hospitals were searched for patients with PRES. Various imaging features at onset of symptoms and on follow-up as well as clinical and paraclinical data were tabulated in those patients fulfilling the criteria for PRES. Exploratory univariate analyses were performed. A total of 96 patients with PRES were included into the study. Wide differences in lesion location, diffusivity, distribution pattern, edema severity, hemorrhage, underlying diseases, symptoms, mean arterial pressure (MAP) and coagulation status were encountered. Hemorrhage occurred significantly more frequently in patients with altered coagulation state and was significantly associated with higher edema grades and with the presence of cytotoxic edema. There was a significant difference in MAP between toxic associations with higher MAP in infection, eclampsy and autoimmune disorders, while lower MAP was found in chemotherapy and immunsupression. In 82% of patients complete or near complete resolution of edema was noted during follow-up. Higher MAP levels were associated with incomplete edema resolution. In 43% of patients residual lesions were seen with a relatively even distribution between focal gliosis, infarction, posthemorrhagic residua, atrophy and laminar necrosis. PRES in this large hospital-based retrospective study comprises a wide radiological and clinical spectrum. Residual lesions were encountered more frequently than commonly expected. Our results point towards a differential contribution of high blood pressure to the course of PRES in different underlying etiologies.

  16. Evaluation of Clinical and Ultrasonographic Parameters in Psoriatic Arthritis Patients Treated with Adalimumab: A Retrospective Study

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    M. Teoli

    2012-01-01

    Full Text Available Objectives. The aim of this study was to evaluate clinical and US-PD parameters in PsA during adalimumab treatment. Methods. A retrospective study has been conducted in forty patients affected by moderate-to-severe peripheral PsA. Clinical, laboratory, and US-PD evaluations were performed at baseline, after 4, 12, and 24 weeks of treatment. They included erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, visual analogue scale (VAS, Health Assessment Questionnaire (HAQ modified for Spondyloarthritis, Psoriasis Area Severity Index (PASI score, the 28-joint Disease Activity Score (DAS 28, and US-PD assessment. US-PD findings were scored according to a semiquantitative scale (ranging 0–3 for synovial proliferation (SP, joint effusion (SE, bone erosions (BE, and PD. Results. Data obtained for clinical, laboratory findings and US-PD evaluation showed statistical significant improvement in all the measures performed except for BE. A significant parallel decrease in SE, SP, and PD values were demonstrated. Conclusion. This study demonstrated that US-PD is a valid technique in monitoring the response to adalimumab in moderate-to-severe PsA.

  17. Clinical course of 63 children with hereditary spherocytosis: a retrospective study

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    Maria Christina Lopes Araujo Oliveira

    2012-01-01

    Full Text Available BACKGROUND: Hereditary spherocytosis (HS is an inherited hemolytic anemia that is caused by deficiency or dysfunction of erythrocyte cytoskeletal proteins. AIM: The aim of this study was to describe the clinical course of hereditary spherocytosis in patients treated in the Pediatric Hematology Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais. METHODS: Sixty-three under 16-year-old patients with hereditary spherocytosis were retrospectively evaluated between January 1988 and December 2007. Hereditary spherocytosis was diagnosed based on clinical history, physical examination and on a positive osmotic fragility curve. Patients underwent screening for cholelithiasis by ultrasonography. They were classified into three groups: mild, moderate and severe. The events of interest were need for blood transfusion, cholelithiasis, splenic sequestration, aplastic crisis, and splenectomy. Differences between subgroups were evaluated by the two-sided log-rank test. RESULTS: The mean age at diagnosis was 5.2 years and most patients were classified as moderate (54%. Patients with the severe form of the disease were younger (p-value = 0.001 and needed more blood transfusions (p-value = 0.004. Seventeen patients (27% developed cholelithiasis, 14 (22.2% splenic sequestration and three (4.8% aplastic crises. Twenty-two patients (34.9% were splenectomized with the main indication being splenic sequestration in nine patients (41%. CONCLUSIONS: The clinical course of patients with hereditary spherocytosis in this study was relatively benign however cholelithiasis was a common complication.

  18. Clinical outcome of surgical periodontal therapy: a short-term retrospective study.

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    Hayakawa, Hiroki; Fujinami, Koushu; Ida, Atsushi; Furusawa, Masahiro; Nikaido, Masahiko; Yamashita, Shuichiro; Saito, Atsushi

    2012-01-01

    This study aimed to investigate retrospectively the outcome of surgical periodontal therapy. Periodontal surgeries implemented at General Dentistry, Tokyo Dental College Suidobashi Hospital during the period of April 2010 through March 2012 were subjected to data analysis. After initial periodontal therapy, 17 clinicians performed a total of 138 periodontal surgeries in 80 patients with moderate to advanced periodontitis (31 men and 49 women; mean age 54). Cases (sites) operated were as follows: open flap debridement=102, periodontal regenerative therapy=29 (17 for intrabony defects, 12 for furcation involvements) and periodontal plastic surgery=7. Enamel matrix derivative or bone graft was used for regenerative therapy. Clinical data were analyzed focusing on the comparison between open flap debridement and regenerative therapy. At 5 months after open flap debridement, mean reduction in probing depth (PD) and gain in clinical attachment level (CAL) was 3.9 mm (range -1.0-9.0) and 2.3 mm (range -1.0-9.0), respectively. The corresponding values with regenerative therapy were 4.0 mm (range 0-8.0) and 2.8 mm (-1.0-6.0), respectively. At sites with initial PD≥8 mm, a significantly greater gain in CAL was obtained with the regenerative therapy than with flap surgery (mean CAL gain 4.3 mm vs. 2.9 mm, pPeriodontal surgery performed in our clinical setting demonstrated a favorable short-term outcome. Our data suggest the efficacy of regenerative therapy, in particular for the treatment of deep pockets.

  19. Clinical and Radiological Profile of Acute Fibrinous and Organizing Pneumonia: A Retrospective Study

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    Jing-Hong Dai; Hui Li; Wei Shen; Li-Yun Miao; Yong-Long Xiao; Mei Huang; Meng-Shu Cao

    2015-01-01

    Background:Acute fibrinous and organizing pneumonia (AFOP) is a unique pathological entity with intra-alveolar fibrin in the form of "fibrin balls" and organizing pneumonia.It was divided into rare idiopathic interstitial pneumonia according to the classification notified by American Thoracic Society/European Respiratory Society in 2013.As a rare pathological entity,it is still not well known and recognized by clinicians.We reviewed the clinical features of 20 patients with AFOP diagnosed in a teaching hospital.Methods:The medical records of 20 patients with biopsy-proven diagnosis of AFOP were retrospectively reviewed.The patients' symptoms,duration of the disease,comorbidities,clinical laboratory data,pulmonary function testing,radiographic studies,and the response to treatment were extracted and analyzed.Results:Fever was the most common symptom and was manifested in 90% of AFOP patients.For clinical laboratory findings,systematic inflammatory indicators,including C-reactive protein and erythrocyte sedimentation rate,were significantly higher than normal in AFOP patients.In accordance with this increased indicators,injured liver functions were common in AFOP patients.Inversely,AFOP patients had worse clinical conditions including anemia and hypoalbuminemia.For pulmonary function testing,AFOP patients showed the pattern of restrictive mixed with obstructive ventilation dysfunction.For high-resolution computerized tomography (HRCT) findings,the most common pattern for AFOP patients was lobar consolidation which was very similar to pneumonia.However,unlike pneumonia,AFOP patients responded well to glucocorticoids.Conclusion:Patients with AFOP manifest as acute inflammatory-like clinical laboratory parameters and lobar consolidation on HRCT,but respond well to steroid.

  20. Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study.

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    Costa, Vanessa Polina Pereira; Goettems, Marilia Leão; Baldissera, Elaine Zanchin; Bertoldi, Andréa Dâmaso; Torriani, Dione Dias

    2016-08-18

    This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child's age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7%) had clinical sequelae and 185 teeth (32.7%), radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%). Clinical sequelae increased with injury severity (p teeth with enamel fracture, and 26.0% (95%CI 14-40) for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35-82) and those with subluxation (15.8% 95%CI 10-22). Risk of premature loss was 27.3% (95%CI 13-45) for teeth with extrusive luxation, and 10.2% (95%CI 5-17) for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.

  1. Dental emergencies in a university-based pediatric dentistry postgraduate outpatient clinic: a retrospective study.

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    Agostini, F G; Flaitz, C M; Hicks, M J

    2001-01-01

    The purpose of this retrospective study was to determine the prevalence and types of dental emergencies occurring in a university-based, pediatric dentistry postgraduate outpatient clinic. All patients presenting for emergency dental care during scheduled clinic hours over a three year were identified, and their charts were retrieved. Each record was reviewed for demographic information, chief complaint and clinical diagnosis. Only those charts with both chief complaints and clinical diagnoses recorded were included in this study. A total of 816 patients received emergency care, representing 15.3 percent of all patient treated during the study period. The patient population had a slight female predilection (53 percent female, 47 percent male) and a mean age of 5.1 years (range 10 days to 15 years). Ethnicity (39 percent African-American, 36 percent Hispanic, 24 percent Caucasian emergency visit was their first dental visit. Reasons for seeking emergency included 1) pain or discomfort due to caries [30.1 percent] with 27 percent due to early childhood caries; 2) dental trauma [23 percent];3) eruption difficulties [18 percent] with 27 percent due to early childhood caries; 2) dental trauma [23 percent];3 eruption difficulties [18 percent];4) soft tissue pathoses [16 percent]; 5) problems with orthodontic appliances or space maintainers [10 percent]; and 6) lost restorations [2 percent]. Pain and bleeding were the most common reasons for seeking emergency dental care. Most causes for seeking outpatient emergency dental care are disease processes which may be avoided by infant oral health and preventive dentistry programs and early treatment intervention.

  2. Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study.

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    Leonardo Gil-Santana

    Full Text Available The rising prevalence of diabetes mellitus (DM worldwide, especially in developing countries, and the persistence of tuberculosis (TB as a major public health issue in these same regions, emphasize the importance of investigating this association. Here, we compared the clinical profile and disease outcomes of TB patients with or without coincident DM in a TB reference center in Brazil.We performed a retrospective analysis of a TB patient cohort (treatment naïve of 408 individuals recruited at a TB primary care center in Brazil between 2004 and 2010. Data on diagnosis of TB and DM were used to define the groups. The study groups were compared with regard to TB disease presentation at diagnosis as well as to clinical outcomes such as cure and mortality rates upon anti-tuberculosis therapy (ATT initiation. A composite score utilizing clinical, radiological and microbiological parameters was used to compare TB severity between the groups.DM patients were older than non-diabetic TB patients. In addition, diabetic individuals more frequently presented with cough, night sweats, hemoptysis and malaise than those without DM. The overall pattern of lung lesions assessed by chest radiographic examination was similar between the groups. Compared to non-diabetic patients, those with TB-diabetes exhibited positive acid-fast bacilli in sputum samples more frequently at diagnosis and at 30 days after ATT initiation. Notably, higher values of the TB severity score were significantly associated with TB-diabetes comorbidity after adjustment for confounding factors. Moreover, during ATT, diabetic patients required more frequent transfers to TB reference hospitals for complex clinical management. Nevertheless, overall mortality and cure rates were indistinguishable between the study groups.These findings reinforce the idea that diabetes negatively impacts pulmonary TB severity. Our study argues for the systematic screening for DM in TB reference centers in endemic

  3. Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study

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    Hickson, Lucas S.; Daltro, Carla; Castro, Simone; Kornfeld, Hardy; Netto, Eduardo M.; Andrade, Bruno B.

    2016-01-01

    Background The rising prevalence of diabetes mellitus (DM) worldwide, especially in developing countries, and the persistence of tuberculosis (TB) as a major public health issue in these same regions, emphasize the importance of investigating this association. Here, we compared the clinical profile and disease outcomes of TB patients with or without coincident DM in a TB reference center in Brazil. Methods We performed a retrospective analysis of a TB patient cohort (treatment naïve) of 408 individuals recruited at a TB primary care center in Brazil between 2004 and 2010. Data on diagnosis of TB and DM were used to define the groups. The study groups were compared with regard to TB disease presentation at diagnosis as well as to clinical outcomes such as cure and mortality rates upon anti-tuberculosis therapy (ATT) initiation. A composite score utilizing clinical, radiological and microbiological parameters was used to compare TB severity between the groups. Results DM patients were older than non-diabetic TB patients. In addition, diabetic individuals more frequently presented with cough, night sweats, hemoptysis and malaise than those without DM. The overall pattern of lung lesions assessed by chest radiographic examination was similar between the groups. Compared to non-diabetic patients, those with TB-diabetes exhibited positive acid-fast bacilli in sputum samples more frequently at diagnosis and at 30 days after ATT initiation. Notably, higher values of the TB severity score were significantly associated with TB-diabetes comorbidity after adjustment for confounding factors. Moreover, during ATT, diabetic patients required more frequent transfers to TB reference hospitals for complex clinical management. Nevertheless, overall mortality and cure rates were indistinguishable between the study groups. Conclusions These findings reinforce the idea that diabetes negatively impacts pulmonary TB severity. Our study argues for the systematic screening for DM in TB

  4. Clinical and Therapeutic Aspects of Childhood Narcolepsy-Cataplexy: A Retrospective Study of 51 Children

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    Aran, Adi; Einen, Mali; Lin, Ling; Plazzi, Guiseppe; Nishino, Seiji; Mignot, Emmanuel

    2010-01-01

    Study Objective: To report on symptoms and therapies used in childhood narcolepsy-cataplexy. Design, Patients, and Setting: Retrospective series of 51 children who completed the Stanford Sleep Inventory. HLA-DQB1*0602 typing (all tested, and 100% positive), polysomnography or Multiple Sleep Latency Test (76%), and cerebrospinal fluid hypocretin-1 measurements (26%, all with low levels) were also conducted. Prospective data on medication response was collected in 78% using a specially designed questionnaire. Measurements and Results: Patients were separated into children with onset of narcolepsy prior to (53%), around (29%), and after (18%) puberty. None of the children had secondary narcolepsy. Clinical features were similar across puberty groups, except for sleep paralysis, which increased in frequency with age. Common features included excessive weight gain (84% ≥ 4 kg within 6 months of onset of narcolepsy) and earlier puberty (when compared with family members), notably in subjects who gained the most weight. Streptococcus-positive throat infections were reported in 20% of cases within 6 months of onset of narcolepsy. Polysomnographic features were similar across groups, but 3 prepubertal children did not meet Multiple Sleep Latency Test diagnostic criteria. Regarding treatment, the most used and continued medications were modafinil (84% continued), sodium oxybate (79%), and venlafaxine (68%). Drugs such as methylphenidate, tricyclic antidepressants, or selective serotonin reuptake inhibitors were often tried but rarely continued. Modafinil was reported to be effective for treating sleepiness, venlafaxine for cataplexy, and sodium oxybate for all symptoms, across all puberty groups. At the conclusion of the study, half of children with prepubertal onset of narcolepsy were treated “off label” with sodium oxybate alone or with the addition of one other compound. In older children, however, most patients needed more than 2 drugs. Conclusion: This study

  5. Retrospective clinical study of eighty-one cases of intracranial mucormycosis

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    Jinjian Ma

    2015-01-01

    Full Text Available Background: Fungal infections of the central nervous system, especially cerebral mucormycosis or brain abscess are very rare.Cerebral mucormycosis is a rare disease. It is not an independent disease, but a secondary opportunistic infectious disease. Materials and methods: This study has collected the data of 81 cases of intracranial mucormycosis from 28 Chinese hospitals, within 37 years, as well as reviewed the literatures and retrospectively analyzed and summarized this disease′s background, clinical classifications, risk factors, pathology, clinical manifestations, diagnosis, treatment, and prognosis. Results: The 81 IM cases were aged between 15 days (the youngest and 79 years (oldest, with a mean age of 41.6 years. Among them, 12 cases were 14 years old (the adult group . 45 cases were male and 36 were female, with a male/female ratio of 1.25:1.0. The shortest duration of the disease was three days, and the longest was 248 days. Conclusions: This study helped to realize an early diagnosis and treatment, improve the cure rate, and reduce mortality.

  6. Epidemiology, microbiology, clinical characteristics, and outcomes of candidemia in internal medicine wards-a retrospective study.

    Science.gov (United States)

    Eliakim-Raz, Noa; Babaoff, Roi; Yahav, Dafna; Yanai, Shirly; Shaked, Hila; Bishara, Jihad

    2016-11-01

    The clinical characteristics of internal medicine ward (IMW) patients with candidemia are unclear. The aim of this study was to define the clinical characteristics of candidemic IMW patients and to study the incidence, species distribution, and outcomes of these patients compared to surgical and intensive care unit (ICU) candidemic patients. A retrospective cohort of candidemic patients in IMWs, general surgery wards, and an ICU at Beilinson Hospital during the period 2007-2014 was analyzed. A total of 118 patients with candidemia were identified in six IMWs, two general surgery wards, and one ICU in the hospital. Candida albicans was the leading causative agent (41.1%). Higher proportions of Candida parapsilosis and Candida tropicalis isolates were observed in the IMW patients. IMW patients were significantly older, with poorer functional capacity, and had more frequently been exposed to antibiotic therapy within 90 days, in particular β-lactam-β-lactamase inhibitor combinations and cephalosporins. At onset of candidemia, a significantly lower number of IMW patients were mechanically ventilated (p48h. IMW candidemic patients account for a substantial proportion of candidemia cases and have unique characteristics and high mortality rates. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. A retrospective study of traumatic dental injuries in a Brazilian dental trauma clinic.

    Science.gov (United States)

    Caldas, A F; Burgos, M E

    2001-12-01

    The purpose of this retrospective study was to analyse data from the records of patients seen in the dental trauma emergency clinic in a general hospital in the city of Recife, Brazil, during the years 1997-1999, according to sex, age, cause, number of injured teeth, type of tooth and type of trauma. The records of all patients seen by dentists were collected. Altogether, 250 patients from 1 to 59 years of age presenting 403 dental injuries were examined and/or treated. The causes of dento-alveolar trauma were classified in five categories: home injuries, street injuries, school injuries, sports activities, violence. The type of trauma was classified by dentists working at the dental trauma clinic on the basis of Andreasen's classification. The gender difference in the number of cases of trauma was statistically significant (males 63.2% vs females 36.8) (PTrauma caused by violence was found to be statistically significant in the 6-15 years age group (P<0.0005).

  8. Cost and clinical consequences of smoking cessation in outpatients after cardiovascular disease: a retrospective cohort study.

    Science.gov (United States)

    Sicras-Mainar, Antoni; Díaz-Cerezo, Silvia; de Burgoa, Verónica Sanz; Navarro-Artieda, Ruth

    2013-01-01

    This cohort retrospective study explored the cost and clinical consequences of smoking cessation in outpatients after cardiovascular events (CVEs), in Spain. A total of 2,540 patients (68.1 years; 60.7% male; 8.4% smokers, 52.9% ex-smokers, and 38.7% never smokers) fulfilling the selection criteria and followed up throughout a period of 36 months after the event were considered eligible for analysis. Total costs were higher among current smokers in comparison with ex-smokers and never smokers (€7,981 versus [vs] €7,322 and €5,619, respectively) (P < 0.001). Both health care costs (€6,273 vs €5,673 and €4,823, respectively) (P < 001) and loss of productivity at work costs (€1,708 vs €1,650 and €796, respectively) (P < 001) accounted for such differences. There was also a difference in CVE recurrence rates (18.6% vs 16.5% and 9.6%, respectively) (P < 01). Smoking cessation in CVE outpatients was associated with lower cost and risk of CVE recurrence compared with smokers, and their health status was similar to that of never smokers, in routine clinical practice in Spain.

  9. Clinical Characteristics and Outcomes in a Population With Disseminated Herpes Zoster: A Retrospective Cohort Study.

    Science.gov (United States)

    Bollea-Garlatti, M L; Bollea-Garlatti, L A; Vacas, A S; Torre, A C; Kowalczuk, A M; Galimberti, R L; Ferreyro, B L

    2017-03-01

    Shingles is the cutaneous expression of the reactivation of latent varicella zoster virus infection in sensory ganglia. It presents as vesicles in the corresponding dermatome. The condition is called disseminated herpes zoster (DHZ) when more than 2 contiguous dermatomes are affected, more than 20 vesicles are observed outside the initial dermatome, or involvement is systemic. DHZ is rare and most frequently occurs in immunocompromised patients. To describe the epidemiology, predisposing factors, clinical presentation, laboratory findings, and clinical course of patients with DHZ, and to compare the findings in immunocompromised and immunocompetent patients. We analyzed a retrospective case series of adults hospitalized between February 2010 and October 2015. Forty-one patients with virologically confirmed manifestations of DHZ were included. Stress as a trigger factor was detected in 39% and immunodepression in 58.5%. Immunocompromised patients were younger than the immunocompetent patients (mean ages, 60.5 vs 82 years, P.01). Six patients died; there was no difference in mortality between the 2 groups. This study provides evidence on the relationship between DHZ, the presence of underlying immunodepression, and complications. Immunosenescence may play an important role in the onset of this disease in older immunocompetent patients. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Clinical characteristics of late-onset neuromyelitis optica spectrum disorder: A multicenter retrospective study in Korea.

    Science.gov (United States)

    Seok, Jin Myoung; Cho, Hye-Jin; Ahn, Suk-Won; Cho, Eun Bin; Park, Min Su; Joo, In-Soo; Shin, Ha Young; Kim, Sun-Young; Kim, Byung-Jo; Kim, Jong Kuk; Cho, Joong-Yang; Huh, So-Young; Kwon, Ohyun; Lee, Kwang-Ho; Kim, Byoung Joon; Min, Ju-Hong

    2017-01-01

    There are currently few studies regarding late-onset neuromyelitis optica spectrum disorder (LO-NMOSD). We aimed to describe the characteristic features of patients with LO-NMOSD in Korea. Anti-aquaporin-4 antibody-positive patients with neuromyelitis optica spectrum disorder (NMOSD) from nine tertiary hospitals were reviewed retrospectively. The patients were divided into two groups based on age of onset: LO-NMOSD (⩾50 years of age at onset) versus early-onset neuromyelitis optica spectrum disorder (EO-NMOSD) (<50 years of age at onset). Clinical, laboratory, and magnetic resonance imaging (MRI) parameters were investigated. Among a total of 147 patients (125 female; age of onset, 39.4 ± 15.2 years), 45 patients (30.6%) had an age of onset of more than 50 years. Compared to patients with EO-NMOSD, patients with LO-NMOSD had more frequent isolated spinal cord involvement at onset (64.4% vs 37.2%, p = 0.002), less frequent involvement of the optic nerve (40.0% vs 67.7%, p = 0.002), and less frequent brain MRI lesions (31.1% vs 50.0%, p = 0.034). Furthermore, there was a significant positive correlation between age of onset and Expanded Disability Status Scale (EDSS) score at last follow-up ( r = 0.246, p = 0.003). Age of onset could be an important predictor of lesion location and clinical course of patients with NMOSD.

  11. Retrospective study on clinical management of indolent ulcers in Boxer dogs

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    Ana Paula Hvenegaard

    2011-10-01

    Full Text Available Indolent ulcers are superficial corneal ulcers secondary to several changes on the corneal surface. They are frequently observed in middle-aged Boxer dogs, cause pain of acute onset and requires appropriate treatment. Aiming to evaluate the efficacy of clinical managements on the rate of healing of indolent ulcers, a retrospective study was conducted (1997-2008. Results demonstrated that proteinase inhibitors were the most often prescribed medication, and its administration did not interfere on the healing rate, as well as observed in dogs that received 1% atropine, antibiotics and anti-inflammatory drugs. Healing was delayed in dogs administered orally with vitamin C, but the healing process was faster on those dogs that went through corneal debridement/cauterization. In conclusion, to know the various types of treatments seems to be fundamental for the rapid resolution of the disease. It is suggested that debridement/cauterization, administration of proteinase inhibitor eye drops, prophylactic topical antibiotics and oral vitamin C, should be considered as an effective clinical management for indolent ulcers in Boxer dogs.

  12. Demographic and clinical profile of oral lichen planus: A retrospective study

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    Anita D Munde

    2013-01-01

    Full Text Available Introduction: Oral lichen planus (OLP is a relatively common inflammatory mucocutaneous disorder that frequently involves the oral mucosa. The clinical presentation of OLP ranges from mild painless white keratotic lesions to painful erosions and ulcerations. An important complication of OLP is the development of oral squamous cell carcinoma, which led the World Health Organization (WHO to classify OLP as a potentially malignant disorder. The demographic and clinical characteristics of OLP have been well-described in several relatively large series from developed countries, whereas such series from developing countries are rare. Objective: The objective of this retrospective study was to investigate the epidemiological and clinical characteristics of 128 OLP patients in rural population of India. Materials and Methods: In this study, the diagnostic criteria proposed by van der Meij et al. in 2003 based on the WHO definition of OLP were used to identify cases. Results: In 128 patients, M:F ratio was 1.61:1. The buccal mucosa was the most common site (88.20%. White lichen was seen in 83.59% and red lichen in 16.40% cases. Reticular type of OLP was the most common form (83.5% followed by erosive (15.6% and atrophic OLP (0.78%. The incidence of systemic diseases included hypertension (11%, diabetes mellitus (2.4%, and hypothyroidism (0.78%. Histopathologically epithelial dysplasia was present in 4 cases. Conclusion: Most of the characteristics are consistent with previous studies with differences in few. Lichen planus is a chronic disease where treatment is directed to control of symptoms. Long-term follow-up is essential to monitor for symptomatic flare ups and possible malignant transformation.

  13. Clinical and psychological repercussions of videolaparoscopic tubal ligation: observational, single cohort, retrospective study

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    Daniel Spadoto Dias

    Full Text Available CONTEXT AND OBJECTIVE: Tubal ligation is one of the most commonly used contraceptive methods worldwide. Since the controversy over the potential effects of tubal sterilization still continues, this study aimed to evaluate the clinical and psychological repercussions of videolaparoscopic tubal ligation.DESIGN AND SETTING: Observational, single cohort, retrospective study, conducted in a tertiary public hospital.METHODS: A questionnaire was applied to 130 women aged 21-46 years who underwent videolaparoscopic tubal ligation by means of tubal ring insertion or bipolar electrocoagulation and sectioning, between January 1999 and December 2007. Menstrual cycle interval, intensity and duration of bleeding, premenstrual symptoms, dysmenorrhea, dyspareunia, noncyclic pelvic pain and degree of sexual satisfaction were assessed in this questionnaire. Each woman served as her own control, and comparisons were made between before and after the surgical procedure and between the two techniques used.RESULTS: The clinical and psychological repercussions were significant, with increases in bleeding (P = 0.001, premenstrual symptoms (P < 0.001, dysmenorrhea (P = 0.019 and noncyclic pelvic pain (P = 0.001; and reductions in the number of sexual intercourse occurrences per week (P = 0.001 and in libido (P = 0.001. Women aged ≤ 35 years at the time of sterilization were more likely to develop menstrual abnormalities. The bipolar electrocoagulation method showed greater clinical and psychological repercussions.CONCLUSION: Regardless of the technique used, videolaparoscopic tubal ligation had repercussions consisting of increased menstrual flow and premenstrual symptoms, especially in women aged ≤ 35 years, and also had a negative influence on sexual activity.

  14. Prevalence and factors affecting home blood pressure documentation in routine clinical care: a retrospective study

    Directory of Open Access Journals (Sweden)

    Babcock Kelly

    2010-05-01

    Full Text Available Abstract Background Home blood pressure (BP is closely linked to patient outcomes. However, the prevalence of its documentation has not been examined. The objective of this study was to analyze the prevalence and factors affecting documentation of home BP in routine clinical care. Methods A retrospective study of 142,973 encounters of 9,840 hypertensive patients with diabetes from 2000 to 2005 was performed. The prevalence of recorded home BP and the factors associated with its documentation were analyzed. We assessed validity of home BP information by comparing the difference between home and office BP to previously published prospective studies. Results Home BP was documented in narrative notes for 2.08% of encounters where any blood pressure was recorded and negligibly in structured data (EMR flowsheets. Systolic and diastolic home BP in narrative notes were lower than office BP readings by 9.6 and 2.5 mm Hg, respectively (p Conclusions Home BP readings provide a valid representation of the patient's condition, yet are seldom documented despite their potential utility in both patient care and research. Strong association between higher patient income and home BP documentation suggests that the cost of the monitors may be a limiting factor; reimbursement of home BP monitoring expenses should be pursued.

  15. Gastric Cancer in the Young: Is It a Different Clinical Entity? A Retrospective Cohort Study

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    Adolfo Pisanu

    2014-01-01

    Full Text Available Background. The rate of gastric cancer in young patients has increased over the past few decades. The aim of this study was to search for independent risk factors related to patients of younger age. Methods. From January 1996 to December 2012, a series of 179 consecutive patients were admitted to our surgical department because of a gastric cancer. We carried out a retrospective cohort study in 20 patients younger than 50 and in 112 patients aged 50 and older treated by curative gastrectomy. The comparison involved the evaluation of patient and tumor characteristics. Results. Younger patients had significantly less comorbidities and a more favorable American Society of Anesthesiology score; they had significantly less preoperative weight loss and a significantly longer duration of symptoms; Helicobacter pylori infection and diffuse histological type were significantly associated with younger age. There was no statistically significant difference regarding overall and cancer-related 5-year survival; advanced cancer stage and diffuse histological type were the independent negative prognostic factors influencing cancer-related survival. Conclusions. We do not have sufficient evidence to consider gastric cancer in younger patients as a different clinical entity. Further studies are needed to understand carcinogenesis in younger patients and to improve gastric cancer classification.

  16. Clinical Evaluation of Small Diameter Straumann Implants in Partially Edentulous Patients: A 5-Year Retrospective Study

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    S. OZER

    2011-06-01

    Full Text Available Objective: The aim of the present study was to retrospectively evaluate small-diameter (3.3 mm Straumann® dental implants placed in the maxilla or the mandible over a period of 5 years in function.Materials and Methods: Twenty- eight partially edentulous patients received a total of 48 implants over a 5-year period. After the standard healing period (3 to 6 months, the implants were restored with single-tooth prostheses or fixed partial dentures. All patients were followed according to a strict maintenance program with regular recalls. The cumulative survival rates of implants were analyzed and prosthetic complications were assessed.Results: After 5 years of function, one single 10-mm-long implant in the maxillary premolar region was lost because of recurrent peri-implant infection in a female patient. Two single 10-mm-long maxillary implants placed in the posterior region were lost due to body fracture. The cumulative 5-year survival rate of the implants was 93.75 %. The most common prosthetic complication was loosening of the occlusal screw.Conclusion: Within the limited observation period and the number of patients included in this study, it may be concluded that the use of small-diameter implants appears to be predictable if clinical guidelines are followed and appropriate prosthetic restorations are provided. However, it should be noted that fatigue fracture may occur.

  17. A retrospective clinical study on longevity of posterior composite and amalgam restorations.

    NARCIS (Netherlands)

    Opdam, N.J.M.; Bronkhorst, E.M.; Roeters, F.J.M.; Loomans, B.A.C.

    2007-01-01

    OBJECTIVES: The purpose of this study was to evaluate retrospectively the longevity of class I and II amalgam and composite resin restorations placed in a general practice. METHODS: Patient records of a general practice were used for collecting the data for this study. From the files longevity and r

  18. Spontaneous elimination of hepatitis C virus infection: A retrospective study on demographic, clinical, and serological correlates

    Institute of Scientific and Technical Information of China (English)

    Perdita Wietzke-Braun; Larissa Bettina M(a)nhardt; Albert Rosenberger; Angela Uy; Giuliano Ramadori; Sabine Mihm

    2007-01-01

    AIM: To find correlates to spontaneous clearance of hepatitis C virus (HCV) infection, this study compared individuals with self-limited and chronic infection with regard to clinical, demographic, and serological parameters.METHODS: Sixty-seven anti-HCV positive and repeatedly HCV RNA negative individuals were considered to have resolved HCV infection spontaneously. To determine the viral genotype these patients had been infected with HCV serotyping was performed. For comparison reasons,62 consecutive patients with chronic hepatitis C were enrolled. Cases and controls were compared stratified for age and sex.RESULTS: Retrospective analysis showed (1) a lower humoral reactivity to HCV in patients with self-limited compared to chronic HCV-infection and (2) that younger age, history of iv drug use, and acute/post-acute hepatitis A or B co-infections, but not viral genotypes,are independent correlates for spontaneous HCV clearance.CONCLUSION: The stronger humoral reactivity to HCV in patients with persistent infections and in those with a history of iv drug use is supposed to be due to continuous or repeated contact(s) to the antigen.Metachronous hepatitis A or hepatitis B infections might favor HCV clearance.

  19. Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study

    Science.gov (United States)

    Perera, Gayan; Stewart, Robert; Higginson, Irene J.; Sleeman, Katherine E.

    2016-01-01

    Background: mortality statistics are a frequently used source of information on deaths in dementia but are limited by concerns over accuracy. Objective: to investigate the frequency with which clinically diagnosed dementia is recorded on death certificates, including predictive factors. Methods: a retrospective cohort study assembled using a large mental healthcare database in South London, linked to Office for National Statistics mortality data. People with a clinical diagnosis of dementia, aged 65 or older, who died between 2006 and 2013 were included. The main outcome was death certificate recording of dementia. Results: in total, 7,115 people were identified. Dementia was recorded on 3,815 (53.6%) death certificates. Frequency of dementia recording increased from 39.9% (2006) to 63.0% (2013) (odds ratio (OR) per year increment 1.11, 95% CI 1.07–1.15). Recording of dementia was more likely if people were older (OR per year increment 1.02, 95% CI 1.01–1.03), and for those who died in care homes (OR 1.89, 95% CI 1.50–2.40) or hospitals (OR 1.14, 95% CI 1.03–1.46) compared with home, and less likely for people with less severe cognitive impairment (OR 0.95, 95% CI 0.94–0.96), and if the diagnosis was Lewy body (OR 0.30, 95% CI 0.15–0.62) or vascular dementia (OR 0.79, 95% CI 0.68–0.93) compared with Alzheimer's disease. Conclusions: changes in certification practices may have contributed to the rise in recorded prevalence of dementia from mortality data. However, mortality data still considerably underestimate the population burden of dementia. Potential biases affecting recording of dementia need to be taken into account when interpreting mortality data. PMID:27146301

  20. Cost and clinical consequences of smoking cessation in outpatients after cardiovascular disease: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Sicras-Mainar A

    2013-08-01

    Full Text Available Antoni Sicras-Mainar,1 Silvia Díaz-Cerezo,2 Verónica Sanz de Burgoa,3 Ruth Navarro-Artieda41Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain; 2Health Economics and Outcomes Research Department, Pfizer, SLU, Alcobendas, Spain; 3Medical Department, Pfizer, SLU, Alcobendas, Spain; 4Medical Documentation Unit, Hospital Germans Trias i Pujol, Badalona, SpainAbstract: This cohort retrospective study explored the cost and clinical consequences of smoking cessation in outpatients after cardiovascular events (CVEs, in Spain. A total of 2,540 patients (68.1 years; 60.7% male; 8.4% smokers, 52.9% ex-smokers, and 38.7% never smokers fulfilling the selection criteria and followed up throughout a period of 36 months after the event were considered eligible for analysis. Total costs were higher among current smokers in comparison with ex-smokers and never smokers (€7,981 versus [vs] €7,322 and €5,619, respectively (P < 0.001. Both health care costs (€6,273 vs €5,673 and €4,823, respectively (P < 0.001 and loss of productivity at work costs (€1,708 vs €1,650 and €796, respectively (P < 0.001 accounted for such differences. There was also a difference in CVE recurrence rates (18.6% vs 16.5% and 9.6%, respectively (P < 0.01. Smoking cessation in CVE outpatients was associated with lower cost and risk of CVE recurrence compared with smokers, and their health status was similar to that of never smokers, in routine clinical practice in Spain.Keywords: mortality, health resources, health care costs

  1. Geographical, clinical, clinicopathological and radiographic features of canine angiostrongylosis in Irish dogs: a retrospective study

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    Gallagher Barbara

    2012-03-01

    Full Text Available Abstract Background Angiostrongylus vasorum infection is associated with high morbidity and mortality in dogs. Although recognised in Ireland, there are no large series of cases reported. The aim of this retrospective study was to identify pertinent clinical and geographical features in Irish dogs. Results The case records of dogs presenting to the University College Dublin Veterinary Hospital (1999-2010 were reviewed. A contemporaneous review of external faecal parasitology and post mortem submissions was also performed. A positive diagnosis of angiostrogylosis was identified in 49 dogs including 24 clinical, 10 post mortem and 15 external faecal sample cases. The majority (n = 44 (90% resided on the East Coast. In the clinical cases, the median age was 20 months, 29% of cases were older than 2 years. Clinical features included cardiorespiratory (63%, coagulopathic (71% and other (63% signs. Cough (n = 10, dyspnoea (n = 5 and tachypnoea (n = 3 were the most common cardiorespiratory abnormalities. Of animals with evidence of coagulopathy, excessive haemorrhage from a wound (n = 5, airway haemorrhage (n = 9, epistaxis (n = 3, haematoma (n = 4, suspected haemarthrosis (n = 3, neurological signs (n = 2 and haematuria (n = 1 were found. Ten dogs were anaemic, of which two were severe (haematocrit ≤ 0.20 L/L. Ten animals had thrombocytopenia, with four severely affected (≤50 × 109/L. PT and APTT values were prolonged in 4 (24% of 17 and a BMBT was prolonged in 5 (63% of 8 cases. Vague signs of exercise intolerance (n = 6, lethargy (n = 6 and weakness (n = 2 were identified, with two (8% animals having only these signs. In one animal the diagnosis appeared to be incidental. Thoracic radiographs (n = 19 identified abnormalities in 100% of cases. Four (17% animals died before or within 24 hours of treatment and post mortem examinations confirmed angiostrongylosis. Fenbendazole was administered in 19 cases, 18 (95% recovered. Two animals were

  2. HIV and cancer: a comparative retrospective study of Brazilian and U.S. clinical cohorts.

    Science.gov (United States)

    Castilho, Jessica L; Luz, Paula M; Shepherd, Bryan E; Turner, Megan; Ribeiro, Sayonara R; Bebawy, Sally S; Netto, Juliana S; McGowan, Catherine C; Veloso, Valdiléa G; Engels, Eric A; Sterling, Timothy R; Grinsztejn, Beatriz

    2015-01-01

    With successful antiretroviral therapy, non-communicable diseases, including malignancies, are increasingly contributing to morbidity and mortality among HIV-infected persons. The epidemiology of AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs) in HIV-infected populations in Brazil has not been well described. It is not known if cancer trends in HIV-infected populations in Brazil are similar to those of other countries where antiretroviral therapy is also widely available. We performed a retrospective analysis of clinical cohorts at Instituto Nacional de Infectologia Evandro Chagas (INI) in Rio de Janeiro and Vanderbilt Comprehensive Care Clinic (VCCC) in Nashville from 1998 to 2010. We used Poisson regression and standardized incidence ratios (SIRs) to examine incidence trends. Clinical and demographic predictors of ADCs and NADCs were examined using Cox proportional hazards models. This study included 2,925 patients at INI and 3,927 patients at VCCC. There were 57 ADCs at INI (65% Kaposi sarcoma), 47 at VCCC (40% Kaposi sarcoma), 45 NADCs at INI, and 82 at VCCC. From 1998 to 2004, incidence of ADCs remained statistically unchanged at both sites. From 2005 to 2010, ADC incidence decreased in both cohorts (INI incidence rate ratio per year = 0.74, p < 0.01; VCCC = 0.75, p < 0.01). Overall Kaposi sarcoma incidence was greater at INI than VCCC (3.0 vs. 1.2 cases per 1,000 person-years, p < 0.01). Incidence of NADCs remained constant throughout the study period (overall INI incidence 3.6 per 1,000 person-years and VCCC incidence 5.3 per 1,000 person-years). Compared to general populations, overall risk of NADCs was increased at both sites (INI SIR = 1.4 [95% CI 1.1-1.9] and VCCC SIR = 1.3 [1.0-1.7]). After non-melanoma skin cancers, the most frequent NADCs were anal cancer at INI (n = 7) and lung cancer at VCCC (n = 11). In multivariate models, risk of ADC was associated with male sex and immunosuppression. Risk of

  3. Safety of methotrexate in rheumatoid arthritis: a retrospective cohort study in clinical practice

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    G. Mennillo

    2011-09-01

    Full Text Available Objective. To evaluate the treatment duration with MTX monotherapy or in association with DMARDs or anti TNFa inhibitors and the incidence and typology of adverse events (AE occurred in rheumatoid arthritis (RA patients. Methods. A retrospective large cohort study of RA outpatients, consecutively seen from January 2000 to June 2005 was performed. Study group were RA patients classified according to the 1984 ACR criteria for the classification of rheumatoid arthritis. The patients were divided in 3 groups according to the treatment regimen: MTX monotherapy, MTX in combination with DMARD or with anti TNFa agents. We analyzed 348 therapeutic cycles, 177 of whom using MTX monotherapy. Results. The 224 RA patients accumulated 800 person-years of follow up. Follow up for each of the groups was: MTX monotherapy 479.4 person-years, MTX in combination with DMARDs 244.5, or with anti TNFa inhibitors, 75.7 person- years. From the Kaplan-Meier analysis, the probability of patients remaining on treatment 5 years was 58.5 after starting MTX. The incidence of any AE was 8.87 per 100 person-years. From all, 69 (97.2% AE were no severe. Among those, more frequently were observed at gastrointestinal tract (31%, liver (19.7%, skin (15.5%. Incidence of severe AE (lung adenocarcinoma, 1 case; pancreatitis, 1 case was 0.25 per 100 person-years, occurring in patients taking MTX monotherapy or MTX in combination with DMARDs, respectively. Conclusions. These data confirm that methotrexate is well tolerated in clinical practice in the medium-long term. Nevertheless, the occurrence of severe AE require an accurate vigilance for methotrexate toxicity.

  4. Clinical features of isolated gestational proteinuria progressing to pre-eclampsia: retrospective observational study

    Science.gov (United States)

    Akaishi, Rina; Yamada, Takahiro; Morikawa, Mamoru; Nishida, Ryutaro; Minakami, Hisanori

    2014-01-01

    Objectives Some women with isolated gestational proteinuria (IGP) later develop hypertension and are diagnosed with pre-eclampsia (PE). This study was performed to determine whether clinical features of such proteinuria preceding PE (P-PE) differ from those of other PE (O-PE). Design Retrospective observational study after approval of the institutional review board of ethics. Setting A single university hospital. Proteinuria was defined as a protein-to-creatinine ratio (mg/mg; P/Cr) of ≥0.27 in the spot urine specimen. IGP was defined as proteinuria in the absence of hypertension. P-PE was defined as PE in which proteinuria preceded hypertension by more than 2 days. Participants All of 10 and 18 consecutive women with P-PE and O-PE, respectively, who gave birth between January 2008 and August 2013. Results Proteinuria appeared earlier (at 30.2±3.0 vs 35.3±4.3 weeks, p=0.001), the P/Cr level was greater at birth (7.28±2.14 vs 3.19±2.49, pIGP was 10.0±5.9 days (range 3–20), and the time interval until delivery after diagnosis of PE was 6.1±8.2 days (range 0–23) in 10 women with P-PE. The P/Cr levels at birth were significantly inversely correlated with the antenatal lowest antithrombin activity and fibrinogen levels among the 28 women with PE. Conclusions Women with P-PE were likely to exhibit greater proteinuria in the urine, greater water retention in the interstitial space and more enhanced coagulation–fibrinolysis, thus suggesting that they may constitute a more severe form of PE than women with O-PE do. PMID:24747797

  5. Clinical associations with a placental diagnosis of delayed villous maturation: a retrospective study.

    LENUS (Irish Health Repository)

    Higgins, Mary

    2012-02-01

    Delayed villous maturation (DVM) is a spectrum of placental disease characterized by decreased tertiary villus formation, reduced vasculosyncytial membrane formation, and, in its more severe forms, increased large bullous villi. In some series it has been associated with an increased risk of stillbirth in the late third trimester, but overall there are few data on its significance. The aim of this study was to assess perinatal factors associated with, and the clinical significance of, the finding of DVM on placental histology. This was a retrospective study investigating all pregnancies with DVM diagnosed on placental histology in a tertiary level unit between December 2001 and August 2006. Over a 6-year period, 2915 placentas were triaged for histopathological assessment, representing 6.1% of all 48 054 deliveries in this time period. One hundred ninety (6.3%) of these selected cases showed DVM. Fifteen placentas from infants with less than 34 completed weeks of gestation were excluded, leaving 175 for further analysis. When compared with controls matched for gestation and delivering within the same time period (n  =  175), DVM was significantly associated with pregestational diabetes (8% vs 2.8%, P < .05; relative risk 2.8 [95% confidence interval 1.03-7.6]), gestational diabetes (8.6% vs 3.4%, P < 0.05; relative risk 2.5 [95% confidence interval 0.99-6.3]), and prenatal or intrapartum intrauterine death (8.6% vs 0%, P < 0.05). Delayed villous maturation is associated with both gestational and pregestational diabetes mellitus and with perinatal death.

  6. Clinical and molecular characteristics of HNSCC patients with brain metastases: a retrospective study.

    Science.gov (United States)

    Bulut, Olcay Cem; Lindel, Katja; Hauswald, Henrik; Brandt, Regine; Klauschen, Frederick; Wolf, Janina; Wolf, Thomas; Plinkert, Peter K; Simon, Christian; Weichert, Wilko; Stenzinger, Albrecht

    2014-06-01

    Among the metastasis patterns of head and neck squamous cell carcinoma (HNSCC), intracranial spread is a rare but dreaded event. To date only very few cases have been reported and clinical and molecular data are sparse. We screened our archives for HNSCC patients from 1992 to 2005 who were diagnosed with brain metastases (BM). For retrospective analysis, all clinico-pathological data including disease-free survival (DFS), local progression-free survival (LPFS), and overall survival (OS) were compiled. Additionally, we assessed the mutational status of the TP53 gene and the prevalence of HPV serotypes by PCR and Sanger sequencing. Immunohistochemistry was applied to detect p16INK4A expression levels as surrogate marker for HPV infection. The prevalence rate of BM in our cohort comprising 193 patients with advanced HNSCC was 5.7%. Of 11 patients with BM, 3 were female and 9 were male. Seven of the primary tumors were of oropharyngeal origin (OPSCC). LPFS of the cohort was 11.8 months, DFS was 12.1 months and OS was 36.0 months. After the diagnosis of BM, survival was 10.5 months. Five tumors showed a mutation in the TP53 gene, while five of the seven OPSCC tumors had a positive HPV status displaying infection with serotype 16 in all cases. Compared with patients who harbored TP53wt/HPV-positive tumors, patients with TP53 mutations showed a poor prognosis. Compared with the whole cohort, the interval between diagnosis of the primary and the detection of BM was prolonged in the HPV-infected OPSCC subgroup (26.4 vs. 45.6 months). The prognosis of HNSCC patients with BM is poor. In our cohort, most tumors were OPSCC with the majority being HPV positive. Our study points toward a putatively unusual metastatic behavior of HPV-positive OPSCC.

  7. A retrospective study of toddlers with autism spectrum disorder: Clinical and developmental profile

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    Prahbhjot Malhi

    2014-01-01

    Full Text Available Objective: To retrospectively examine the developmental and clinical characteristics of children with autism spectrum disorders (ASD in the first 2 years of life in order to narrow the interval between parental concern and getting a reliable diagnosis of autism. Materials and Methods: The case records of 21 children in whom a diagnosis of ASD was made in the first 2 years of life and confirmed 6 months to 1 year later were examined. The inclusion criterion was absence of neurological, metabolic, or genetic disorders and sensory or motor impairments. These case records were maintained in the Pediatric Psychology Clinic at the Department of Pediatrics of a tertiary care teaching hospital in North India. Results: The average age at presentation to the clinic was 21.23 months (SD = 2.18. The clinical characteristics that were found in two-thirds or more children included lack of speech, inability to follow verbal commands, lack of pretend play, no index finger pointing, difficulty in playing with toys in a constructive manner, lack of joint attention, and motor stereotypies. The mean IQ was 66.62 (SD = 15.11 and the mean SQ as measured by the Vineland Social Maturity Scale was 80.43 (SD = 17.45. Conclusions: Given the validity of early diagnosis over time, clinicians should be encouraged not only to make an early diagnosis but also to initiate early interventions in children with ASD.

  8. First dorsal metacarpal artery flap for thumb reconstruction: a retrospective clinical study

    Science.gov (United States)

    Muyldermans, Thomas

    2009-01-01

    Extensive pulp (zone 4) defects of the thumb, with the exposure of tendon or bone, are challenging reconstructive problems. Surgical treatment includes the use of local, regional, and free flaps. The first dorsal metacarpal artery flap has been used successfully for defects of the thumb. The innerved first dorsal metacarpal artery flap from the dorsum of the index finger was first described by Hilgenfeldt and refined by Holevich. An island flap carried on a neurovascular pedicle consisting of the first dorsal metacarpal artery was first demonstrated by Foucher and Braun. Seven innervated FDMCA island flaps were performed from May 2005 until July 2007 for thumb reconstruction. There were three women and four men with an average age of 54.9 years (range 28–89 years). The mean follow-up period was 15.4 months (range 4–29 months). The dominant hand was involved in six (85.7%) patients. In a retrospective clinical study, the following criteria were evaluated: (1) etiology of the defect, (2) time of reconstruction (primary vs. delayed), (3) survival rate of flap, (4) sensory function (Semmes–Weinstein monofilaments, static 2-PD, pain, cortical reorientation), (5) TAM measured with the Kapandji index, and (6) subjective patient satisfaction (SF 36). Four patients presented with trauma, two patients with defects after tumor resection and one with infection of the thumb. The flap was used for immediate reconstruction in three (42.9%) patients and for delayed reconstruction in four (57.1%) patients. Delayed reconstruction was performed 4.75 (1–12) months after initial trauma or first surgery. The donor area was grafted with full-thickness skin grafts in all cases. All flaps survived. The mean SWMF was 3.31 g and average statis 2-PD over the flap was 10.57 mm. Pain at the flap scored 3.71 over 10 and at the donor site 2.17 over 10. Paresthesia at the flap scored 0.57 over 4 and at the donor site 0.33 over 4. Complete cortical reorientation was only seen in one

  9. Clinical characteristics, neurophysiological grade and outcome of patients with carpal tunnel syndrome A retrospective study

    Institute of Scientific and Technical Information of China (English)

    Jingxia Dang

    2007-01-01

    BACKGROUND: Carpal tunnel syndrome (CTS) is diagnosed mainly according to clinical symptoms, physical sign and neurodiagnostic laboratory examination. The therapeutic effect of conservative management and surgical operation in treating CTS need to be further observed and evaluated. OBJECTIVE: To analyze the clinical characteristics, neurophysiological grade and outcome in patients with CTS.DESIGN: Retrospective case-analysis.SETTING: Department of Neurology, First Affiliated Hospital, Medical College, Xi'an Jiaotong University. PARTICIPANTS: Totally 161 patients with suspected CTS from National Neuroscience Institute of Singapore referred to the Neurodiagnostic Laboratory for the confirmatory testing between January and September 2002. The involved patients, 137 male and 24 female, were aged 21-85 years. METHODS:①The condition of diabetes mellitus complicated by abnormal thyroid function was observed.②The effect on predominant hand, and paraesthesia were observed.③Neuroelectrophysiological studies were performed and the results were graded into mild, moderate and severe CTS according to the American Association of Electrodiagnostic Medicine (AAEM) criteria.④Conservative management and surgical intervention were followed up 3 months later, and symptoms and physical sign basically disappeared, and function was basically recovered, which indicated that disease condition improved.MAIN OUTCOME MEASURES:①Condition of CTS complicated by metabolic disease;②Effects on predominant hand and paraesthesia;③Electrophysiological grading; ④Prognosis.RESULTS: Totally 161 patients participated in the final analysis.①Condition of CTS complicated by metabolic disease: Among 161 patients, 17.4% (28/161) were documented to have diabetes mellitus and 7(4.3%) had hypothyroidism.②Effects on predominant hand and paraesthesia: Dominant hand involvement was present in 134 patients (83.2%) and more than 75% had onset of symptoms in the dominant hand. Sensory symptoms like

  10. Clinical factors influencing normalization of prothrombin time after stopping warfarin: a retrospective cohort study

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    Zondag Michelle

    2008-10-01

    Full Text Available Abstract Background Anticoagulation with warfarin should be stopped 4–6 days before invasive procedures to avoid bleeding complications. Despite this routine, some patients still have high International Normalized Ratio (INR values on the day of surgery and the procedure may be cancelled. We sought to identify easily available clinical characteristics that may influence the rate of normalization of prothrombin time when warfarin is stopped before surgery or invasive procedures. Methods Clinical data were collected retrospectively from consecutive cases from two cohorts, who stopped warfarin 6 days before surgery. An INR value of 1.6 or higher on the day of surgery or requirement for reversal with vitamin K the day before surgery were criteria for slow return (S to normal INR. Results Of 202 patients, 14 (7% were classified as S. Eight of the S-patients required reversal with vitamin K one day before surgery and in another case surgery was cancelled due to high INR. Baseline INR was the only variable significantly associated with classification as S in stepwise logistic regression analysis (p = 0.003. The odds ratio for being in the normal group was 0.27 (95% confidence interval 0.12–0.62 for each unit baseline INR increased. The positive predictive value of baseline INR with a cut off at > 3.0 was only 15% and for INR > 3.5 it was 33%. Conclusion Baseline INR, but not the size of the maintenance dose, is associated with the rate of normalization of prothrombin time after stopping warfarin, but it has limited utility as predictor in clinical practice. Whenever normal hemostasis is considered crucial for the safety, the INR should be checked again before the invasive procedure.

  11. Relationship between reflection ability and clinical performance: a cross-sectional and retrospective-longitudinal correlational cohort study in midwifery.

    Science.gov (United States)

    Embo, M; Driessen, E; Valcke, M; van der Vleuten, C P M

    2015-01-01

    increasingly, reflection is highlighted as integral to core practice competencies but empirical research into the relationship between reflection and performance in the clinical workplace is scarce. this study investigated the relationship between reflection ability and clinical performance. we designed a cross-sectional and a retrospective-longitudinal cohort study. Data from first, second and third year midwifery students were collected to study the variables 'clinical performance' and 'reflection ability'. Data were analysed with SPSS for Windows, Release 20.0. Descriptive statistics, Pearson׳s Product Moment Correlation Coefficients (r) and r² values were computed to investigate associations between the research variables. the results showed a moderate observed correlation between reflection ability and clinical performance scores. When adopting a cross-sectional perspective, all correlation values were significant (pcorrelations. Assuming perfect reliability in the measurement, the adjusted correlations, for year 2 and year 3 indicated a high association between reflection ability and clinical performance (>0.6). The results based on the retrospective-longitudinal data set explained a moderate proportion of the variance after correction for attenuation. Finally, the results indicate that 'reflection ability' scores of earlier years are significant related with 'clinical performance' scores of subsequent years. These results suggest that (1) reflection ability is linked to clinical performance; (2) that written reflections are an important, but not the sole way to assess professional competence and that (3) reflection is a contributor to clinical performance improvement. the data showed a moderate but significant relationship between 'reflection ability' and 'clinical performance' scores in clinical practice of midwifery students. Reflection therefore seems an important component of professional competence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Effects of Bailing capsules for renal transplant recipients: a retrospective clinical study

    Institute of Scientific and Technical Information of China (English)

    WANG Wei; ZHANG Xi-nuo; YIN Hang; LI Xiao-bei; HU Xiao-peng; LIU Hang; WANG Yong

    2013-01-01

    Background The administration of immunosuppressive agents is always an important factor affecting the long-term survival of organ transplantation recipients.The best therapeutic regimen which either decreases the side effects of immune inhibitors or enhances the immunosuppressive efficacy is the goal of transplantation surgeons continue to search.This study investigated the effects of Bailing (Cordyceps sinensis) capsules on renal function and other systems of the body after renal transplantation.Methods Clinical data of 80 renal transplant recipients who were administered Bailing capsules and 100 renal transplant recipients in the control group were retrospectively analyzed to compare the incidences of graft rejection and infection after transplantation.The results of routine blood and urine tests,liver and kidney functions,uric acid (UA),24-hour urine protein (24 h-Upro),as well as 1-and 5-year patient renal allograft survival rates were compared between the two groups.Results The follow-up was 3-5 years.The two groups were not shown to have statistically significant differences in age,gender,cold ischemia time,donor-recipient human leukocyte antigen typing,panel reactive antibodies,lymphocytotoxicity tests,and the application of immunosuppressive agents at the baseline.The two groups were also not significantly different in the incidence of acute injection after transplantation,recovery of renal function,and blood glucose level.The Bailing group was significantly lower than the control in the incidence of infection,serum aspartate aminotransferase/alanine aminotransferase,total bilirubin,UA,and 24-hour Upro,but significantly higher than the control group in peripheral red blood cell count and white blood cell count (P<0.05).One-year and 5-year patient survival rates were 98.7% and 98.0%,respectively in the Bailing group,95.0% and 93.0%,respectively,in the control group.One-year and 5-year renal allograft survival rates were 97.5% and 95.0

  13. Demographic and clinical profile of oral squamous cell carcinoma patients: A retrospective study

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    R Shenoi

    2012-01-01

    Full Text Available Background: Oral cancers are one of the ten leading cancers in the world. However, in India, it is one of the most common cancer and constitutes a major public health problem. Aim: The purpose of this study was to evaluate, retrospectively, the epidemiologic profile of patients with oral squamous cell carcinoma (OSCC. Materials and Methods: OSCC cases were retrospectively analyzed from January 2008 to September 2010 for age, gender, occupation, duration of the symptoms, habits (tobacco and alcohol consumption, site of primary tumor, and TNM staging, and the findings were formulated to chart the trends in central India population. Results: Male to female ratio was 4.18:1. Mean age was 49.73 years. The most common site of presentation of tumor was in mandibular alveolus region. Tobacco chewing was the major cause for the development of OSCC. Maximum number of patients, i.e., 201 (68.14% were presented within 6 months of onset of symptoms. Majority of patients were presented in Stage III (82.37%. Correlation between the two variables, i.e., site to habits, staging to site involved, staging to duration of the disease, staging to habits, and staging to age of the patient, were found to be statistically nonsignificant (P>0.05. Conclusions: The aim of the study was the demographic description of oral squamous cell carcinoma. Most of the cases report at advanced stages of the disease which often leads to delay in the management coupled with the fact that health care centers are burdened with long waiting lists. Strategies to overcome the present situation must be undertaken by oral health programs for the early diagnosis and prevention and management and follow up of oral cancer.

  14. Changes to physician processing times in response to clinic congestion and patient punctuality: a retrospective study.

    Science.gov (United States)

    Chambers, Chester G; Dada, Maqbool; Elnahal, Shereef; Terezakis, Stephanie; DeWeese, Theodore; Herman, Joseph; Williams, Kayode A

    2016-10-18

    We examine interactions among 3 factors that affect patient waits and use of overtime in outpatient clinics: clinic congestion, patient punctuality and physician processing rates. We hypothesise that the first 2 factors affect physician processing rates, and this adaptive physician behaviour serves to reduce waiting times and the use of overtime. 2 urban academic clinics and an affiliated suburban clinic in metropolitan Baltimore, Maryland, USA. Appointment times, patient arrival times, start of service and physician processing times were collected for 105 visits at a low-volume suburban clinic 1, 264 visits at a medium-volume academic clinic 2 and 22 266 visits at a high-volume academic clinic 3 over 3 distinct spans of time. Data from the first clinic were previously used to document an intervention to influence patient punctuality. This included a policy that tardy patients were rescheduled. Clinicians' processing times were gathered, conditioned on whether the patient or clinician was tardy to test the first hypothesis. Probability distributions of patient unpunctuality were developed preintervention and postintervention for the clinic in which the intervention took place and these data were used to seed a discrete-event simulation. Average physician processing times differ conditioned on tardiness at clinic 1 with p=0.03, at clinic 2 with p=10(-5) and at clinic 3 with p=10(-7). Within the simulation, the adaptive physician behaviour degrades system performance by increasing waiting times, probability of overtime and the average amount of overtime used. Each of these changes is significant at the p<0.01 level. Processing times differed for patients in different states in all 3 settings studied. When present, this can be verified using data commonly collected. Ignoring these behaviours leads to faulty conclusions about the efficacy of efforts to improve clinic flow. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  15. Clinical features of the overlap syndrome of autoimmune hepatitis and primary biliary cirrhosis: retrospective study

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ PBC-AIH overlap syndrome is an autoimmune liver disease between AIH (autoimmune hepatitis) and PBC (primary biliary cirrhosis). To investigate the characteristic of the PBC-AIH overlap syndrome, we have conducted a retros- pective study of 12 diagnosed overlap syndrome patients and compared them with typical PBC and AIH on the basis of clinical, biochemical, serological and histopathological findings.

  16. The Murri clinic: a comparative retrospective study of an antenatal clinic developed for Aboriginal and Torres Strait Islander women

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    Kildea Sue

    2012-12-01

    Full Text Available Abstract Background Indigenous Australians are a small, widely dispersed population. Regarding childbearing women and infants, inequities in service delivery and culturally unsafe services contribute to significantly poorer outcomes, with a lack of high-level research to guide service redesign. This paper reports on an Evaluation of a specialist (Murri antenatal clinic for Australian Aboriginal and Torres Strait Islander women. Methods A triangulated mixed method approach generated and analysed data from a range of sources: individual and focus group interviews; surveys; mother and infant audit data; and routinely collected data. A retrospective analysis compared clinical outcomes of women who attended the Murri clinic (n=367 with Indigenous women attending standard care (n=414 provided by the same hospital over the same period. Both services see women of all risk status. Results The majority of women attending the Murri clinic reported high levels of satisfaction, specifically with continuity of carer antenatally. However, disappointment with the lack of continuity during labour/birth and postnatally left some women feeling abandoned and uncared for. Compared to Indigenous women attending standard care, those attending the Murri clinic were statistically less likely to be primiparous or partnered, to experience perineal trauma, to have an epidural and to have a baby admitted to the Neonatal Intensive Care Unit, and were more likely to have a non-instrumental vaginal birth. Multivariate analysis found higher normal birth (spontaneous onset of labour, no epidural, non-instrumental vaginal birth without episiotomy rates amongst women attending the Murri clinic. Conclusions Significant benefits were associated with attending the Murri clinic. Recommendations for improvement included ongoing cultural competency training for all hospital staff, reducing duplication of services, improving co-ordination and communication between community and tertiary

  17. Rituximab Treatment for Membranous Nephropathy: A French Clinical and Serological Retrospective Study of 28 Patients

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    Pierre-Antoine Michel

    2011-12-01

    Full Text Available The development of well-tolerated and effective therapies that target the pathogenesis of membranous nephropathy (MN would be useful. Our objective was to evaluate the efficacy of rituximab in MN. We analyzed the outcome of 28 patients treated with rituximab for idiopathic MN. Anti-PLA2R antibodies in serum and PLA2R antigen in kidney biopsy were assessed in 10 and 9 patients, respectively. Proteinuria was significantly decreased by 56, 62 and 87% at 3, 6 and 12 months, respectively. At 6 months, 2 patients achieved complete remission (CR and 12 partial remission (PR; overall renal response, 50%. At 12 months (n = 23, CR was achieved in 6 patients and PR in 13 patients (overall renal response, 82.6%. Three patients suffered a relapse of nephrotic proteinuria 27–50 months after treatment. Univariate analysis suggested that the degree of renal failure (MDRD estimated glomerular filtration rate 2 is an independent factor that predicts lack of response to rituximab. Anti-PLA2R antibodies were detected in the serum of 10 patients, and PLA2R antigen in immune deposits in 8 of 9 patients. Antibodies became negative in all 5 responsive patients with available follow-up sera. In this retrospective study, a high rate of remission was achieved 12 months after treatment.

  18. Chronic pancreatitis in dogs: a retrospective study of clinical, clinicopathological, and histopathological findings in 61 cases.

    Science.gov (United States)

    Bostrom, Brier M; Xenoulis, Panagiotis G; Newman, Shelley J; Pool, Roy R; Fosgate, Geoffrey T; Steiner, Jörg M

    2013-01-01

    The objective of this study was to characterize the clinical, clinicopathological, and histopathological findings of dogs with chronic pancreatitis. The necropsy database at Texas A&M University was searched for reports of dogs with histological evidence of chronic pancreatitis defined as irreversible histologic changes of the pancreas (i.e. fibrosis or atrophy). A reference necropsy population of 100 randomly selected dogs was used for signalment and concurrent disease comparisons. Cases were categorized as clinical or incidental chronic pancreatitis based on the presence of vomiting, decreased appetite, or both vs. neither of these signs. All archived pancreas samples were scored histologically using a published scoring system. Sixty-one dogs with chronic pancreatitis were included. The most frequent clinical signs were lethargy, decreased appetite, vomiting, and diarrhea. Compared to the reference necropsy population, chronic pancreatitis cases were more likely to be older, neutered, of the non-sporting/toy breed group, and to have concurrent endocrine, hepatobiliary, or neurological disease. Clinical cases had significantly higher histological scores for pancreatic necrosis and peripancreatic fat necrosis, and were significantly more likely to have hepatobiliary or endocrine disease as well as increased liver enzyme activities, or elevated cholesterol and bilirubin concentrations. In conclusion, clinical disease resulting from chronic pancreatitis might be related to the presence of pancreatic necrosis and pancreatic fat necrosis. The signalment, presentation, and concurrent diseases of dogs with chronic pancreatitis are similar to those previously reported for dogs with acute pancreatitis.

  19. Clinical features and surgical management of spinal osteoblastoma: a retrospective study in 18 cases.

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    Zhonghai Li

    Full Text Available OBJECTIVES: To investigate the clinical manifestation and surgical outcome of spinal osteoblastoma. METHODS: From June 2006 to July 2011, 18 patients with spinal osteoblastoma treated surgically were analyzed retrospectively. There were 11 males and 7 females with an average age of 27.5 years(range, 16-38 years. The tumors were located at C5 in 7, C6 in 6, C7 in 3, C6-T1 1 in 1 and T11 in 1. Based on WBB classification, 16 were 1-3 or 10-12 and 2 were 4-9 and 1-3. 18 operations had been performed with en bloc resection. A posterior approach was used for 16 patients, and a combined posterior and anterior approach was used for 2 patients. Reconstruction using instrumentation and fusion was performed using spinal instrumentation in 13 patients. We used visual analogue scales (VAS to evaluate the change of pain before and after the operation, and the McCormick System to assess functional status of the spine. Imaging test was used to review the stability and recurrence rate of spine cord, and the confluence of graft bones. RESULTS: All cases were followed up for 24-80 months (average, 38.4 months. The average surgical time was 120.8 minutes (range, 80-220 minutes, with the average intraoperative blood loss of 520 ml (range, 300-1200 ml. During the follow-up period, the VAS grade reduced from 6.46±1.32 to 2.26±1.05 (P <0.05. 15 patients had neurological function improved and 3 remained no change which was evaluated by McCormick scale for spinal function status at final follow-up. CONCLUSIONS: Spinal osteoblastoma has its own specific radiographic features. There is some recurrence in simple curettage of tumor lesion. The thoroughly en bloc resection of tumor or spondylectomy, bone fusion and strong in Ter fixation are the key points for successful surgical treatment.

  20. 'Rumours' and clinical trials: a retrospective examination of a paediatric malnutrition study in Zambia, southern Africa

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    Amadi Beatrice

    2010-09-01

    Full Text Available Abstract Background Many public health researchers conducting studies in resource-constrained settings have experienced negative 'rumours' about their work; in some cases they have been reported to create serious challenges and derail studies. However, what may appear superficially as 'gossip' or 'rumours' can also be regarded and understood as metaphors which represent local concerns. For researchers unaccustomed to having concerns expressed from participants in this manner, possible reactions can be to be unduly perturbed or conversely dismissive. This paper represents a retrospective examination of a malnutrition study conducted by an international team of researchers in Zambia, Southern Africa. The fears of mothers whose children were involved in the study and some of the concerns which were expressed as rumours are also presented. This paper argues that there is an underlying logic to these anxieties and to dismiss them simply as 'rumours' or 'gossip' would be to overlook the historic and socio-economic factors which have contributed to their production. Methods Qualitative interviews were conducted with the mothers whose children were involved in the study and with the research nurses. Twenty five face-to-face interviews and 2 focus group discussions (FGDs were conducted with mothers. In addition, face-to-face interviews were conducted with research nurses participating in the trial. Results A prominent anxiety expressed as rumours by the mothers whose children were involved in the study was that recruitment into the trial was an indicator that the child was HIV-infected. Other anxieties included that the trial was a disguise for witchcraft or Satanism and that the children's body parts would be removed and sold. In addition, the liquid, milk-based food given to the children to improve their nutrition was suspected of being insufficiently nutritious, thus worsening their condition. The form which these anxieties took, such as rumours

  1. The clinical and microbiological profile of the diabetic hand: A retrospective study from South India

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    Sreekanth Raveendran

    2016-01-01

    Full Text Available Background: Pyogenic Infections of the hand in diabetes are largely a tropical entity and published material in the area are rather meagre. Patients and Methods: This is a retrospective study on the pattern of hand infections and involves the microbiological profile of 39 cases of diabetes hand-related infections admitted to the hospital between the years 2004 and 2010. Results: This study included 39 patients, among whom 23 (59% had necrotizing fasciitis (NF, and 16 (9-abscess and 7-tenosynovitis had nonnecrotizing infection. Among 25 culture positive patients, polymicrobial infections were isolated in 13 (52% patients, a single organism was isolated in 9 (36% and 3 (12% had sterile cultures. Out of the 41 different bacterial isolates, 51.12% were Gram-negative and 48.78% were Gram-positive. Patients with NF had a higher mean glycated hemoglobin (10.83 ± 2.59 vs. 8.64 ± 1.8%, P = 0.020, when compared to the nonnecrotizing group. Patients with NF also had more polymicrobial infections (P = 0.017, and a longer duration of hospitalization when compared to patients without NF (21.8 ± 9.96 vs. 12.7 ± 14.5 days, P = 0.021. Seven (17.94% patients required amputation of the affected digits of which six (15.38% had NF. Conclusion: Patients with poor glycemic control, polymicrobial infection, delay in presentation, and a prior surgical intervention at another medical center was associated with more severe necrotizing infections. The duration of hospitalization and amputation rates was greater among patients with NF.

  2. Retrospective study of disease incidence and other clinical conditions diagnosed in owned dogs in Delta State, Nigeria

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    Kundu F. Shima

    2015-12-01

    Full Text Available In Nigeria, knowledge on the epidemiology of diseases of dogs is limited. A retrospective study of data from clinical records of six veterinary clinics was undertaken to determine the incidence of disease in owned dogs in Delta State, Nigeria from 2012 to 2014. Association between the diagnosed diseases and the studied variables was explored using Chi-Squared test statistics. This study revealed that most of the conditions presented to the veterinary clinics were preventable. Thirty-one (31 clinical conditions were diagnosed from 571 cases recorded, involving nonspecific (21.6%, infectious (70.9%; P=0.001 and non-infectious (7.5% diseases. The most occurring clinical conditions comprised helminthoses (21.4%, mange (10.5%, parvovirosis (8.4%, babesiosis (7.9%, septicemia (7.2%, gastroenteritis (7.0%, myiasis (7.0%, trauma (6.3%, poisoning (6.0%, ectoparasitism (3.7%, ascites (2.5%, dermatitis (2.3%, aural hematoma (1.2%, and orchitis (1.1%. Disease incidence was highest in Alsatian (40.3%, mixed/cross (33.1%, Rottweiler (7.0% and toy breeds (4.6%. Details on the least occurring diseases and the association between disease and the studied variables are given. The outcomes demonstrate the prevalence of the clinical conditions diagnosed, inadequate husbandry and veterinary care accorded to owned dogs in the State. Education of dog owners on preventive measures is paramount in alleviating some of these health problems.

  3. A RETROSPECTIVE CLINICAL STUDY OF LAPAROSCOPIC AND OPEN SURGERY FOR CHOLECYSTECTOMY PROCEDURE

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    Konduru Siva Prasada Raju

    2017-03-01

    Full Text Available BACKGROUND The gall stone is one of the commonest ailments for which the hospital doors are knocked in India. Recent statistics suggest that about 15 to 30 percent of women in the fourth and fifth decade of life commonly suffer from this. The gall bladder should not be removed just considering the fact that the stones are there but the stones are formed in it and one major problem is its recurrence. Recent non – operative procedures like shock wave therapy and drugs are non - promising. Minimal access surgery is now the trend in any kind of surgery and cholecystectomy is no exception. Initially there was a huge benefit seen but now more and more complications are reported. In this study an effort has been put to understand the complications involved in both the Laparoscopic and Open type of surgery. This study is intended to help the practicing surgeon to anticipate the commonly involved complications in both the type of surgeries and also to help them understand the pros and cons of each type especially in resource challenged settings. MATERIALS AND METHODS This study was done in the Department of General Surgery in RIMS Medical College at Ongole. This study was done from January 2014 to December 2016. A sample size of 131 patients was selected and the retrospective analysis was done. RESULTS The mean age of the population in the sample size was 44.18 years and the range of the patients included from 10 years to 81 years. There were thirty seven males and ninety four females in the total study population. Female preponderance was seen which was statistically significant. Open surgery is the method of choice in an emergencyod of choice in case of emergency.All twenty three patients who underwent open surgery had significant post operative pain complained of post - operative pain requiring analgesic intervention. Only two patients complained of post – operative pain in case of laparoscopic procedure and none of them needed analgesics. Other

  4. Clinical features and prognosis of obese breast cancer patients:a retrospective study*

    Institute of Scientific and Technical Information of China (English)

    Zhendong Zheng; Heng Cao; Shuxian Qu; Yongye Liu; Ying Piao; Xiaodong Xie

    2013-01-01

    Objective:The aim of our study was to investigate the prognosis of obese breast cancer patients. Methods:This study was conducted on a total of 317 breast cancer patients who were histopathological y and clinical y diagnosed at the General Hospital of Shenyang Military Region (China) from 2004 to 2006. Clinical data including height, weight, age at diagnosis, tumor size, lymph node status, menopausal status, family history of cancer and hormone receptor status were col-lected. Log-rank test was performed to compare the disease free survival (DFS) and overal survival (OS). Cox proportional hazards regression analysis was conducted to make multivariate analysis. The Chi square test was used to compare the clinical features among normal weight group, overweight group, and obese group. Results:Obesity was an independent prognostic factor for DFS (P=0.022) and OS (P=0.032) in breast cancer patients. In the stratified analysis based on the hormone receptor status, obesity was independently associated with OS in patients with negative ER/PR (P=0.002), but such association was not observed in patients with positive hormone receptors. Obesity was also associated with lymph node status (P=0.001) and smoking (P=0.009). Conclusion:Obesity is associated with poor DFS and OS in patients with breast cancer. Therefore, maintaining normal weight may benefit breast cancer patients.

  5. Clinical and epidemiological characteristics of young patients with Peyronie's disease: a retrospective study

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    Paulis G

    2015-07-01

    Full Text Available Gianni Paulis,1,7 Giorgio Cavallini,2 Davide Barletta,3 Paolo Turchi,4 Antonio Vitarelli,5 Andrea Fabiani6 1Regina Apostolorum Hospital, Andrology Center, Rome, Italy; 2Andrological Section, Gynepro Medical Team, Bologna, Italy; 3Department of Urology, Andrology Center, San Matteo Hospital, Pavia, Italy; 4Azienda ASL 4 Prato – Andrology Service, Prato, Italy; 5Department of Urology, University of Bari, Bari, Italy; 6Department of Surgery, Section of Urology and Andrology, ASUR Marche 9, Macerata, Italy; 7Castelfidardo Medical Team, Peyronie's Disease Care Center, Rome, Italy Abstract: The average age of men affected by Peyronie's disease (PD is approximately 50–55 years, but cases have been reported even in adolescence. Several studies have already investigated the presence of PD in young men, and these studies reported a PD prevalence that varies between 1.5% and 10.8%. Having noticed a greater number of young patients in our centers in recent years, we decided to carry out a retrospective study to evaluate the prevalence of PD in patients aged <40 years, as well as to investigate any possible difference in evolution based on the age of PD patients. We selected a sample of patients (n=271 with a similar time of onset of disease. We then stratified all 271 patients into two groups: group A (age <40 years [n=46] and group B (age ≥40 years [n=225]. All 271 patients were evaluated for the following variables: penile plaque volume, degree of penile curvature, penile pain, and erectile function. Plaque volume was measured in cm3 by dynamic penile color Doppler sonography after administration of intracavernosal alprostadil 10 mcg. The number of younger patients was 46, accounting for 16.9% of the whole sample. Our study showed more frequent appearance and greater progression of penile curvature in younger patients. The average angle of penile curvature and average score of penile pain intensity in the younger men were significantly higher than

  6. Mucocele of the glands of Blandin-Nuhn in children: A clinical, histopathologic, and retrospective study

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    Saurabh R Joshi

    2012-01-01

    Full Text Available Background: The anterior lingual salivary glands (glands of Blandin-Nuhn are mixed mucous and serous glands that are embedded within the musculature of anterior tongue ventrum. Aim: The present study was designed to describe the clinical and histopathological features. Material and Methods : We investigated the clinical and histopathologic features of 30 cases of mucocele of glands of Blandin-Nuhn. All the cases were seen in the department of pedodontics. Results: All the lesions were located on the ventral surface of the tongue. Lesions were situated at the midline in 24 patients and laterally in 6 patients. All the lesions were surgically treated. There was female predominance, and most patients were younger than 15 years. Conclusion : Histopathological examination showed extravasation type of mucocele, suggesting that trauma may be a frequent initiating factor. All the patients were younger than 15 years.

  7. Maxillofacial Prosthesis in Dentofacial Traumas: A Retrospective Clinical Study and Introduction of New Classification Method

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    Edoardo Brauner

    2017-01-01

    Full Text Available Background. Maxillofacial trauma represents a field of common interest as regards both the maxillofacial surgery and prosthodontics, especially for the functional and aesthetic stomatognathic rehabilitation. This condition necessitates relationship between maxillofacial surgeon and prosthodontist, to achieve the ultimate treatment goal. Purpose. The purpose of this study is to make predictable patients outcomes classifying their clinical data, using certain parameters and introducing a new classification method. Materials and Methods. We have chosen 7 parameters to classify the entity of the damage of these patients and to make their treatment and their prognosis predictable: number of teeth lost (T1–T4, upper/lower maxilla (U/L, alveolar/basal bone (Alv/B, gingival tissues (G, soft tissues (S, adult/child (a/c, and reconstructed patient (R. Results and Conclusions. The multidisciplinary approach and the collaboration between multiple clinical figures are therefore critical for the success of the treatment of these patients. The presence and quantification of above parameters influence the treatment protocol; patients undergo different levels of treatment depending on the measured data. The recognition of certain clinical parameters is fundamental to frame diagnosis and successful treatment planning.

  8. Maxillofacial Prosthesis in Dentofacial Traumas: A Retrospective Clinical Study and Introduction of New Classification Method

    Science.gov (United States)

    Brauner, Edoardo; Pompa, Giorgio; Jamshir, Sara; Di Carlo, Stefano; Valentini, Valentino

    2017-01-01

    Background. Maxillofacial trauma represents a field of common interest as regards both the maxillofacial surgery and prosthodontics, especially for the functional and aesthetic stomatognathic rehabilitation. This condition necessitates relationship between maxillofacial surgeon and prosthodontist, to achieve the ultimate treatment goal. Purpose. The purpose of this study is to make predictable patients outcomes classifying their clinical data, using certain parameters and introducing a new classification method. Materials and Methods. We have chosen 7 parameters to classify the entity of the damage of these patients and to make their treatment and their prognosis predictable: number of teeth lost (T1–T4), upper/lower maxilla (U/L), alveolar/basal bone (Alv/B), gingival tissues (G), soft tissues (S), adult/child (a/c), and reconstructed patient (R). Results and Conclusions. The multidisciplinary approach and the collaboration between multiple clinical figures are therefore critical for the success of the treatment of these patients. The presence and quantification of above parameters influence the treatment protocol; patients undergo different levels of treatment depending on the measured data. The recognition of certain clinical parameters is fundamental to frame diagnosis and successful treatment planning. PMID:28337459

  9. Clinical performance of CEREC AC Bluecam conservative ceramic restorations after five years--A retrospective study.

    Science.gov (United States)

    Nejatidanesh, Farahnaz; Amjadi, Mehrak; Akouchekian, Mohadese; Savabi, Omid

    2015-09-01

    The aim of this study was to assess the clinical performance of CAD/CAM partial coverage posterior restorations made by CEREC AC Bluecam system after 5 years. 159 ceramic partial coverage posterior restorations were placed in 109 patients in a private practice. The restorations were made using CEREC AC Bluecam with CEREC Blocs or Empress CAD blocks. The clinical performance of the restorations was evaluated with modified California Dental Association (CDA) guidelines, gingival and plaque indices, probing pocket depth, and bleeding on probing in a period of 5 years. Patients' satisfaction was assessed using visual analogue scale. The Kaplan-Meier method was used to analyze survival probability of the restorations (α=0.05). The restorations included 102CEREC Blocs and 57 Empress CAD. The survival rates of CEREC Blocs and Empress CAD blocks were 96.0% and 94.6%, respectively (P=0.67). A total of 7 (4.5%) failures were found. The failures were not significantly influenced by restoration size, type and position of teeth. The ceramic fracture was significantly more in nonvital teeth (P=0.04). The periodontal parameters were not significantly different between the restored and control teeth except plaque index. The mean score of patients' satisfaction was 94.4 ± 8.1. Chair-side CEREC AC ceramic partial coverage posterior restorations were clinically successful restorations with mean survival rate of 95.5% after 5 years. Conservative chair-side CAD/CAM ceramic restorations with less reduction of tooth structure can be a successful restorative method with acceptable survival rate and patient's satisfaction. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Retrospective study of the clinical effects of acupuncture on cervical neurological diseases in dogs

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    Liu, Ching Ming; Chang, Fang Chia

    2016-01-01

    This study was conducted to evaluate new acupuncture protocols for the clinical treatment of cervical spinal cord diseases in 19 dogs. Three treatment options containing Jing-jiaji (cervical jiaji) were developed to treat neck pain, hemiparesis, and tetraparesis depending on the severity. The interval between the neurological disease onset and treatment (duration of signs), time to improvement after treatment, and recovery time were compared in dogs by body weight, age, and dry needle acupuncture (AP) with or without electro-AP (EAP). The duration of signs was longer in dogs weighing greater than 10 kg than in those weighing less than 10 kg (p Acupuncture with Jing-jiaji was effective in cervical spinal cord diseases in different sized dogs and in middle-aged and senior dogs. This report standardized AP treatment containing Jing-jiaji for canine cervical problems and evaluated its effects. The newly standardized AP methodology offers clinical practitioners an effective way to improve the outcomes of cervical neurological diseases in dogs. PMID:26645331

  11. Dental emergencies in a university pediatric dentistry clinic: a retrospective study

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    Ayah Qassem Shqair

    2012-02-01

    Full Text Available A significant number of children visit a dentist for the first time due to emergency situations. However, little is known regarding the prevalence, etiology, and treatment provided for children at emergency dental visits. This study aimed to evaluate the profile of children attending a dental school emergency clinic, the reasons for seeking dental care, and the treatment provided. Records of 270 patients who attended an emergency clinic during 2010 were analyzed, and 253 were selected. Demographic, diagnostic, and procedural information was collected. The mean child age was 7.8 years. For 208 children (82%, pain was the main reason for the emergency visit. Nearly 79% of the visits were due to caries, and the most frequently required treatment was endodontic intervention (31.22%. Of the decayed teeth, 61.70% were primary posterior teeth and 31.9% permanent posterior teeth. Pain caused by dental decay was the most frequent chief complaint. A large number of children were brought to the dentist with complaints that had started long before, for which over-the-counter medications had been used.

  12. Gastrointestinal failure in intensive care: a retrospective clinical study in three different intensive care units in Germany and Estonia

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    Starkopf Joel

    2006-06-01

    Full Text Available Abstract Background While gastrointestinal problems are common in ICU patients with multiple organ failure, gastrointestinal failure has not been given the consideration other organ systems receive. The aim of this study was to evaluate the incidence of gastrointestinal failure (GIF, to identify its risk factors, and to determine its association with ICU mortality. Methods A retrospective analysis of adult patients (n = 2588 admitted to three different ICUs (two ICUs at the university hospital Charité-Universitätsmedizin Berlin, Germany and one at Tartu University Clinics, Estonia during the year 2002 was performed. Data recorded in a computerized database were used in Berlin. In Tartu, the data documented in the patients' charts was retrospectively transferred into a similar database. GIF was defined as documented gastrointestinal problems (food intolerance, gastrointestinal haemorrhage, and/or ileus in the patient data at any period of their ICU stay. ICU mortality, length of stay, and duration of mechanical ventilation were assessed as outcome parameters. Results GIF was identified in 252 patients (9.7% of all patients. Only 20% of GIF patients were identifiable at admission. GIF was related to significantly higher mortality (43.7% vs. 5.3% in patients without GIF, as well as prolonged length of ICU stay (10 vs. 2 days and mechanical ventilation (8 vs. 1 day, p Conclusion Gastrointestinal failure represents a relevant clinical problem accompanied by an increased mortality, longer ICU stay and mechanical ventilation.

  13. A RETROSPECTIVE STUDY ON CLINICAL PRESENTATION OF STEROID SENSITIVE NEPHROTIC SYNDROME

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    Sosamma M. M

    2016-09-01

    Full Text Available BACKGROUND Nephrotic syndrome is a disease affecting the renal system. Most paediatricians will invariably encounter children with nephrotic syndrome in their clinic. The disease is characterised by the presence of oedema, persistent heavy proteinuria, hypoproteinaemia and hypercholesterolaemia. The disease is influenced by factors like age, geography, race and also has certain genetic influence related to HLA (DR7, B12, B8. In children, minimal change nephrotic syndrome is the most common variant of primary nephrotic syndrome. It accounts to more than eighty per cent of the cases seen children under seven years whereas it has a chance of fifty per cent in the age group of seven to sixteen years. Males are affected two times higher compared to females. The parents usually bring the child to the hospital with signs of oedema. Usually, the child recovers with treatment, but in some cases, there can be relapse. MATERIALS AND METHODS  The study was conducted in the Department of Paediatrics, Travancore Medical College, Kollam.  The study was done from January 2015 to January 2016.  Sixty cases were identified and were chosen for the study. INCLUSION CRITERIA 1. Steroid sensitive cases of nephrotic syndrome. 2. Age less than twelve years. 3. Admitted cases. EXCLUSION CRITERIA 1. Steroid-resistant and steroid-dependent cases. 2. Age more than twelve years. 3. Outpatient cases. RESULTS Out of the sixty cases studied, forty one cases belonged to male sex and nineteen cases belonged to female sex. Based on the age group, maximum number of cases belonged to age group four to eight years, which amounted to thirty four cases followed by age group eight to twelve years, which amounted to eighteen cases. Age group zero to four years had the least number of cases, which amounted to eight in number. Based on clinical signs and symptoms, fifty five cases presented with oedema either periorbital, scrotal or pedal oedema. Ten cases presented with fever

  14. Clinical and radiographic predictors of acute compartment syndrome in the treatment of tibial plateau fractures: a retrospective cohort study.

    Science.gov (United States)

    Gamulin, Axel; Lübbeke, Anne; Belinga, Patrick; Hoffmeyer, Pierre; Perneger, Thomas V; Zingg, Matthieu; Cunningham, Gregory

    2017-07-18

    The aim of the study was to evaluate the relation between demographic, injury-related, clinical and radiological factors of patients with tibial plateau fractures and the development of acute compartment syndrome. All consecutive adult patients with intra-articular tibial plateau fractures admitted in our urban academic medical centre between January 2005 and December 2009 were included in this retrospective cohort study. The main outcome measurement was the development of acute compartment syndrome. The charts of 265 patients (mean age 48.6 years) sustaining 269 intra-articular tibial plateau fractures were retrospectively reviewed. Acute compartment syndrome occurred in 28 fractures (10.4%). Four patients presented bilateral tibial plateau fractures; of them, 2 had unilateral, but none had bilateral acute compartment syndrome. Non-contiguous tibia fracture or knee dislocation and higher AO/OTA classification (type 41-C) were statistically significantly associated with the development of acute compartment syndrome in multivariable regression analysis, while younger age (compartment syndrome seemed unlikely during initial assessment. However, larger studies are mandatory to confirm and refine both factors in predicting the occurrence of acute compartment syndrome.

  15. Somatic Genomics and Clinical Features of Lung Adenocarcinoma: A Retrospective Study

    Science.gov (United States)

    Zhu, Bin; Wang, Mingyi; Pariscenti, Gianluca; Jones, Kristine; Bouk, Aaron J.; Boland, Joseph; Luke, Brian T.; Song, Lei; Duan, Jubao; Liu, Pengyuan; Kohno, Takashi; Chen, Qingrong; Meerzaman, Daoud; Marconett, Crystal; Mills, Ian; Caporaso, Neil E.; Gail, Mitchell H.; Pesatori, Angela C.; Consonni, Dario; Bertazzi, Pier Alberto; Chanock, Stephen J.; Landi, Maria Teresa

    2016-01-01

    Background Lung adenocarcinoma (LUAD) is the most common histologic subtype of lung cancer and has a high risk of distant metastasis at every disease stage. We aimed to characterize the genomic landscape of LUAD and identify mutation signatures associated with tumor progression. Methods and Findings We performed an integrative genomic analysis, incorporating whole exome sequencing (WES), determination of DNA copy number and DNA methylation, and transcriptome sequencing for 101 LUAD samples from the Environment And Genetics in Lung cancer Etiology (EAGLE) study. We detected driver genes by testing whether the nonsynonymous mutation rate was significantly higher than the background mutation rate and replicated our findings in public datasets with 724 samples. We performed subclonality analysis for mutations based on mutant allele data and copy number alteration data. We also tested the association between mutation signatures and clinical outcomes, including distant metastasis, survival, and tumor grade. We identified and replicated two novel candidate driver genes, POU class 4 homeobox 2 (POU4F2) (mutated in 9 [8.9%] samples) and ZKSCAN1 (mutated in 6 [5.9%] samples), and characterized their major deleterious mutations. ZKSCAN1 was part of a mutually exclusive gene set that included the RTK/RAS/RAF pathway genes BRAF, EGFR, KRAS, MET, and NF1, indicating an important driver role for this gene. Moreover, we observed strong associations between methylation in specific genomic regions and somatic mutation patterns. In the tumor evolution analysis, four driver genes had a significantly lower fraction of subclonal mutations (FSM), including TP53 (p = 0.007), KEAP1 (p = 0.012), STK11 (p = 0.0076), and EGFR (p = 0.0078), suggesting a tumor initiation role for these genes. Subclonal mutations were significantly enriched in APOBEC-related signatures (p < 2.5×10−50). The total number of somatic mutations (p = 0.0039) and the fraction of transitions (p = 5.5×10−4) were

  16. Influence of bone density on implant stability parameters and implant success: a retrospective clinical study

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    McGlumphy Edwin A

    2008-11-01

    Full Text Available Abstract Background The aim of the present clinical study was to determine the local bone density in dental implant recipient sites using computerized tomography (CT and to investigate the influence of local bone density on implant stability parameters and implant success. Methods A total of 300 implants were placed in 111 patients between 2003 and 2005. The bone density in each implant recipient site was determined using CT. Insertion torque and resonance frequency analysis were used as implant stability parameters. The peak insertion torque values were recorded with OsseoCare machine. The resonance frequency analysis measurements were performed with Osstell instrument immediately after implant placement, 6, and 12 months later. Results Of 300 implants placed, 20 were lost, meaning a survival rate of %. 93.3 after three years (average 3.7 ± 0.7 years. The mean bone density, insertion torque and RFA recordings of all 300 implants were 620 ± 251 HU, 36.1 ± 8 Ncm, and 65.7 ± 9 ISQ at implant placement respectively; which indicated statistically significant correlations between bone density and insertion torque values (p Conclusion CT is a useful tool to determine the bone density in the implant recipient sites, and the local bone density has a prevailing influence on primary implant stability, which is an important determinant for implant success.

  17. Septic arthritis: a 12 years retrospective study in a rheumatological university clinic

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    L. Riato

    2011-09-01

    Full Text Available Background: Septic arthritis is a disabling and potentially life-threatening condition that requires prompt diagnosis and treatment. The most important risk factors are joint prosthesis, pre-existing joint disease and immunosuppressive drugs. The aim of our study therefore was to revaluate all septic arthritis cases discharged from our Rheumatologic Unit in the last 12 years, to assess the risk factors, the clinical and laboratory characteristics, the causative microorganisms and its possible increase in frequency. Methods: The medical records of 42 consecutive patients with septic arthritis discharged from our Rheumatology Unit between January 1995 and December 2006 were reviewed. The patients ranged in age from 23 to 90 and there isn’t gender predominance. Septic arthritis was diagnosed based on the finding of purulent material in the joint space and/or the isolation of a bacterial pathogen from joint fluid. Demographic data, risk factors, co-morbidity, clinical manifestations, time interval between symptoms onset and diagnosis, treatment and laboratory data including serum white blood cell count, erythrocyte sedimentation rate (ESR, C reactive protein (CRP, synovial white blood cells and culture results were analysed. We considered these parameters in the whole population and in two different age groups (≤60, >60 and tried to determine if there was a change of microorganisms involved in septic arthritis during the years. Results: Of 42 patients, 47% were aged 60 and younger. Only 10 patients were admitted to our unit before 2001. A predisposing factor was recorded in 90,5% of cases: 15 patients had rheumatoid arthritis, 8 were diabetic, 6 had seronegative arthritis, 4 had a connective tissue disease, 8 patients had a prosthetic infection and 3 were subjected recently to arthrocentesis. We found that patients aged 60 and younger were more frequently affected by joint disease and had a synovial white blood cell count lower than patients

  18. Assessing clinical outcomes of patients with acute calculous cholecystitis in addition to the Tokyo grading: A retrospective study

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    Wei-Chun Cheng

    2014-09-01

    Full Text Available The management of acute cholecystitis is still based on clinical expertise. This study aims to investigate whether the outcome of acute cholecystitis can be related to the severity criteria of the Tokyo guidelines and additional clinical comorbidities. A total of 103 patients with acute cholecystitis were retrospectively enrolled and their medical records were reviewed. They were all classified according to therapeutic modality, including early cholecystectomy and antibiotic treatment with or without percutaneous cholecystostomy. The impact of the Tokyo guidelines and the presence of comorbidities on clinical outcome were assessed by univariate and multivariate regression analyses. According to Tokyo severity grading, 48 patients were Grade I, 31 patients were Grade II, and 24 patients were Grade III. The Grade III patients had a longer hospital stay than Grade II and Grade I patients (15.2 days, 9.2 days, and 7.3 days, respectively, p < 0.05. According to multivariate analysis, patients with Grade III Tokyo severity, higher Charlson’s Comorbidity Score, and encountering complications had a longer hospital stay. Based on treatment modality, surgeons selected the patients with less severity and fewer comorbidities for cholecystectomy, and these patients had a shorter hospital stay. In addition to the grading of the Tokyo guidelines, comorbidities had an additional impact on clinical outcomes and should be an important consideration when making therapeutic decisions.

  19. A retrospective study of a modified 1-minute formocresol pulpotomy technique part 1: clinical and radiographic findings.

    Science.gov (United States)

    Kurji, Zahra A; Sigal, Michael J; Andrews, Paul; Titley, Keith

    2011-01-01

    The purpose of this study was to assess the clinical and radiographic outcomes of a 1-minute application of full-strength Buckley's formocresol with concurrent hemostasis using the medicated cotton pledget in human primary teeth. Using a retrospective chart review, clinical and radiographic data were available for 557 primary molars in 320 patients. Descriptive statistics and survival analysis were used to assess outcomes. Overall clinical success, radiographic success, and cumulative 5-year survival rates were approximately 99%, 90%, and 87%, respectively. Internal root resorption (∼5%) and pulp canal obliteration (∼2%) were the most frequently observed radiographic failures. Thirty-nine teeth were extracted due to clinical and or radiographic failure. Mandibular molars were 6 times more prone to radiographic failure than maxillary molars. Success rates for the modified technique are comparable to techniques that use the 5-minute diluted or full-strength solutions reported in the literature. This 1-minute full-strength formocresol technique is an acceptable alternative to published traditional techniques.

  20. Laparoscopic Cholecystectomy of Patients with Cardiac Disease in Our Clinic; Retrospective Study

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    Ömer Faruk Şavluk

    2013-03-01

    Full Text Available Introduction: The application of laparoscopic cholecystectomy is investigated to effected on patients with cardiac surgery or examination of patients that were identified with cardiac problem.Patients and Methods: Between 2008-2010 total of 233 patients with laporoscopiccholecystectomy were retrospectively analyzed follow up papers. Systolic blood pressure, diastolic blood pressure, heart rate, X-rays and ECGs were evaluated in preoperative examination in all patients. ECG, SpO2 monitoring was performed to all patients in the operating room. In all patients systolic blood pressure, diastolic blood pressure, heart rate and SpO2 values before the operation and during the operation were recorded. End-tidal CO2 was monitored during the operation. Additional disease duration of surgery, duration of intubation, preoperative, perioperative and postoperative need to inotropic support were recorded. Results: One hundred and one (43% patients were men and 132 (57% female. Forty five of 233 patients with cardiac problems are sick. Twenty five patients of these patients had coronary bypass surgery and eight patients underwent prosthetic valve surgery. As a result of preoperative transthoracic echocardiography in 12 patients were diagnosed with valve insufficiency. Demographic characteristics were similar than between the two groups. The mean operation time, insuflation time, extubation time, staying hospital time and hemodynamic data were similar than between the two groups. Conclusion: Laparoscopic cholecystectomy safely and easily can apply for application of the balanced anesthesia, low-pressure pneumoperitoneum after being stable cardiac status in patients with cardiac problem.

  1. Microscopic colitis: A retrospective study of clinical presentation in 53 patients

    Institute of Scientific and Technical Information of China (English)

    Zsolt Barta; Gabriella Mekkel; István Csíp(o); László Tóth; Szabolcs Szakáll; Gábor G. Szabó; Gyula Bakó; Gyula Szegedi; Margit Zeher

    2005-01-01

    AIM: To evaluate the relationship between symptoms and microscopic colitis (MC) subtypes: to test whether collagenous colitis (CC) and/or lymphocytic colitis (LC)might be related to both constipation and diarrhea.METHODS: A cohort of patients with independently confirmed typical histopathological changes was investigated. Fifty-three patients with histologically proved MC (46 with CC, 7 with LC) were included. The existence of diarrhea or constipation and the co-existence of autoimmune diseases were also investigated and all data were retrospectively analyzed.RESULTS: Twenty-three (43.39%) of MC patients had chronic constipation (20 in CC, 3 in LC patients). Twentyfour(45.28%) of MC patients had autoimmune disease and the diagnosis of autoimmune disease was always prior to MC. Sjogren's syndrome was associated only with the constipation subgroup.CONCLUSION: The Janus face of MC resembles the subgroups of irritable bowel syndrome. The co-existence of autoimmune diseases and MC is confirmed in both the constipation and diarrhea subgroups.

  2. PREVALENCE OF SKIN DISEASES IN A DERMATOLOGY OUTPATIENT CLINIC IN RIMS, KADAPA, A CROSS - SECTIONAL, RETROSPECTIVE STUDY

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    Sirisha

    2015-07-01

    Full Text Available BACKGROUND: Dermatological diseases vary widely as a result of geographic location climate socioeconomic status and personal habits and internal factors such as age gender and heredity. OBJECTIVE: The aim of the study was to determine the main causes for outpatient visits in dermatology outpatient clinic in RIMS Kadapa. MATERIALS AND METHOD S: The outpatient clinic records of the department of dermatology RIMS Kadapa, dated between 1 st March 2014 t o 1 st March 2015 were retrospectively assessed. Patients were grouped according to age, gender, and clinical diagnosis. RESULTS: A total of 8,545 new patients with 9,416 skin problems were included in the study. The study group was 52.3% female and 47.7% m ale. The age range was between 1 and 99 years. The most commonly encountered diseases were: contact dermatitis (11.7% of patients, scabies (8.9%, fungal infections (8.9%, urticaria (6.0%, acne (4.4% each. CONCLUSION: It appears that certain skin disea ses contact dermatitis, scabies, fungal infections, urticaria, and acne causes serious health problems. P ublic health policies should be implemented in order to manage these problems rationally.

  3. Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification: a pilot retrospective cohort study.

    Science.gov (United States)

    Alobaid, Adel S; Cortes, Lina M; Lo, Jeffery; Nguyen, Thuan T; Albert, Jeffery; Abu-Melha, Abdulaziz S; Lin, Louis M; Gibbs, Jennifer L

    2014-08-01

    This retrospective cohort study compared clinical and radiographic outcomes of endodontic treatment performed in immature nonvital permanent teeth by apexification (calcium hydroxide or apical barrier with mineral trioxide aggregate) versus revascularization. A comprehensive chart review was performed to obtain a cohort of previously completed cases with recalls. Clinical and radiographic data were collected for 31 treated teeth (19 revascularization and 12 apexification) with an average follow-up time of 17 months and a recall rate of 63%. Tooth survival, success rate, and adverse events were analyzed. Changes in radiographic root length, width, and area were quantified. The majority of treated teeth survived throughout the study period, with 30 of 31 (97%) teeth surviving (18/19 [95%] revascularization and 12/12 apexification). Most cases were also clinically successful, with 27 of 31 (87%) meeting criteria for success (15/19 [78%] revascularization and 12/12 apexification; nonsignificant difference). A greater incidence of adverse events was observed in the revascularization group (8/19 [42%] vs 1/12 [11%] in apexification) (risk ratio = 5.1; P = .04; 95% confidence interval, 0.719-35.48). Although more revascularization cases than apexification cases showed an increase in radiographic root area and width, the effect was not statistically significant. In this study, revascularization was not superior to other apexification techniques in either clinical or radiographic outcomes. Studies with large subject cohorts and long follow-up periods are needed to evaluate outcomes of revascularization and apexification while accounting for important covariants relevant to clinical success. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. Stevens Johnson syndrome, toxic epidermal necrolysis and SJS-TEN overlap: A retrospective study of causative drugs and clinical outcome

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    Sharma Vinod

    2008-01-01

    Full Text Available Background and Aims: Stevens Johnson syndrome (SJS, toxic epidermal necrolysis (TEN and SJS-TEN overlap are serious adverse cutaneous drug reactions. Drugs are often implicated in these reactions. Methods: A retrospective analysis of inpatients′ data with these dermatological diagnoses were carried out for three years, to study the causative drugs, clinical outcome, and mortality in these conditions. Results: Thirty patients (15 TEN, nine SJS-TEN overlap, and six SJS were admitted. In 21 cases, multiple drugs were implicated whereas single drugs were responsible in nine. Anticonvulsants (35.08% were the most commonly implicated drugs followed by antibiotics (33.33% and NSAIDS (24.56%. Twenty-five patients recovered whereas five died (four TEN, one SJS-TEN overlap. Conclusion: Anticonvulsants, antibiotics and NSAIDs were the most frequently implicated drugs. TEN causes higher mortality than both SJS and SJS-TEN overlap.

  5. Clinically relevant QTc prolongation due to overridden drug-drug interaction alerts: A retrospective cohort study

    NARCIS (Netherlands)

    I.H. van der Sijs (Heleen); R. Kowlesar (Ravi); A.P.J. Klootwijk (Peter); S.P. Nelwan (Stefan); A.G. Vulto (Arnold); T. van Gelder (Teun)

    2009-01-01

    textabstractAIMS: To investigate whether, in patients in whom drug-drug interaction (DDI) alerts on QTc prolongation were overridden, the physician had requested an electrocardiogram (ECG), and if these ECGs showed clinically relevant QTc prolongation. METHODS: For all patients with overridden DDI a

  6. Clinical and prognostic features among children with acute encephalitis syndrome in Nepal; a retrospective study

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    Impoinvil Daniel E

    2011-10-01

    Full Text Available Abstract Background Acute encephalitis syndrome (AES is commonly seen among hospitalized Nepali children. Japanese Encephalitis (JE accounts for approximately one-quarter of cases. Although poor prognostic features for JE have been identified, and guide management, relatively little is reported on the remaining three-quarters of AES cases. Methods Children with AES (n = 225 were identified through admission records from two hospitals in Kathmandu between 2006 and 2008. Patients without available lumbar puncture results (n = 40 or with bacterial or plasmodium infection (n = 40 were analysed separately. The remaining AES patients with suspected viral aetiology were classified, based on positive IgM antibody in serum or cerebral spinal fluid, as JE (n = 42 or AES of unknown viral aetiology (n = 103; this latter group was sub-classified into Non-JE (n = 44 or JE status unknown (n = 59. Bad outcome was defined as death or neurological sequelae at discharge. Results AES patients of suspected viral aetiology more frequently had a bad outcome than those with bacterial or plasmodium infection (31% versus 13%; P = 0.039. JE patients more frequently had a bad outcome than those with AES of unknown viral aetiology (48% versus 24%; P = 0.01. Bad outcome was independently associated in both JE and suspected viral aetiology groups with a longer duration of fever pre-admission (P = 0.007; P = 0.002 respectively and greater impairment of consciousness (P = 0.02; P Conclusions Nepali children with AES of suspected viral aetiology or with JE frequently suffered a bad outcome. Despite no specific treatment, patients who experienced a shorter duration of fever before hospital admission more frequently recovered completely. Prompt referral may allow AES patients to receive potentially life-saving supportive management. Previous studies have indicated supportive management, such as fluid provision, is associated with better outcome in JE. The lower weight and higher

  7. Clinical Effectiveness and Cognitive Impact of Electroconvulsive Therapy for Schizophrenia: A Large Retrospective Study.

    Science.gov (United States)

    Kaster, Tyler S; Daskalakis, Zafiris J; Blumberger, Daniel M

    2017-04-01

    To determine the clinical effectiveness and cognitive impact of electroconvulsive therapy (ECT) in a large clinical sample of patients with schizophrenia and explore factors associated with treatment response and transient cognitive impairment. We examined the clinical records of 144 patients with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who were treated at an academic mental health hospital from October 2009 to August 2014. These patients received 171 acute courses of ECT; we attempted to determine their treatment response and transient cognitive impairment from ECT. We explored the impact of various factors including ECT indication, clinical characteristics, medication during ECT, and technical parameters on treatment response and transient cognitive impairment. Treatment with ECT resulted in a 76.7% response rate. Factors associated with a better response to ECT were absence of treatment with antiepileptic medication (17.9% vs 3.9%, P = .007), a previous good response to ECT (36.4% vs 15.4%, P = .017), and primary indication for ECT referral other than failed pharmacotherapy (89.7% vs 69.8%, P = .012). Factors not associated with treatment response included age, clozapine treatment, and benzodiazepine treatment (P > .05). Treatment with ECT caused transient cognitive impairment in 9% of treatment courses; no demographic or clinical factors were associated with cognitive impairment. This work demonstrates the effectiveness of ECT for schizophrenia treatment and several factors associated with treatment response. The rate of transient cognitive impairment is lower than expected based on the rate of cognitive impairment seen in ECT for depression. ECT appears to be an effective treatment option for schizophrenia that is tolerated by the majority of patients.

  8. A retrospective study of 22 patients with necrotising fasciitis treated at the University Clinical Center of Kosovo (2005-2010).

    Science.gov (United States)

    Arifi, Hysni M; Duci, Shkelzen B; Zatriqi, Violeta K; Ahmeti, Hasan R; Ismajli, Vildane H; Gashi, Musli M; Zejnullahu, Ylber M; Mekaj, Agon Y

    2013-08-01

    Necrotising fasciitis (NF) is a destructive invasive infection of skin, subcutaneous tissue and deep fascia. The aim of the study is to determine the causative agents of NF, its localisation, predisposing factors and comorbid conditions, duration of treatment and distribution of NF in different age groups and over the years. We conducted a retrospective study including 22 patients with NF from 2005 to 2010 in the University Clinical Center of Kosovo. The data were collected and analysed from the archives and protocols of the University Clinical Center of Kosovo. The average age of patients was 56·9 years. In eight cases or 36·4% of total patients studied, NF was caused by monobacterial agents with a predominance of Pseudomonas aeruginosa (five cases or 22·7% of total infections). Polybacterial agents were responsible for NF infection in other 14 cases (63·6%). Majority of the patients had other comorbidities like diabetes, trauma and prior history of surgical interventions. Diabetes was present in 17 patients or 77·3%. The remaining five patients (22·7%) had previous trauma and recent surgical intervention. Average length of treatment was 43 days. The hospital mortality rate in our case series was 22·6%. Early identification and diagnosis of NF significantly improves outcome and reduces mortality. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

  9. [Clinical aspects, outcome and prognosis of Horton's disease. Retrospective study of 47 cases].

    Science.gov (United States)

    Godeau, P; Aubert, L; Guillevin, L; Tard, P; Maaouni, A; Wechsler, B; Bletry, O; Herreman, G

    1982-01-01

    The authors report their experience of Horton's disease in 47 histologically confirmed cases treated between 1966 and 1979. The symptomatology is recalled with the incidence of the various clinical and biochemical signs. The actuarial survival curve shows a 71.2 p. cent three year and a 61 p. cent five year survival rate. There was no statistically significant difference at three years with a control population. The duration of maintenance therapy was, on average, of 24.8 months, never less than 15 months and sometimes reaching 60 months. The average maintenance dose was 12 mg. Specific and non-specific complications are discussed. The incidence of refractory and cortico-dependent forms shows that the optimal treatment for this disease has yet to be found; the often brilliant initial results of corticotherapy do not reflect its long-term efficacy.

  10. Clinical retrospective and comparative study on diaphragm injuries in 46 cases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To explore a way of guiding diagnosis and treatment of blunt and penetrating diaphragm injuries.   Methods: According to injury violence, 46 chest trauma patients with diaphragm rupture were divided into two groups: a blunt injury group and a penetrating injury group. The injury condition and trauma scores between the two groups were compared and analyzed.   Results: The incidence of blunt diaphragm injuries was lower than that of penetrating injuries (1.78% vs 8.53%, P0.05), but the blunt injury group had lower Glasgow Coma Scale (GCS) and abdominal AIS than the penetrating group (P<0.05).   Conclusions: Blunt and penetrating diaphragm injuries have different clinical characteristics. So they should be dealt with differently to reduce the incidence of complication and improve prognosis.

  11. Clinical effectiveness of posaconazole versus fluconazole as antifungal prophylaxis in hematology-oncology patients: a retrospective cohort study.

    Science.gov (United States)

    Kung, Hsiang-Chi; Johnson, Melissa D; Drew, Richard H; Saha-Chaudhuri, Paramita; Perfect, John R

    2014-06-01

    In preventing invasive fungal disease (IFD) in patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS), clinical trials demonstrated efficacy of posaconazole over fluconazole and itraconazole. However, effectiveness of posaconazole has not been investigated in the United States in real-world setting outside the environment of controlled clinical trial. We performed a single-center, retrospective cohort study of 130 evaluable patients ≥18 years of age admitted to Duke University Hospital between 2004 and 2010 who received either posaconazole or fluconazole as prophylaxis during first induction or first reinduction chemotherapy for AML or MDS. The primary endpoint was possible, probable, or definite breakthrough IFD. Baseline characteristics were well balanced between groups, except that posaconazole recipients received reinduction chemotherapy and cytarabine more frequently. IFD occurred in 17/65 (27.0%) in the fluconazole group and in 6/65 (9.2%) in the posaconazole group (P = 0.012). Definite/probable IFDs occurred in 7 (10.8%) and 0 patients (0%), respectively (P = 0.0013). In multivariate analysis, fluconazole prophylaxis and duration of neutropenia were predictors of IFD. Mortality was similar between groups. This study demonstrates superior effectiveness of posaconazole over fluconazole as prophylaxis of IFD in AML and MDS patients. Such superiority did not translate to reductions in 100-day all-cause mortality.

  12. Clinical and Microbiological Characteristics of Visceral Leishmaniasis Outbreak in a Northern Italian Nonendemic Area: A Retrospective Observational Study

    Directory of Open Access Journals (Sweden)

    E. Franceschini

    2016-01-01

    Full Text Available Background. Visceral leishmaniasis (VL caused by Leishmania infantum is endemic in the Mediterranean area. In the last decades a northward spread of the parasite has been observed in Italy. This paper describes a VL outbreak in Modena province (Emilia-Romagna, Northern Italy between 2012 and 2015. Methods. Retrospective, observational study to evaluate epidemiological, microbiological characteristics, and clinical management of VL in patients referring to Policlinico Modena Hospital. Results. Sixteen cases of VL occurred in the study period. An immunosuppressive condition was present in 81.3%. Clinical presentation included anemia, fever, leukopenia, thrombocytopenia, and hepatosplenomegaly. Serology was positive in 73.3% of cases, peripheral blood PCR in 92.3%, and bone marrow blood PCR in 100%. Culture was positive in 3/6 cases (50% and all the isolates were identified as L. infantum by ITS1/ITS2 sequencing. The median time between symptom onset and diagnosis was 22 days (range 6–131 days. All patients were treated with liposomal amphotericin b. 18.8% had a VL recurrence and were treated with miltefosine. Attributable mortality was 6.3%. Conclusions. VL due to L. infantum could determine periodical outbreaks, as the one described; thus it is important to include VL in the differential diagnosis of fever of unknown origin, even in low-endemic areas.

  13. Clinical pathological characteristics of breast cancer patients with secondary diabetes after systemic therapy: a retrospective multicenter study.

    Science.gov (United States)

    Juanjuan, Li; Wen, Wei; Zhongfen, Liu; Chuang, Chen; Jing, Cheng; Yiping, Gong; Changhua, Wang; Dehua, Yu; Shengrong, Sun

    2015-09-01

    The objective of this study was to investigate the clinical pathological characteristics of breast cancer (BC) patients with secondary diabetes after systemic therapy without preexisting diabetes. A total of 1434 BC patients received systemic therapy and were analyzed retrospectively. Fasting plasma glucose (FPG) levels were monitored prior to the treatments, during the course of systemic therapy, and at the follow-up visits. Cox regression models were used to estimate the associations between the clinical pathological characteristics of BC and the cause-specific hazard of developing secondary diabetes. Among the 1434 BC patients, 151 had preexisting type 2 diabetes. Of the remaining 1283 patients with normal FPG levels prior to the systemic therapy, 59 developed secondary diabetes and 72 displayed secondary impaired fasting glucose (IFG) over a mean follow-up of 41 months. The prevalence of secondary type 2 diabetes in BC patients was 4.6 % (59/1283), which was obviously higher than that of the normal control group (1.4 %, P systemic therapy, especially the patients with later pathological stages, more lymph node metastasis, negative hormone receptor expression, and positive HER2 expression. Our study suggests that greater diabetes screening and prevention strategies among breast cancer patients after systemic treatment are needed in China.

  14. Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case–control study

    Science.gov (United States)

    Yuan, Ting; Wang, Wei; Li, Xue-Lan; Li, Chun-Fang; Li, Chao; Gou, Wen-Li; Han, Zhen

    2016-01-01

    Abstract The aim of our study was to compare the clinical characteristics of fetal and neonatal outcomes in twin pregnancies between women with preeclampsia (PE) and those with normotension in a Chinese population. There were 143 preeclamptic women and 367 normotensive women with twin pregnancies included in this retrospective case–control study. The baseline characteristics and perinatal outcomes were collected and compared between the groups. Multiple logistic regression and linear regression were used to assess the correlations between PE and the outcomes. Significant increases were observed in the frequencies of preterm delivery (OR = 2.75, P < 0.001), iatrogenic preterm birth (OR = 3.52, P < 0.001), and IUGR (OR = 2.94, P = 0.001) in the PE group, and the PE group had more than a 2-fold risk of adverse neonatal outcomes. Preeclamptic twin neonates had lower birth weights (β = −147.34, P = 0.005; β = −169.47, P = 0.001). The comparison on the discordance of intertwin weight was not significantly different. Twin pregnancies with PE are associated with worse perinatal outcomes. The adverse outcomes of preeclamptic twin pregnancies may be associated with lower birth weights rather than the discordance of the intertwin weight, which requires further confirmation. The results may provide helpful references for better clinical assessments, evaluations of prognosis, and a deeper understanding of preeclamptic twin pregnancies. PMID:27787375

  15. Clinical effectiveness of posaconazole versus fluconazole as antifungal prophylaxis in hematology–oncology patients: a retrospective cohort study

    Science.gov (United States)

    Kung, Hsiang-Chi; Johnson, Melissa D; Drew, Richard H; Saha-Chaudhuri, Paramita; Perfect, John R

    2014-01-01

    In preventing invasive fungal disease (IFD) in patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS), clinical trials demonstrated efficacy of posaconazole over fluconazole and itraconazole. However, effectiveness of posaconazole has not been investigated in the United States in real-world setting outside the environment of controlled clinical trial. We performed a single-center, retrospective cohort study of 130 evaluable patients ≥18 years of age admitted to Duke University Hospital between 2004 and 2010 who received either posaconazole or fluconazole as prophylaxis during first induction or first reinduction chemotherapy for AML or MDS. The primary endpoint was possible, probable, or definite breakthrough IFD. Baseline characteristics were well balanced between groups, except that posaconazole recipients received reinduction chemotherapy and cytarabine more frequently. IFD occurred in 17/65 (27.0%) in the fluconazole group and in 6/65 (9.2%) in the posaconazole group (P = 0.012). Definite/probable IFDs occurred in 7 (10.8%) and 0 patients (0%), respectively (P = 0.0013). In multivariate analysis, fluconazole prophylaxis and duration of neutropenia were predictors of IFD. Mortality was similar between groups. This study demonstrates superior effectiveness of posaconazole over fluconazole as prophylaxis of IFD in AML and MDS patients. Such superiority did not translate to reductions in 100-day all-cause mortality. PMID:24644249

  16. Clinical characteristics and risk factors of pulmonary hypertension associated with chronic respiratory diseases: a retrospective study

    Science.gov (United States)

    Chen, Yonghua; Liu, Chunli; Lu, Wenju; Li, Mengxi; Hadadi, Cyrus; Wang, Elizabeth Wenqian; Yang, Kai; Lai, Ning; Huang, Junyi; Li, Shiyue; Zhong, Nanshan

    2016-01-01

    Background Chronic respiratory disease-associated pulmonary hypertension (PH) is an important subtype of PH, which lacks clinical epidemiological data in China. Methods Six hundred and ninety three patients hospitalized from 2010 to 2013 were classified by echocardiography according to pulmonary arterial systolic pressure (PASP): mild (36≤ PASP 20 mm) were associated with moderate-to-severe PH, while RV [odds ratio (OR) =3.53, 95% CI, 2.17–5.74], NT-proBNP (OR=2.44, 95% CI, 1.51–3.95), HCT (OR=1.03, 95% CI, 1.00–1.07) and PaCO2 (OR=1.01, 95% CI, 1.00–1.03) were independent risk factors. Conclusions PH related to respiratory diseases is mostly mild to moderate, and the severity is associated with the category of respiratory disease. Increased HCT can be an independent risk factor for PH related to chronic respiratory diseases. PMID:27076929

  17. Clinical analysis of vascular anomalies: a hospital-based retrospective study of 592 patients in southeast China

    Institute of Scientific and Technical Information of China (English)

    YE Cai-sheng; PAN Ling-xiao; HUANG Yong-bo; HAN An-jia; YE Run-yi; LI Song-qi; LI Xiao-xi; L(U) Wei-ming; WANG Shen-ming

    2011-01-01

    Background Vascular anomalies are common and multidisciplinary involved diseases. The greatest impediment to their treatment in the past was their confusing terminology and clinical heterogeneities. This hospital-based retrospective study assessed some clinical characteristics, diagnosis, therapies and outcomes of patients with vascular anomalies in southeast China.Methods A total of 592 vascular anomalies patients (patients with intracranial tissues or viscera involved were excluded), admitted to the First Affiliated Hospital of Sun Yat-sen University from January 2006 to September 2009, were enrolled in the study. Data for clinical characteristics, diagnosis, therapies and outcomes were collected and analyzed.Results Of the 592 patients, the male:female ratios in the vascular tumor group (n=187) and the vascular malformation group (n=405) were 1∶1.49 and 1∶1.06 respectively, with no significant difference between them. The mean onset age of the vascular tumor group was significantly younger than that of the vascular malformation group (P <0.001). The head and neck were the most commonly (31.4%) involved areas in vascular anomalies. A total of 23.8% of the patients with vascular anomalies had definite symptoms caused by the vascular lesions. In the vascular tumor group, 94.1% of them were infantile hemangiomas. Venous malformation was the most common (41.0%) subtype of vascular malformations.Surgical therapy was undertaken in 94.2% of the patients with vascular anomalies. Of the 519 patients available for the 16-58 month follow-up, 322 patients (62.0%) were cured, 108 patients (20.8%) were markedly improved, 57 patients (11.0%) were partially improved, and 32 patients (6.2%) were uncured.Conclusions Vascular anomalies are clinically heterogeneous. While the outcome is generally favorable, further effort should be made to determine the appropriate terminology and management.

  18. Clinical and echocardiographic characteristics of papillary fibroelastomas: a retrospective and prospective study in 162 patients

    Science.gov (United States)

    Sun, J. P.; Asher, C. R.; Yang, X. S.; Cheng, G. G.; Scalia, G. M.; Massed, A. G.; Griffin, B. P.; Ratliff, N. B.; Stewart, W. J.; Thomas, J. D.

    2001-01-01

    BACKGROUND: Cardiac papillary fibroelastoma (CPF) is a primary cardiac neoplasm that is increasingly detected by echocardiography. The clinical manifestations of this entity are not well described. METHODS AND RESULTS: In a 16-year period, we identified patients with CPF from our pathology and echocardiography databases. A total of 162 patients had pathologically confirmed CPF. Echocardiography was performed in 141 patients with 158 CPFs, and 48 patients had CPFs that were not visible by echocardiography (patients with 110 CPFs. An additional 45 patients with a presumed diagnosis of CPF were identified. The mean age of the patients was 60+/-16 years of age, and 46.1% were male. Echocardiographically, the mean size of the CPFs was 9+/-4.6 mm; 82.7% occurred on valves (aortic more than mitral), 43.6% were mobile, and 91.4% were single. During a follow-up period of 11+/-22 months, 23 of 26 patients with a prospective diagnosis of CPF that was confirmed by pathological examination had symptoms that could be attributable to embolization. In the group of 45 patients with a presumed diagnosis of CPF, 3 patients had symptoms that were likely due to embolization (incidence, 6.6%) during a follow-up period of 552+/-706 days. CONCLUSIONS: CPFs are generally small and single, occur most often on valvular surfaces, and may be mobile, resulting in embolization. Because of the potential for embolic events, symptomatic patients, patients undergoing cardiac surgery for other lesions, and those with highly mobile and large CPFs should be considered for surgical excision.

  19. A retrospective clinical study on 37 subtalar arthrodesis patients of nine years follow-up.

    Science.gov (United States)

    Xu, Xiangyang; Yang, Chonglin; Zhu, Yuan; Liu, Jinhao; Wei, Baofu

    2015-08-04

    Subtalar arthrodesis is a common therapy for subtalar joint disorders. In this article, we evaluate the effect of subtalar arthrodesis on the ankle and hindfoot joints. Fifty patients (33 men and 17 women) underwent subtalar arthrodesis between January 1, 1996, and August 31, 2011. The 36-item Short-Form Health Survey and American Orthopaedic Foot and Ankle Society ankle hindfoot scores were used for clinical evaluation. Radiographic analysis included assessment of degenerative changes and ankle and hindfoot joint function in the frontal and sagittal planes. Thirty-seven patients (27 men and 10 women; mean age, 42.6 years) were followed up for an average of 9.2 years (range, 2-17 years). The mean ± SD 36-item Short-Form Health Survey score improved from 30.21 ± 7.19 before surgery to 78.50 ± 12.23, and the American Orthopaedic Foot and Ankle Society ankle hindfoot score increased from 50.32 ± 12.39 to 73.14 ± 15.44. Degenerative changes in the talonavicular, calcaneocuboid, metatarsocuboid, and ankle joints occurred. The talar-vertical angle was positively related to the tibial-plantar minimal angle (affected side: r = 0.56; P < .01; healthy side: r = 0.46; P < .01). The difference in hindfoot height is positively related to the difference in tibial-plantar minimal angle (r = 0.54; P < .01). Subtalar arthrodesis is effective treatment for subtalar joint disease but could induce joint degeneration and ankle joint motion limitation related to talar declination and hindfoot height.

  20. Sonographic and Clinical Features of Papillary Thyroid Microcarcinoma Less than or Equal to Five Millimeters: A Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Xingjian Lai

    Full Text Available To retrospectively compare the sonographic and clinical features of papillary thyroid microcarcinoma (PTMC ≤5 mm and PTMC >5 mm to improve the diagnostic value of ultrasonography.A total of 367 cases of PTMC between January 2013 and December 2014 was included in this study. The patients were classified into group A (≤5 mm, n = 181 or group B (>5 mm, n = 186, and the sonographic and clinical features were reviewed and compared between the two groups.There was no significant difference in the shape, ratio of length/width, boundary, peripheral halo ring, echogenicity, cystic change and accompanying Hashimoto's thyroiditis between these two groups. However, the calcification (61.3% vs. 72.6% and hypervascularity (13.8% vs. 24.7% were more frequent in group B (p = 0.026 and 0.008, respectively. The patients were younger, and more patients were aged less than 45 years (41.4% vs. 57.0% in group B. Capsular invasion (7.2% vs. 34.4%, multifocality (21.5% vs. 48.9%, bilaterality (17.1% vs. 39.8%, central lymph node metastasis (13.8% vs. 38.2% and lateral lymph node metastasis (1.1% vs. 5.4% were more frequent in group B. No clinical or sonographic feature was related to cervical lymph node metastasis in group A, while less than 45 years in age (p = 0.010, male gender (p = 0.040, capsular invasion (p5 mm, including an irregular shape, a length/width ratio of ≥1, an unclear boundary, no peripheral halo ring, hypoechogenicity, no cystic change, calcification, no hypervascularity and no accompanying Hashimoto's thyroiditis. The clinical features of PTMC ≤5 mm were less aggressive than those of PTMC >5 mm.

  1. Clinical Use of Fungal PCR from Deep Tissue Samples in the Diagnosis of Invasive Fungal Diseases - A Retrospective, Observational Study.

    Science.gov (United States)

    Ala-Houhala, Mari; Koukila-Kähkölä, Pirkko; Antikainen, Jenni; Valve, Jaana; Kirveskari, Juha; Anttila, Veli-Jukka

    2017-09-01

    We evaluated the clinical use of panfungal polymerase chain reaction (PCR) for diagnosis of invasive fungal diseases (IFDs). We focused on the deep tissue samples. We first described the design of panfungal PCR, which is in clinical use at Helsinki University Hospital. Secondly, we retrospectively evaluated the results of 307 fungal PCR tests performed from 2013-2015. Samples were taken from normally sterile tissues and fluids. The patient population was non-selected. We classified the likelihood of IFD according to the criteria of the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG), compering the fungal PCR results to the likelihood of IFD along with the culture and microscopy results. There were 48 (16%) positive and 259 (84%) negative PCR results. The sensitivity and specificity of PCR for diagnosing invasive fungal disease were 60.5% and 91.7%, respectively, while the NPV and PPV were 93.4% and 54.2%, respectively. The concordance between the PCR and the culture results was 86% and 87% between PCR and microscopy, respectively. Of the 48 patients with positive PCR results 23 had a proven or probable IFD. Fungal PCR can be useful for diagnosing IFDs in deep tissue samples. It is beneficial to combine fungal PCR with culture and microscopy. Copyright © 2017. Published by Elsevier Ltd.

  2. Clinical and audiologic characteristics of patients with sensorineural tinnitus and its association with psychological aspects: an analytic retrospective study.

    Science.gov (United States)

    Al-Swiahb, Jamil Nasser; Hwang, Eul Seung; Kong, Ji Sun; Kim, Woo Jin; Yeo, Sang Won; Park, Shi Nae

    2016-12-01

    This study was performed to analyze clinical and audiologic characteristics of sensorineural tinnitus and to investigate the associating factors reflecting psychological aspects of stress and depression of the patients. This is a retrospective analytical study conducted in a tinnitus clinic of a tertiary referral center of a university hospital. The medical records of 216 patients suffering from sensorineural tinnitus were thoroughly evaluated to determine correlations between clinical and audiological characteristics, including age, sex, predisposing or etiologic factors, hearing levels up to extended high frequencies, and tinnitus severity. Psychological aspects of stress and depression were also evaluated and analyzed to seek the associations with tinnitus severity. All data were stored in our database bank and were statistically analyzed. Our study subjects showed a slight male predominance. The highest percentage of tinnitus was found in patients of 60-80 years old. Only 32.5 % of tinnitus patients were subjectively aware of their hearing loss, whereas 73 % of subjects had hearing deficits in some frequencies in their audiogram. Hearing impairments were of the low-frequency sensorineural type in 18.2 % of patients and were limited to the high frequencies in 77.9 % of patients. Tinnitus was unilateral in 51 % of patients and had a tonal nature in 45 % of patients. In total, 45.8 % of patients with high-frequency sensorineural hearing loss had high-pitched tinnitus. There were significant correlations between tinnitus severity, loudness and annoyance. Correlations with THI (Tinnitus Handicap Inventory) and Beck depression index scores were also found. Sensorineural tinnitus was related with hearing loss in some frequencies nevertheless of patients' own awareness of hearing loss. Loudness and annoyance of tinnitus seems to be two important factors reflecting psychological problems of patients' stress and depression.

  3. [Diabetes mellitus and its influence on the success of endodontic treatment: a retrospective clinical study].

    Science.gov (United States)

    Ferreira, Manuel Marques; Carrilho, Eunice; Carrilho, Francisco

    2014-01-01

    Diabetes mellitus is an endocrine disease in which are involved the hormones produced by the islets of Langerhans. The diabetes mellitus can affect various functions of the immune system of the individual, predisposing them to chronic inflammation, progressive degradation of tissues and decreased tissue repair. The changes caused by this disease at the level of the oral cavity can highlight xerostomia, dysgeusia, periodontal alterations, increased susceptibility to infection and changes both in the dental pulp and periapical tissues. The aim of this study is to evaluate the influence of diabetes mellitus at the periapical tissues and the success of endodontic treatment in these patients. We analyzed 737 cases treated in consultation Area of Dental Medicine, which were made nonsurgical endodontic treatments, between the years 2003 and 2012. These were selected patients with diabetes mellitus, a total of 32, of whom 23 were willing to come to the consultation and to participate in this study. The data collected were analyzed using the Statistical Package for the Social Sciences, version 19, at a significance level of 5%. A total of 37 teeth in the test group and 25 in the control group. For the analyzed parameters related to the diagnosis pulp, mobility, fistula, pain on percussion horizontal and vertical evaluation of final restoration and the time interval between the query and the final restoration shutter and / or the control visit, there were no differences statistically significant (p > 0.05). Regarding the assessment of the success of endodontic treatment, this was 62% in the test group and 80% in the control group (p > 0.05). The results of this study are inconclusive regarding the increasing prevalence of apical periodontitis in diabetic patients. Regarding the evaluation of the success of endodontic treatments examined it was found that the success rate in diabetic patients is lower, though not statistically significant. For this reason and given the

  4. A descriptive retrospective study of the treatment and outpatient service use in a clinical group of delusional disorder patients.

    Science.gov (United States)

    González-Rodríguez, Alexandre; Molina-Andreu, Oriol; Imaz Gurrutxaga, María Luisa; Catalán Campos, Rosa; Arroyo, Miquel Bernardo

    2014-01-01

    Gender differences in attendance rates for appointments in delusional disorder have been poorly studied. Furthermore, delusional disorder is traditionally considered a treatment-resistant disorder. We conducted a longitudinal retrospective study with a one-year follow-up, including 78 delusional disorder patients (DSM-IV-TR), consecutively admitted over a period of 10 years. We performed a follow-up for one year in order to describe demographic and clinical variables, and to compare the therapeutic effectiveness. In this study, due to the non-interventional nature of this study, indirect measures were used to measure treatment effectiveness. The sample was divided into three groups according to the antipsychotic received at the first admission. Twenty-three patients received Risperidone Long-Acting Injection (RILD), 30 oral risperidone, and 25 patients received other oral atypical antipsychotics. Delusional disorder women had a later age at onset and needed a longer duration of hospitalization. No statistically significant differences were found between the three treatment groups as regards demographic data, social and personal functioning, and psychopathology at admission. The RILD group showed higher maintenance rates at the end of the follow-up period. Furthermore, the RILD group required treatment with antidepressants and benzodiazepines less often. We concluded that treatment with RLAI may increase maintenance rates at follow-up in DD patients when compared with other oral atypical antipsychotics. Copyright © 2012 SEP y SEPB. Published by Elsevier España. All rights reserved.

  5. Diagnosis, clinical staging, and treatment of breast cancer: a retrospective multiyear study of a large controlled population.

    Science.gov (United States)

    Legorreta, Antonio P; Chernicoff, Helen O; Trinh, Jennifer B; Parker, Robert G

    2004-04-01

    This study compares diagnosis, staging, and treatment of newly diagnosed breast cancer cases over a several-year period. The study design was a retrospective, multiyear comparison between new breast cancer cases diagnosed in 1995 (n = 827) and 1997 (n = 815). Cases were identified through claims data, and medical record abstraction was used to verify each case and to identify clinical staging and type of treatment. All medical records were reviewed by one physician to maximize internal reliability. Both cohorts were predominantly 40 and older, white, married, and postmenopausal. The latter cohort (1997) had a higher proportion of women aged 70 to 79 and a lower proportion of women aged 40 to 49. In both cohorts, women age 40 and older were likely to be diagnosed with breast cancer at the time of mammographic screening, while women younger than 40 were more likely to be diagnosed by clinical breast examination. In logistic regression analyses, controlling for confounding factors such as age, undergoing mammographic screening increased the likelihood of having a low cancer stage at diagnosis by more than three and a half times. Mammographic screening was statistically significantly positively associated with having eligibility for breast-conserving treatment (BCT); however, although an increase in BCT eligibility was observed, actual use of BCT did not change. Mammography leads to a lower clinical stage as well as a greater likelihood of BCT eligibility at time of breast cancer diagnosis, but may not have a substantial effect on treatment choice (lumpectomy vs. mastectomy). Between 1995 and 1997, a trend was observed toward downstaging of disease at diagnosis; further research is warranted to observe whether this trend continues over time.

  6. Clinical impact of sarcopenia on prognosis in pancreatic ductal adenocarcinoma: A retrospective cohort study.

    Science.gov (United States)

    Ninomiya, Go; Fujii, Tsutomu; Yamada, Suguru; Yabusaki, Norimitsu; Suzuki, Kojiro; Iwata, Naoki; Kanda, Mitsuro; Hayashi, Masamichi; Tanaka, Chie; Nakayama, Goro; Sugimoto, Hiroyuki; Koike, Masahiko; Fujiwara, Michitaka; Kodera, Yasuhiro

    2017-03-01

    To investigate the impact of the body composition such as skeletal muscle, visceral fat and body mass index (BMI) on patients with resected pancreatic ductal adenocarcinoma (PDAC). A total of 265 patients who underwent curative surgery for PDAC were examined in this study. The total skeletal muscle and fat tissue areas were evaluated in a single image obtained at the third lumber vertebra during a preoperative computed tomography (CT) scan. The patients were assigned to either the sarcopenia or non-sarcopenia group based on their skeletal muscle index (SMI) and classified into high visceral fat area (H-VFA) or low VFA (L-VFA) groups. The association of clinicopathological features and prognosis with the body composition were statistically analyzed. There were 170 patients (64.2%) with sarcopenia. The median survival time (MST) was 23.7 months for sarcopenia patients and 25.8 months for patients without sarcopenia. The MST was 24.4 months for H-VFA patients and 25.8 months for L-VFA patients. However, sarcopenia patients with BMI ≥22 exhibited significantly poorer survival than patients without sarcopenia (MST: 19.2 vs. 35.4 months, P = 0.025). There was a significant difference between patients with and without sarcopenia who did not receive chemotherapy (5-year survival rate: 0% vs. 68.3%, P = 0.003). The multivariate analysis revealed that tumor size, positive dissected peripancreatic tissue margin, and sarcopenia were independent prognostic factors. Sarcopenia is an independent prognostic factor in PDAC patients with a BMI ≥22. Therefore, evaluating skeletal muscle mass may be a simple and useful approach for predicting patient prognosis. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  7. A retrospective study of clinical profile and outcomes of critically ill patients with heat-related illness

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    M S Kalaiselvan

    2015-01-01

    Full Text Available Background and Aims: Heat-related illness (HRI due to high ambient temperatures is a common feature during the Indian summer. HRI often results in Intensive Care Unit (ICU admissions and are associated with significant morbidity and mortality. However, published report on the effects of HRI among the Indian population is lacking. This study was undertaken to identify the profile of patients admitted to ICU with clinical features of HRI and study their clinical outcomes. Methods: This was a retrospective case series of patients admitted with features of HRI during the summer of 2012 in our multidisciplinary ICU. Data on demographics, co-morbid illness, admission severity of illness (Acute Physiology and Chronic Health Evaluation II [APACHE II], organ failure scores (Sequential Organ Failure Assessment [SOFA] and neuroimaging studies were collected. Outcome data studied included mortality, ICU length of stay (LOS, ventilator days and hospital LOS. Statistical analysis was performed using Student′s t-test, Chi-square test and multivariate analysis. Results: Twenty-six patients met the diagnostic criteria for HRI. Fifteen were males. The mean age was 53.12 ΁ 18.6 years. Mean APACHE II score was 19.6 ΁ 7.7 and mean SOFA score was 7.5 ΁ 2.6. The common presenting symptoms were fever with neurological impairment (100% and gastrointestinal symptoms (30%. Major organ systems involvement include neurological (100%, renal (57%, hepatic (34% and coagulation abnormalities (26%. Most common metabolic abnormality noted was hyponatraemia (73%. Magnetic resonance imaging findings suggestive of heat stroke were seen in 5 of 26 patients. Mortality rate was 34%. 8 of 17 survivors had residual neurological impairment. Conclusion: HRI carries a high mortality and significant neurological morbidity.

  8. A Retrospective Study of Epidemiological and Clinical Patterns of ACDRs in Goa Medical College over a 6 Year Period

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    Rakhi Ghodge

    2017-04-01

    Full Text Available Background: Adverse Cutaneous Drug Reactions (ACDRs account for 3% of all hospitalizations. The spectrum of drug reactions can be varied from mild to life threatening forms. Since the diagnosis of ACDR is purely clinical, early and prompt identification and withdrawal of drug (s is life saving for the patient. Aim and Objectives: To study the epidemiological and common clinical patterns and drugs causing ACDRs in tertiary care hospital of Goa Medical College, Goa over a 6 year period. Material and Methods:This was a retrospective study conducted over a period of 6 years. The medical records were analyzed for demographic profiles, morphology of drug eruptions, common groups of drugs involved, presence of co-morbid factors, systemic and mucosal involvement, common haematological abnormalities encountered, time interval between drug intake and onset of rash and mortality. Results: Our study population had 256 patients and the age group of 21-40 years was commonly affected. Maculopapular rash followed by angioedema were the commonest morphology of drug rash patterns encountered in our study. The time interval between consumption of drugs and onset of ACDR varied with interval of 1-7 days being the commonest group in having 158 (61.7% patients. Antibiotics followed by anticonvulsants and antiretrovirals were the commonest groups of drugs causing ACDR. We found that significant proportion of our patients had haematological, renal and hepatic system involvement. Conclusion: Early identification and withdrawal of the culprit drug remains the cornerstone in prevention of mortalities in ACDRs. A prior knowledge about the reaction patterns and common offending drugs in the population by the treating physician cannot be overemphasized.

  9. Cytomorphologic spectrum of Hashimoto′s thyroiditis and its clinical correlation: A retrospective study of 52 patients

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    Shirish S Chandanwale

    2014-01-01

    Full Text Available Background: Hashimoto′s thyroiditis (HT is an autoimmune disease and it is more prevalent in Asians. The incidence of HT seems to be increasing in the recent times. It is one of the most common cause of hypothyroidism. The purpose of this study is to review the cytomorphologic spectrum of HT and correlate it with clinical findings including thyroid function and antibody profile. Materials and Methods: We retrospectively analyzed the fine-needle aspiration (FNA features of 52 HT patients. Based on cytomorphologic features patients were categorized into three groups. Clinical findings including thyroid function and thyroid peroxidase (TPO antibody profile were correlated with cytomorphologic features in all three groups. Results: Majority of the patients were females and in 2 nd , 3 rd and 4 th decades. Diffuse goiter and thyroid hypofunction were the common findings. Significant number of patients had thyroid hyperfunction. Increased lymphocytes on the background and lymphocytic infiltration of thyroid follicular cell clusters in cytology smears were diagnostic of HT. The 32 patients showed elevated titers of TPO antibodies. In the early stages and mild form of the disease, results of thyroid function and anti TPO antibodies are quite variable. Conclusions: HT is a disease of young and middle age and mostly occur in females. Clinical findings alone may not be adequate for definitive diagnosis. FNA is the gold standard for diagnosis. In the presence of abundant colloid, follicular hyperplasia or co-existing neoplasm, careful interpretation of cytology smears should be done. Aspiration from more than one site minimizes the diagnostic pitfalls.

  10. A Retrospective Study of the Clinical Characteristics and Post-treatment Hearing Outcome in Idiopathic Sudden Sensorineural Hearing Loss

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    Kothandaraman, Purushothaman Pavanjur; Swapna, Simham; Manchaiah, Vinaya

    2017-01-01

    The purpose of this retrospective study was to analyze the clinical characteristics and document hearing recovery in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). 122 patients diagnosed with unilateral ISSNHL, from March 2009 to December 2014, were treated with oral steroids and pentoxifylline. Hearing change was evaluated by comparing pre-treatment and post-treatment pure-tone average (PTA) (500, 1K, and 2K Hz), and categorized into complete, partial, and no recovery of hearing. T-test, Wilcoxon Signed Rank test and Regression analysis were employed to analyze the statistical significance. Of the 122 patients, seventy-one (58%) had complete recovery and 34 (28%) had partial recovery. The average pre-treatment PTA was 78.3±16.9 dB whereas post-treatment average was 47.0±20.8 dB, showing statistically significant improvement (t=24.89, P≤0.001). The factors such as presence of tinnitus (P=0.005) and initial milder hearing loss (P=0.005) were found to be significant predictors for hearing recovery. Conventional steroid regimes produced a recovery rate in ISSNHL, which exceeds the spontaneous recovery rate. The current study results highlight the importance of medical treatment in the management of ISSNHL. PMID:28286637

  11. A retrospective study of the clinical characteristics and post-treatment hearing outcome in idiopathic sudden sensorineural hearing loss

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    Purushothaman Ganesan

    2017-02-01

    Full Text Available The purpose of this retrospective study was to analyze the clinical characteristics and document hearing recovery in patients with idiopathic sudden sensorineural hearing loss (ISSNHL. 122 patients diagnosed with unilateral ISSNHL, from March 2009 to December 2014, were treated with oral steroids and pentoxifylline. Hearing change was evaluated by comparing pre-treatment and post-treatment pure-tone average (PTA (500, 1K, and 2K Hz, and categorized into complete, partial, and no recovery of hearing. T-test, Wilcoxon Signed Rank test and Regression analysis were employed to analyze the statistical significance. Of the 122 patients, seventy-one (58% had complete recovery and 34 (28% had partial recovery. The average pre-treatment PTA was 78.3 ± 16.9 dB whereas post-treatment average was 47.0 ± 20.8 dB, showing statistically significant improvement (t=24.89, P≤0.001. The factors such as presence of tinnitus (P=0.005 and initial milder hearing loss (P=0.005 were found to be significant predictors for hearing recovery. Conventional steroid regimes produced a recovery rate in ISSNHL, which exceeds the spontaneous recovery rate. The current study results highlight the importance of medical treatment in the management of ISSNHL.

  12. Recombinant tissue plasminogen activator as a novel treatment option for infective endocarditis: a retrospective clinical study in 32 children.

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    Levitas, Aviva; Krymko, Hanna; Richardson, Justin; Zalzstein, Eli; Ioffe, Viktoriya

    2016-01-01

    Infective endocarditis is a life-threatening infectious syndrome, with high morbidity and mortality. Current treatments for infective endocarditis include intravenous antibiotics, surgery, and involve a lengthy hospital stay. We hypothesised that adjunctive recombinant tissue plasminogen activator treatment for infective endocarditis may facilitate faster resolution of vegetations and clearance of positive blood cultures, and therefore decrease morbidity and mortality. This retrospective study included follow-up of patients, from 1997 through 2014, including clinical presentation, causative organism, length of treatment, morbidity, and mortality. We identified 32 patients, all of whom were diagnosed with endocarditis and were treated by recombinant tissue plasminogen activator. Among all, 27 patients (93%) had positive blood cultures, with the most frequent organisms being Staphylococcus epidermis (nine patients), Staphylococcus aureus (six patients), and Candida (nine patients). Upon treatment, in 31 patients (97%), resolution of vegetations and clearance of blood cultures occurred within hours to few days. Out of 32 patients, one patient (3%) died and three patients (9%) suffered embolic or haemorrhagic events, possibly related to the recombinant tissue plasminogen activator. None of the patients required surgical intervention to assist vegetation resolution. In conclusion, it appears that recombinant tissue plasminogen activator may become an adjunctive treatment for infective endocarditis and may decrease morbidity as compared with current guidelines. Prospective multi-centre studies are required to validate our findings.

  13. A Retrospective Study on Clinical Features and Visual Outcome of Patients Hospitalized for Ocular Trauma in Cangzhou, China

    Science.gov (United States)

    2017-01-01

    Purpose. To describe clinical features and to analyze visual outcome of ocular trauma in Cangzhou in 2012–2015, China. Methods. A retrospective study of ocular trauma cases admitted to Cangzhou Central Hospital from January 2012 till December 2015 was performed. Results. This study included a total of 507 eyes from 478 patients. Four hundred (83.7%) patients were male, with a male-to-female ratio of 5.1 : 1. Mean age was 43.6 ± 18.3 years (5–95 years). The largest age group was 45–59 years old, followed by 30–44 years old, presenting two peaks of the age distribution and accounting for 28.5% and 27.2%, respectively. The most frequent type of injuries was work-related (194, 40.6%) followed by home-related (123, 25.7%). Initial visual acuity (VA) correlated with final VA (Spearman's test, r = 0.703, p = 0.001). The Ocular Trauma Score also correlated with the final VA significantly (Spearman's test, r = 0.802, p = 0.001). Conclusions. Susceptible population of eye injuries were middle- and young-aged working groups, and the proportion of males was higher. The leading two types of ocular trauma were work-related and home-related. Initial VA was a significant predictor of the final VA and the OTS possibly had predictive value in the final VA.

  14. Clinical outcomes of first-line antiretroviral therapy in Latin America: analysis from the LATINA retrospective cohort study.

    Science.gov (United States)

    Angriman, Federico; Belloso, Waldo H; Sierra-Madero, Juan; Sánchez, Jorge; Moreira, Ronaldo Ismerio; Kovalevski, Leandro O; Orellana, Liliana C; Cardoso, Sandra Wagner; Crabtree-Ramirez, Brenda; La Rosa, Alberto; Losso, Marcelo H

    2016-02-01

    Nearly 2 million people are infected with human immunodeficiency virus (HIV) in Latin America. However, information regarding population-scale outcomes from a regional perspective is scarce. We aimed to describe the baseline characteristics and therapeutic outcomes of newly-treated individuals with HIV infection in Latin America. A Retrospective cohort study was undertaken. The primary explanatory variable was combination antiretroviral therapy based on either a protease inhibitor (PI) or a non-nucleoside reverse transcriptase inhibitor (NNRTI). The main outcome was defined as the composite of all-cause mortality and the occurrence of an AIDS-defining clinical event or a serious non-AIDS-defining event during the first year of therapy. The secondary outcomes included the time to a change in treatment strategy. All analyses were performed according to the intention to treat principle. A total of 937 treatment-naive patients from four participating countries were included (228 patients with PI therapy and 709 with NNRTI-based treatment). At the time of treatment initiation, the patients had a mean age of 37 (SD: 10) years and a median CD4 + T-cell count of 133 cells/mm(3) (interquartile range: 47.5-216.0). Patients receiving PI-based regimens had a significantly lower CD4 + count, a higher AIDS prevalence at baseline and a shorter time from HIV diagnosis until the initiation of treatment. There was no difference in the hazard ratio for the primary outcome between groups. The only covariates associated with the latter were CD4 + cell count at baseline, study site and age. The estimated hazard ratio for the time to a change in treatment (NNRTI vs PI) was 0.61 (95% CI 0.47-0.80, p Latin America present with similar clinical outcomes regardless of the choice of initial therapy. Patients treated with PIs are more likely to require a treatment change during the first year of follow up.

  15. Clinical Spectrum Time Course in Anti Jo-1 Positive Antisynthetase Syndrome: Results From an International Retrospective Multicenter Study.

    Science.gov (United States)

    Cavagna, Lorenzo; Nuño, Laura; Scirè, Carlo Alberto; Govoni, Marcello; Longo, Francisco Javier Lopez; Franceschini, Franco; Neri, Rossella; Castañeda, Santos; Sifuentes Giraldo, Walter Alberto; Caporali, Roberto; Iannone, Florenzo; Fusaro, Enrico; Paolazzi, Giuseppe; Pellerito, Raffaele; Schwarting, Andreas; Saketkoo, Lesley Ann; Ortego-Centeno, Norberto; Quartuccio, Luca; Bartoloni, Elena; Specker, Christof; Murcia, Trinitario Pina; La Corte, Renato; Furini, Federica; Foschi, Valentina; Corral, Javier Bachiller; Airò, Paolo; Cavazzana, Ilaria; Martínez-Barrio, Julia; Hinojosa, Michelle; Giannini, Margherita; Barsotti, Simone; Menke, Julia; Triantafyllias, Kostantinos; Vitetta, Rosetta; Russo, Alessandra; Bajocchi, Gianluigi; Bravi, Elena; Barausse, Giovanni; Bortolotti, Roberto; Selmi, Carlo; Parisi, Simone; Montecucco, Carlomaurizio; González-Gay, Miguel Angel

    2015-08-01

    Anti Jo-1 antibodies are the main markers of the antisynthetase syndrome (ASSD), an autoimmune disease clinically characterized by the occurrence of arthritis, myositis, and interstitial lung disease (ILD). These manifestations usually co-occur (for practical purpose complete forms) in the same patient, but cases with only 1 or 2 of these findings (for practical purpose incomplete forms) have been described. In incomplete forms, the ex novo occurrence of further manifestations is possible, although with frequencies and timing not still defined. The aim of this international, multicenter, retrospective study was to characterize the clinical time course of anti Jo-1 positive ASSD in a large cohort of patients. Included patients should be anti Jo-1 positive and with at least 1 feature between arthritis, myositis, and ILD. We evaluated the differences between complete and incomplete forms, timing of clinical picture appearance and analyzed factors predicting the appearance of further manifestations in incomplete ASSD. Finally, we collected 225 patients (58 males and 167 females) with a median follow-up of 80 months. At the onset, complete ASSD were 44 and incomplete 181. Patients with incomplete ASSD had frequently only 1 of the classic triad findings (110 cases), in particular, isolated arthritis in 54 cases, isolated myositis in 28 cases, and isolated ILD in 28 cases. At the end of follow-up, complete ASSD were 113, incomplete 112. Only 5 patients had an isolated arthritis, only 5 an isolated myositis, and 15 an isolated ILD. During the follow-up, 108 patients with incomplete forms developed further manifestations. Single main feature onset was the main risk factor for the ex novo appearance of further manifestation. ILD was the prevalent ex novo manifestation (74 cases). In conclusion, ASSD is a condition that should be carefully considered in all patients presenting with arthritis, myositis, and ILD, even when isolated. The ex novo appearance of further

  16. Diagnosis and treatment of the Pierre Robin sequence: results of a retrospective clinical study and review of the literature.

    NARCIS (Netherlands)

    Elzen, A. van der; Semmekrot, B.A.; Bongers, M.H.F.; Huygen, P.L.M.; Marres, H.A.M.

    2001-01-01

    We performed a retrospective study of all children with Pierre Robin sequence (PRS), admitted to our hospital from 1981-1998 in order to evaluate diagnosis, treatment and prognosis. Patients were divided into two categories: isolated PRS (group 1) and PRS plus, i.e. PRS as part of a more complex syn

  17. Clinical Outcomes of Endoscopic Submucosal Dissection for Early Esophageal Squamous Cell Neoplasms: A Retrospective Single-Center Study in China

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    Yanfang Chen

    2016-01-01

    Full Text Available Aims. To retrospectively analyze the clinical outcomes for a large number of endoscopic submucosal dissections (ESDs in early esophageal squamous cell neoplasms (ESCNs at the First Affiliated Hospital of Nanjing Medical University. Patients and Methods. From January 2010 to February 2014, 296 patients (mean age 61.4 years, range 31–85 years; 202 men with 307 early ESCNs (79 intramucosal invasive esophageal squamous cell carcinomas (ESCCs and 228 high-grade intraepithelial neoplasia (HGIN cases were included from a total of 519 consecutive patients who were treated by esophageal ESD at our hospital. The primary end points of the study were rates of en bloc resection and complete resection. Secondary end points were complications, residual and recurrence rates, and mortality during follow-up. Results. The en bloc resection rate and complete resection rate were 93.5% and 78.2%, respectively. Complications included strictures (8.4%, perforations (1.0%, and bleedings (0.7%. Twenty-seven (9.1% patients experienced residual and 18 (6.1% patients experienced recurrence during a mean follow-up period of 30 months. Thirteen patients died from causes unrelated to ESCC, and no cancer-related death was observed. Conclusions. Our study showed that ESD is a successful and relatively safe treatment for intramucosal invasive ESCC and HGIN, fulfilling the criteria of lymph node negative tumors. This should encourage clinicians to select ESD performed by experienced operators as a potential or even preferred treatment option for lesions amenable to endoscopic treatment.

  18. Incidence and impact on clinical outcome of infections with piperacillin/tazobactam resistant Escherichia coli in ICU: A retrospective study

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    Mounier Roman

    2008-05-01

    Full Text Available Abstract Background Escherichia coli infections are frequent in ICU patients. The increased resistance to fluoroquinolones and amoxicillin/clavulanate of this pathogen mandates the prescription of broad-spectrum antibiotics such as piperacillin/tazobactam (PIP-TAZ or third generation cephalosporins (3GC. Methods To assess incidence and impact on clinical outcome of infections with PIP-TAZ resistant E. coli in ICU patients, we conducted a retrospective cohort study with infections due to PIP-TAZ resistant (PIP-TAZ R or to PIP-TAZ susceptible strains (PIP-TAZ S between 1 January 2002 and 30 June 2004. Results Of 83 strains, 13 were PIP-TAZ R: 2 strains produced an extended-spectrum β-lactamase (2%, 11 produced a high level penicillinase (13%. Prior amoxicillin or amoxicillin/clavulanate prescription was reported in 7 cases (54% of infections with PIP-TAZ R isolates and in 15 cases (21% of infections with PIP-TAZ S isolates (p = 0.03. Time of onset of the infection from hospital admission was longer in case of infections with PIP-TAZ R than with PIP-TAZ S isolates (22 ± 32 vs 10 ± 21 days, p = 0.01. The overall ICU mortality rate was 38%. Mortality and length of stay in ICU were similar in case of infections with PIP-TAZ R isolates and with PIP-TAZ S isolates. Conclusion Infections with PIP-TAZ R E. coli are frequent in ICU patients. No prognostic impact of this pattern of resistance was found. Prescription of PIP-TAZ for empirical treatment of E. coli infections in ICU however exposes to inappropriate therapy.

  19. A Retrospective Study of the Characteristics and Clinical Significance of A-Waves in Amyotrophic Lateral Sclerosis

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    Jia Fang

    2017-09-01

    Full Text Available A-wave was observed in patients with motor neuron disease (1. However, data on the characteristics and clinical significance of A-waves in patients with amyotrophic lateral sclerosis (ALS have been scarce. The F-wave studies of 83 patients with ALS and 63 normal participants which were conducted previously at the Department of Neurology in Peking Union Medical College Hospital were retrospectively reviewed to determine the occurrence of A-waves in ALS. A-waves occurred more frequently in ALS patients than in normal controls. For the median and peroneal nerves, the frequencies of nerves with A-waves and frequencies of patients with A-waves were comparable between the ALS patients and normal controls. For the ulnar and tibial nerves, the frequencies of nerves with A-waves and frequencies of patients with A-waves were significantly increased in the ALS patients compared with those of the normal participants. Disease progression rate was slower in the ALS patients with A-waves (0.73 ± 0.99 than that in the ALS patients without A-waves (0.87 ± 0.55, P = 0.007. No correlations were found between the amplitudes of F-waves with A-waves and those of A-waves in the ulnar nerves (r = 0.423, P = 0.149. No correlations were found between the persistence of F-waves with A-waves and the persistence of A-waves in the ulnar nerves as well (r = 0.219, P = 0.473. The occurrence of A-waves may indicate dysfunction of lower motor neurons and possibly imply a relatively slower degenerative process.

  20. A single-site retrospective study of pediatric arterial ischemic stroke etiology, clinical presentation, and radiologic features

    Institute of Scientific and Technical Information of China (English)

    SUN Dan; WU Xiao-man; WANG Zeng-wu; JIN Run-ming; LIU Zhi-sheng; LIU Fan; HUANG Sui

    2013-01-01

    Background Stroke occurs upon obstruction of cerebral blood circulation and is clinically characterized by sudden onset symptoms.Advanced age is the main risk factor of stroke,but cases of pediatric stroke have been rarely reported.This study aimed to determine the etiology,clinical presentation,and radiologic features of neurological deficit for pediatric arterial ischemic stroke (PALS).Methods The medical records of 42 PAlS patients (age range:9 months to 13 years) treated at Wuhan Children's Hospital between July 2007 and January 2011 were retrospectively reviewed.Infarction location was first determined by craniocerebral computed tomography and magnetic resonance (MR) imaging.The stenotic or occluded main cerebral arteries and/or branches were determined by MR angiography and digital subtraction angiography.Results The majority of the 42 PAlS cases (66.7%,n=28) were <3 years old (vs.>3 years old:33.3%,n=14; P<0.05),but the male:female ratio was similar in both groups (P>0.05).The most frequently reported signs and symptoms for both age groups were limited physical activity followed by convulsions and delirium,but convulsions were more prevalent in children <3 years-old.Children>3 years-old mainly experienced the limited physical activity symptoms,including hemiparalysis,aphasia,and ataxia.For all 42 cases,the most frequent etiologies were infections (38.1%,n=16),iron deficiency anemia (16.7%,n=7),and moyamoya syndrome (11.9%,n=5).The predominant infarcts among all cases were middle cerebral artery (63.6%,n=21)and basal ganglia (64.3%,n=27).Conclusions PAlS occurs more frequently in younger children and this group most frequently presents with convulsion as the initial symptom.The overall etiologies of PAlS may be different from those of adult stroke and the involved regions may be distinguishing features of PAlS or its different forms,but more research is required.

  1. Neurocysticercosis in Nepal: a retrospective clinical analysis

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    Rajeev Ojha

    2015-01-01

    Full Text Available Aim: The prevalence of epilepsy is higher in Nepal. This study was conducted to analyze the clinical manifestations of neurocysticercosis (NCC among seizure patients admitted to our center. Methods: We retrospectively studied all the NCC patients admitted to Neurology Department, Bir Hospital, Kathmandu, Nepal from April 2012 to February 2014. Computer tomography/magnetic resonance imaging (CT/MRI head, clinical profile, lab investigations and exclusion of other causes were the basis of the NCC diagnosis. Chi-square and Student′s t-test were used for comparison of variables. Results: Out of 131 seizure patients admitted, 21 patients were diagnosed with NCC (mean age: 33.95 ± 16.41; male: 15 (71.4%, female: 6 (28.6%. Generalized tonic clonic seizure was the most common seizure type in NCC patients (18 patients; 85.7%, two of them had status epilepticus during presentation in Emergency Department. Three patients had focal seizure, one with epilepsia partialis continua. Neuroimaging showed multiple NCC lesions in 8 (38.1% and a single NCC lesion in 13 (61.9% patients. Seven of them (33.3% sought traditional healers before being presented to our center. Eight patients (38.1% were treated with antiepileptics in local health-post without neuroimaging studies done. Calcified stage of NCC was the most frequent CT/MRI findings (12 patients; 57.1%. Phenytoin was preferred both by physicians and patients due to its low cost. Conclusion: NCC is a common finding among seizure patients in Nepal. Poor economic status, illiteracy and underdeveloped rural society are the major challenges in prevention and treatment of NCC.

  2. Clinically defined non-specific symptoms in the vicinity of mobile phone base stations: A retrospective before-after study

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    Baliatsas, Christos, E-mail: c.baliatsas@nivel.nl [Netherlands Institute for Health Services Research (NIVEL), Utrecht (Netherlands); Kamp, Irene van, E-mail: irene.van.kamp@rivm.nl [National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Bolte, John, E-mail: john.bolte@rivm.nl [National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Kelfkens, Gert, E-mail: gert.kelfkens@rivm.nl [National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Dijk, Christel van, E-mail: Christel.Van.Dijk@amsterdam.nl [Department of Research, Information and Statistics (OIS), Municipality of Amsterdam, Amsterdam (Netherlands); Spreeuwenberg, Peter, E-mail: p.spreeuwenberg@nivel.nl [Netherlands Institute for Health Services Research (NIVEL), Utrecht (Netherlands); Hooiveld, Mariette, E-mail: m.hooiveld@nivel.nl [Netherlands Institute for Health Services Research (NIVEL), Utrecht (Netherlands); Lebret, Erik, E-mail: erik.lebret@rivm.nl [National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht (Netherlands); Yzermans, Joris, E-mail: J.Yzermans@nivel.nl [Netherlands Institute for Health Services Research (NIVEL), Utrecht (Netherlands)

    2016-09-15

    The number of mobile phone base station(s) (MPBS) has been increasing to meet the rapid technological changes and growing needs for mobile communication. The primary objective of the present study was to test possible changes in prevalence and number of NSS in relation to MPBS exposure before and after increase of installed MPBS antennas. A retrospective cohort study was conducted, comparing two time periods with high contrast in terms of number of installed MPBS. Symptom data were based on electronic health records from 1069 adult participants, registered in 9 general practices in different regions in the Netherlands. All participants were living within 500 m from the nearest bases station. Among them, 55 participants reported to be sensitive to MPBS at T1. A propagation model combined with a questionnaire was used to assess indoor exposure to RF-EMF from MPBS at T1. Estimation of exposure at T0 was based on number of antennas at T0 relative to T1. At T1, there was a > 30% increase in the total number of MPBS antennas. A higher prevalence for most NSS was observed in the MPBS-sensitive group at T1 compared to baseline. Exposure estimates were not associated with GP-registered NSS in the total sample. Some significant interactions were observed between MPBS-sensitivity and exposure estimates on risk of symptoms. Using clinically defined outcomes and a time difference of > 6 years it was demonstrated that RF-EMF exposure to MPBS was not associated with the development of NSS. Nonetheless, there was some indication for a higher risk of NSS for the MPBS-sensitive group, mainly in relation to exposure to UMTS, but this should be interpreted with caution. Results have to be verified by future longitudinal studies with a particular focus on potentially susceptible population subgroups of large sample size and integrated exposure assessment. - Highlights: • There was an important increase in the total number of MPBS at T1 compared to T0. • Prevalence of NSS was

  3. A retrospective study of pheochromocytoma

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    Larigani B

    1997-08-01

    Full Text Available Pheochromocytoma is a rare disease. A retrospective study of the signs and clinical course of this disorder was performed by evaluating medical records. Our fidings indicate that the prevalence of pheochromocytoma was equal in men and women, and most patients (56% were in their second and third decades of life. In 10% of the cases, the disease was bilateral, and in 13% it was outside the adrenal (totally para-aortic. The tumor was more common on the right side (8%, and 3.5% were familial. Almost all cases had a history of hypertension and hypertensive crises. Attack-like episodes of clinical symptoms and signs and hypertension were observed in 98%, headache in 71% and profuse perspiration in 68% of the cases. An abdominal mass was palapated in 13% of the cases, 26% had overt diabetes, 23% had ECG changes. Malignancy was observed in 4%, with metastases to the liver (n=2 lung (n=1 and spine (n=1. In the latter four cases, the metastic lesion was histologically proven to be pheochromocytoma. In three of the 28 female cases, the first hypertensive crisis occurred during pregnancy causing abortion in one case.

  4. Relationship between reflection ability and clinical performance: a cross-sectional and retrospective-longitudinal correlational cohort study in midwifery

    NARCIS (Netherlands)

    Embo, M.; Driessen, E.; Valcke, M.; Vleuten, C.P.M. van der

    2015-01-01

    BACKGROUND: increasingly, reflection is highlighted as integral to core practice competencies but empirical research into the relationship between reflection and performance in the clinical workplace is scarce. AIM: this study investigated the relationship between reflection ability and clinical per

  5. Translator Studies in Retrospect

    Institute of Scientific and Technical Information of China (English)

    郭勤

    2009-01-01

    The concern about translator has run for thousands of years on which many translators and translation scholars have made comments.A rough examination of the translator within translation studies at home and abroad is expounded in a loosely chronological way as follows.

  6. Immunological and Clinical Responses following the Use of Antiretroviral Therapy among Elderly HIV-Infected Individuals Attending Care and Treatment Clinic in Northwestern Tanzania: A Retrospective Cohort Study

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    Bonaventura C. T. Mpondo

    2016-01-01

    Full Text Available Background. Limited information exists on adults ≥50 years receiving HIV care in sub-Saharan Africa despite their increasing number. We aimed at studying immunologic and clinical responses to ART in this population. Methods. Data of patients who initiated HAART between 30th of June 2004 and 1st of May 2008 at Sekou Toure Care and Treatment Clinic were retrospectively analyzed. Date of ART initiation was used as a baseline and 48 months as a follow-up date. Immune recovery was defined as a CD4 count of ≥350 cells/mm3 at 48 months and late presentation as presentation with WHO stage 3 or 4 at clinic enrollment. Proportions of patients reaching this endpoint were compared between the two groups. Results. A total of 728 patients were included in our study; of these 73 (10.0% were aged 50 years and above. Late presentation was more common in elderly patients than young patients (65.7% versus 56.1%, P=0.12. Proportion of patients with CD4 count ≥350 (immune recovery was higher in younger patients than in elderly patients, although this was not statistically significant (54.5% versus 44.9%, P=0.2. Median absolute increase in CD4 at 48 months was higher in younger patients than in elderly patients (+241.5 cells/mm3 versus +146 cells/mm3, P=0.007. Conclusion. Elderly HIV patients have higher rates of late presentation, with lower immune recovery. Strategies to increase HIV testing in this group are required for early diagnosis and treatment to improve outcomes.

  7. Clinical indications and radiation doses to the conceptus associated with CT imaging in pregnancy: a retrospective study

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    Woussen, S.; Vanbeckevoort, D.; Bosmans, H.; Oyen, R. [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Lopez-Rendon, X.; Zanca, F. [University Hospitals Leuven, Department of Imaging and Pathology, Leuven (Belgium)

    2016-04-15

    To perform an internal audit at a university hospital with the aim of evaluating the number, clinical indication and operating procedure of computed tomography (CT) performed on pregnant patients and of estimating the radiation doses to the conceptus. A retrospective review was conducted of all CT examinations performed in a single centre on pregnant patients between January 2008 and July 2013. The radiation doses to the conceptus were estimated. The results were compared with published data. The number of CT examinations during pregnancy increased from 3-4 per year in 2008-2011 to 11 per year in 2012. The mean estimated conceptus radiation dose was considered negligible for CT of the head and cervical spine, being less than 0.01 mGy, and for CT of the chest, less than 0.1 mGy. The estimated conceptus radiation dose from abdominopelvic CT was on average 28.7 mGy (range 6.7-60.5 mGy). The number of CT scans of pregnant patients increased threefold during the last few years. Most clinical indications and doses were in line with good clinical practice and literature; only in two cases the dose to the conceptus was higher than 50 mGy. (orig.)

  8. Infections on the rise: Raoultella spp., clinical and microbiological findings from a retrospective study, 2010-2014.

    Science.gov (United States)

    Boattini, Matteo; Almeida, André; Cardoso, Catarina; Cruz, Cristiano Silva; Machado, Catarina; Vesza, Zsófia; Tosatto, Valentina; Maia, Dionísio; Cardoso, Sara; Pinto, Margarida; Moura, Rita Barata; Garcia, Teresa; Guerreiro, António Sousa

    2016-01-01

    We performed a retrospective analysis of clinical and laboratory data over 5 years in a tertiary centre to assess clinical and microbiological characteristics of patients with Raoultella spp. infection. Raoultella spp. were deemed responsible for clinical infections in 57 patients (R. planticola, n = 32 and R. ornithinolytica, n = 25). The most prevalent diagnoses for R. planticola were cystitis (50%; n = 16) followed by bacteraemia and pneumonia (9.4%; n = 3); for R. ornithinolytica, cystitis (36%; n = 9) followed by pneumonia (24%; n = 6). Immunodeficiency was present in 18 patients (56.3%) with R. planticola and in 16 patients (64%) with R. ornithinolytica infection. Of these, 55.6% and 37.5% had diabetes and 27.8% and 18.% were solid organ transplant recipients, respectively. All isolates were sensitive to third-generation cephalosporins, fluoroquinolones and aminoglycosides. Mortality of infections with R. planticola (n = 5; 15.6%) was higher than for R. ornithinolytica (n = 2; 8.0%), but the difference was not statistically significant.

  9. a retrospective cohort study

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    RP Lystad

    2015-09-01

    Full Text Available The objectives of this study were to estimate the incidence and describe the pattern and severity of training injuries in taekwondo, and to compare pattern and severity of training injuries with competition injuries. One hundred and fifty-two active Australian amateur taekwondo athletes, aged 12 years or over, completed an online survey comprising questions on training exposure and injury history over the preceding 12 months. The main outcome measures were: overall injury incidence rate per athlete-year; training injury incidence rate per athlete-year, per 1000 athlete-training-sessions, and per 1000 athlete-hours of training; injury severity; and injury proportions by anatomical region and by type of injury. Injury incidence rates were calculated with 95% confidence intervals using standard methods, while injury proportions were compared using Fisher’s exact test. The vast majority (81.5% of taekwondo injuries in an average athlete-year occurred during training. The training injury incidence rate was estimated to be 1.6 (95% CI: 1.4, 1.9 per athlete-year, 11.8 (95% CI: 10.4, 13.4 per 1000 athlete-training-sessions, and 7.0 (95% CI: 6.1, 7.9 per 1000 athlete-hours of training. Among athletes with five or fewer injuries, the severity and injury pattern of training injuries were, by and large, the same as for competition injuries. Approximately sixty percent (60.3% of training injuries required treatment by a health professional. Considering the burden of training injuries exceeds that of competition injuries, taekwondo governing bodies and stakeholders are encouraged to devote more efforts towards the identification of risk factors for, and prevention of, training injuries in the sport of taekwondo.

  10. Clinical signs, magnetic resonance imaging findings and outcome in 77 cats with vestibular disease: a retrospective study.

    Science.gov (United States)

    Negrin, Arianna; Cherubini, Giunio B; Lamb, Chris; Benigni, Livia; Adams, Vicky; Platt, Simon

    2010-04-01

    Medical records of 77 cats that had clinical signs of vestibular disease and magnetic resonance imaging (MRI) of the head were reviewed retrospectively. The aetiological, clinical and MRI characteristics were described and evaluated for a relationship with patient outcome. Forty cats (52%) had signs of central vestibular dysfunction (CVD), which was part of a multifocal disease in 17 cats (43%). The most frequent causes of CVD were inflammatory conditions (18 cats; 45%), including bacterial inflammation as an intracranial extension of otitis interna (five cats; 13%), feline infectious peritonitis (three cats; 8%) and toxoplasmosis (two cats; 5%). Neoplasia (12 cats; 30%) and vascular disease (four cats; 10%) were respectively the second and the third most frequent causes of CVD. Thiamine deficiency was diagnosed in one cat based on MRI findings and improvement following vitamin B(1) supplementation. Of 37 cats (48%) with peripheral vestibular dysfunction (PVD), idiopathic vestibular syndrome (IVS) was suspected in 16 (43%) and otitis media/interna was suspected in 16 (43%). Within the group of cats with evident MRI lesions, the location of the imaged lesions agreed with the clinical classification of vestibular dysfunction in 52/55 (95%) cats. Most of the cats (nine cases; 56%) with presumed IVS had rapid and complete recovery of their clinical signs. As most of these cats presented with progressive clinical signs over 3 weeks they were classified as having 'atypical' IVS to differentiate them from cats with the typical non-progressive IVS. No underlying systemic diseases were documented in any of these cases. Statistically significant predictors of survival included neurolocalisation (central or peripheral vestibular system), age and gender. No difference in survival was observed between cats with presumed idiopathic peripheral syndrome and cats with otitis media/interna.

  11. Clinical presentation of inflammatory bowel disease: a hospital based retrospective study of 379 patients in eastern China

    Institute of Scientific and Technical Information of China (English)

    CAO Qian; SI Jian-min; GAO Min; ZHOU Gang; HU Wei-ling; LI Jin-hong

    2005-01-01

    Background Numerous studies from Europe and North America have provided a wealth of information regarding the epidemiological and clinical characteristics of inflammatory bowel disease (IBD) in Caucasians. Previous studies in mainland China have been limited by small patient numbers or by lack of detailed information about clinical subgroups of the disease. This study was carried out to assess the demographic and clinical characteristics of IBD in Chinese patients. Methods In the Sir Run Run Shaw Hospital between 1994 and 2003, 379 patients were diagnosed as IBD. Demographic and clinical data were collected and analysed. Conclusions This study shows similar caracteristics of IBD to that in the West but there are some differences with respect to severity and extraintestinal manifestations. The ethnic and geographic differences may give important clues to the aetiology of IBD.

  12. Clinical Features of Japanese Patients with Central Retinal Vein Occlusion Complicated by Normal-Tension Glaucoma: A Retrospective Study.

    Science.gov (United States)

    Kida, Teruyo; Fukumoto, Masanori; Sato, Takaki; Oku, Hidehiro; Ikeda, Tsunehiko

    2017-01-01

    The association of central retinal vein occlusion (CRVO) with primary open-angle glaucoma (POAG) or ocular hypertension has been reported, and lowering intraocular pressure (IOP) helps to improve the retinal circulation in eyes with CRVO. However, the clinical features of CRVOs with normal-tension glaucoma (NTG) are not well known. Therefore, we investigated Japanese CRVO patients with NTG. We retrospectively investigated 234 CRVO patients over 5 years, with follow-ups of more than 12 months, and evaluated the prevalence of glaucoma. Of the 234 CRVO patients, 18 (7.7%) were diagnosed with NTGs (n = 10) or POAGs (n = 8). Seven POAG (87.5%) and 3 NTG (30%) patients had systemic hypertension. At the initial CRVO evaluation, 6 NTGs showed a significantly increased IOP; mean IOP was 13.3 mm Hg before CRVO, 16.2 mm Hg at CRVO, and 13.5 mm Hg at the final visit. The proportion of NTGs with systemic hypertension was low. IOP of NTG patients was significantly elevated at the initial CRVO evaluation, even in the presence of anti-glaucoma drugs. © 2017 S. Karger AG, Basel.

  13. A RETROSPECTIVE STUDY OF EPIDEMIOLOGY CLINICAL COURSE AND TREATMENT OUTCOME OF SCORPION STING IN PAEDIATRIC AGE GROUP

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    Ramesh

    2015-12-01

    Full Text Available INTRODUCTION We know that habitat of scorpion is warm, and dry region. They inhibit commonly under logs, debris, paddy husk, sugar cane fields, and Coconut and banana plantations. (1 Konaseema region of Andhra Pradesh is famous for paddy, banana and coconut which are good habitat for scorpion. It is a retrospective study in which all the date of scorpion sting cases admitted in Konaseema institute of medical science and general hospital the only referral hospital in Konaseema region in last 3 years that is from Oct 2012 to Nov 2015 was collected. Mesobuthus tamulus is common in Andhra Pradesh. With the combined use of SAV and prazosin mortality has been reduced. But the awareness about the scorpion to the parent and its habitat will prevent the sting.

  14. Clinical and electrodiagnostic findings in a cohort of 61 dogs with peripheral nervous system diseases - a retrospective study

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    EG Giza, JE Nicpon and MA Wrzosek

    2014-04-01

    Full Text Available The electrodiagnostic examination provides the basis for a diagnostic workup in diseases involving nerve roots, peripheral nerves, neuromuscular junctions and muscles in humans and animals. It is a functional test that enables identification, localization and characterization of the disease within the peripheral nervous system. The study was carried out retrospectively on a group of 61 dogs of different breeds referred for an electrodiagnostic examination because of local or generalized peripheral nervous system impairment. The electrodiagnostic examination consisted of electromyography, electroneurography, F-wave and repetitive nerve stimulation testing. The results of electrodiagnostic studies and their impact on the diagnosis of neuromuscular diseases of different etiology is presented in the study. The lesion was localized to peripheral nerves in 38%, nerve roots in 34%, skeletal muscles in 18% and the neuromuscular junction in 10% of cases. Electrodiagnostics enabled an objective assessment of the extent, distribution and nature of the disease in the study group. However, only when it is used in conjunction with a complete physical and neurological examination and appropriate laboratory or imaging studies, it may be helpful in determining the etiological diagnosis in patients with peripheral nervous system disease.

  15. Retrospective study of clinical and hematological aspects associated with dogs naturally infected by Hepatozoon canis in Ludhiana, Punjab, India

    Institute of Scientific and Technical Information of China (English)

    Sushma Chhabra; Sanjeev Kumar Uppal; Lachhman Das Singla

    2013-01-01

    To evaluate clinical and hematological aspects of dogs naturally infected withHepatozoon canis (H. canis) presented at the Small Animal Clinics of Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana. Methods: Blood films of 34 naturally infected dogs were examined for haematological alterations and parasitaemia. Signalment and clinical signs were recorded from the animals. Clinical histories were filled out during the consultation. Results: Of the 34 positive dogs by Giemsa stained peripheral blood films, 88.23% presented parasitaemia by H. canis only, while 11.77% had the combination ofH. canis, Babesia sp. and Ehrlichia sp. Young male dogs less than one-year-old, of non-descript breed, were the most commonly affected. And 26.47% were presented with anorexia/inappetence as the only clinical symptom. Other clinical symptoms were mild to moderate fever, pale mucosae and lethargy; a few were also showing the signs of vomiting and diarrhoea. Haematological alterations showed mainly normochromic-normocytic anaemia, leukocytosis and neutrophilia. Conclusions: The findings of this study substantiate that H. canis caused clinical and haematological alterations of the varied intensity in dogs, even with low parasitaemia, should be taken into consideration.

  16. Agreements between Industry and Academia on Publication Rights: A Retrospective Study of Protocols and Publications of Randomized Clinical Trials.

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    Benjamin Kasenda

    2016-06-01

    Full Text Available Little is known about publication agreements between industry and academic investigators in trial protocols and the consistency of these agreements with corresponding statements in publications. We aimed to investigate (i the existence and types of publication agreements in trial protocols, (ii the completeness and consistency of the reporting of these agreements in subsequent publications, and (iii the frequency of co-authorship by industry employees.We used a retrospective cohort of randomized clinical trials (RCTs based on archived protocols approved by six research ethics committees between 13 January 2000 and 25 November 2003. Only RCTs with industry involvement were eligible. We investigated the documentation of publication agreements in RCT protocols and statements in corresponding journal publications. Of 647 eligible RCT protocols, 456 (70.5% mentioned an agreement regarding publication of results. Of these 456, 393 (86.2% documented an industry partner's right to disapprove or at least review proposed manuscripts; 39 (8.6% agreements were without constraints of publication. The remaining 24 (5.3% protocols referred to separate agreement documents not accessible to us. Of those 432 protocols with an accessible publication agreement, 268 (62.0% trials were published. Most agreements documented in the protocol were not reported in the subsequent publication (197/268 [73.5%]. Of 71 agreements reported in publications, 52 (73.2% were concordant with those documented in the protocol. In 14 of 37 (37.8% publications in which statements suggested unrestricted publication rights, at least one co-author was an industry employee. In 25 protocol-publication pairs, author statements in publications suggested no constraints, but 18 corresponding protocols documented restricting agreements.Publication agreements constraining academic authors' independence are common. Journal articles seldom report on publication agreements, and, if they do

  17. Agreements between Industry and Academia on Publication Rights: A Retrospective Study of Protocols and Publications of Randomized Clinical Trials

    Science.gov (United States)

    Kasenda, Benjamin; von Elm, Erik; You, John J.; Tomonaga, Yuki; Saccilotto, Ramon; Amstutz, Alain; Bengough, Theresa; Meerpohl, Joerg J.; Stegert, Mihaela; Olu, Kelechi K.; Tikkinen, Kari A. O.; Neumann, Ignacio; Carrasco-Labra, Alonso; Faulhaber, Markus; Mulla, Sohail M.; Mertz, Dominik; Akl, Elie A.; Bassler, Dirk; Busse, Jason W.; Nordmann, Alain; Gloy, Viktoria; Ebrahim, Shanil; Schandelmaier, Stefan; Sun, Xin; Vandvik, Per O.; Johnston, Bradley C.; Walter, Martin A.; Burnand, Bernard; Hemkens, Lars G.; Bucher, Heiner C.; Guyatt, Gordon H.; Briel, Matthias

    2016-01-01

    Background Little is known about publication agreements between industry and academic investigators in trial protocols and the consistency of these agreements with corresponding statements in publications. We aimed to investigate (i) the existence and types of publication agreements in trial protocols, (ii) the completeness and consistency of the reporting of these agreements in subsequent publications, and (iii) the frequency of co-authorship by industry employees. Methods and Findings We used a retrospective cohort of randomized clinical trials (RCTs) based on archived protocols approved by six research ethics committees between 13 January 2000 and 25 November 2003. Only RCTs with industry involvement were eligible. We investigated the documentation of publication agreements in RCT protocols and statements in corresponding journal publications. Of 647 eligible RCT protocols, 456 (70.5%) mentioned an agreement regarding publication of results. Of these 456, 393 (86.2%) documented an industry partner’s right to disapprove or at least review proposed manuscripts; 39 (8.6%) agreements were without constraints of publication. The remaining 24 (5.3%) protocols referred to separate agreement documents not accessible to us. Of those 432 protocols with an accessible publication agreement, 268 (62.0%) trials were published. Most agreements documented in the protocol were not reported in the subsequent publication (197/268 [73.5%]). Of 71 agreements reported in publications, 52 (73.2%) were concordant with those documented in the protocol. In 14 of 37 (37.8%) publications in which statements suggested unrestricted publication rights, at least one co-author was an industry employee. In 25 protocol-publication pairs, author statements in publications suggested no constraints, but 18 corresponding protocols documented restricting agreements. Conclusions Publication agreements constraining academic authors’ independence are common. Journal articles seldom report on

  18. The Incidence, Clinical Outcomes, and Risk Factors of Thrombocytopenia in Intra-Abdominal Infection Patients: A Retrospective Cohort Study.

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    Qin Wu

    Full Text Available Studies on the incidence and risk factors of thrombocytopenia among intra-abdominal infection patients remain absent, hindering efficacy assessments regarding thrombocytopenia prevention strategies.We retrospectively studied 267 consecutively enrolled patients with intra-abdominal infections. Occurrence of thrombocytopenia was scanned for all patients. All-cause 28-day mortality was recorded. Variables from univariate analyses that were associated with occurrence of hospital-acquired thrombocytopenia were included in a multivariable logistic regression analysis to determine thrombocytopenia predictors.Median APACHE II score and SOFA score of the whole cohort was 12 and 3 respectively. The overall ICU mortality was 7.87% and the 28-day mortality was 8.98%. The incidence of thrombocytopenia among intra-abdominal infection patients was 21.73%. Regardless of preexisting or hospital-acquired one, thrombocytopenia is associated with an increased ICU mortality and 28-day mortality as well as length of ICU or hospital stay. A higher SOFA and ISTH score at admission were significant hospital-acquired thrombocytopenia risk factors.This is the first study to identify a high incidence of thrombocytopenia in patients with intra-abdominal infections. Our findings suggest that the inflammatory milieu of intra-abdominal infections may uniquely predispose those patients to thrombocytopenia. More effective thrombocytopenia prevention strategies are necessary in intra-abdominal infection patients.

  19. A comparative, retrospective, observational study of the clinical and microbiological profiles of post-penetrating keratoplasty keratitis

    Science.gov (United States)

    Lin, I.-Huang; Chang, Yi-Sheng; Tseng, Sung-Huei; Huang, Yi-Hsun

    2016-09-01

    Infectious keratitis after penetrating keratoplasty (PK) is a devastating condition that may result in graft failure and poor visual outcome. In this study, we retrospectively reviewed the medical records of patients who underwent PK between 2009 and 2014, and recorded those who developed infectious keratitis. We compared the predisposing factors and organisms isolated to those identified in our previous study, conducted between 1989 and 1994. The incidence of post-PK infectious keratitis decreased from 11.6% (41 out of 354 cases, 1989-1994) to 6.5% (9 out of 138 cases, 2009-2014). Graft epithelial defect and suture-related problems remained the leading two risk factors of infectious keratitis after PK. Gram-positive and Gram-negative bacterial infection decreased from 58.5% and 46.3% to 11.1% and 22.2%, respectively (P = 0.023 and P = 0.271). In contrast, fungus infection increased from 9.8% to 66.7% (P = 0.001) fungi have become the major pathogen for post-PK infectious keratitis. In conclusion, while the incidence of post-PK infectious keratitis has decreased over time, the number and frequency of fungal infections have significantly increased in the recent study period. Clinicians should be aware of the shifting trend in pathogens involved in post-PK infectious keratitis.

  20. Vertical Midface Lifting with Periorbital Anchoring in the Management of Lower Eyelid Retraction: A 10-Year Clinical Retrospective Study.

    Science.gov (United States)

    Pascali, Michele; Botti, Chiara; Cervelli, Valerio; Botti, Giovanni

    2017-07-01

    Lower eyelid retraction can be the unfortunate result of aesthetic surgery, trauma, disease, or the aging processes. The purpose of this article is to assess whether midface lifting based on purely vertical repositioning constitutes an effective procedure for its correction. A retrospective study was carried out on 199 patients (311 eyelids) operated on between January of 2004 and January of 2014. The various causes of eyelid retraction in this population included cosmetic blepharoplasty (56.8 percent), involutional ectropion (23.1 percent), tumor resection (9.5 percent), facial nerve paralysis (8.5 percent), and trauma and related surgery (2 percent). The study was restricted exclusively to cases of moderate and severe lower eyelid retraction addressed by means of midface lifting. The mean follow-up time was 16.8 months. All of the patients were subjected to midface lifting with strengthening of the lateral canthus. A spacer graft was also used in 37.7 percent of the cases. One hundred ninety-five patients (97.9 percent) displayed objective improvement of the eyelid retraction and a marked degree of improvement both in aesthetic terms and as regards the functional disorders reported. Only four patients (2 percent) presented complications such as needing another operation. Midface lifting based on purely vertical repositioning makes it possible to recruit a considerable amount of "new" skin at the lower eyelid, thus ensuring a decrease in vertical distraction and correct recovery of the height of the external lamellar plane. Therapeutic, IV.

  1. Clinical Risk Scoring Models for Prediction of Acute Kidney Injury after Living Donor Liver Transplantation: A Retrospective Observational Study.

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    Mi Hye Park

    Full Text Available Acute kidney injury (AKI is a frequent complication of liver transplantation and is associated with increased mortality. We identified the incidence and modifiable risk factors for AKI after living-donor liver transplantation (LDLT and constructed risk scoring models for AKI prediction. We retrospectively reviewed 538 cases of LDLT. Multivariate logistic regression analysis was used to evaluate risk factors for the prediction of AKI as defined by the RIFLE criteria (RIFLE = risk, injury, failure, loss, end stage. Three risk scoring models were developed in the retrospective cohort by including all variables that were significant in univariate analysis, or variables that were significant in multivariate analysis by backward or forward stepwise variable selection. The risk models were validated by way of cross-validation. The incidence of AKI was 27.3% (147/538 and 6.3% (34/538 required postoperative renal replacement therapy. Independent risk factors for AKI by multivariate analysis of forward stepwise variable selection included: body-mass index >27.5 kg/m2 [odds ratio (OR 2.46, 95% confidence interval (CI 1.32-4.55], serum albumin 20 (OR 2.01, 95%CI 1.17-3.44, operation time >600 min (OR 1.81, 95%CI 1.07-3.06, warm ischemic time >40 min (OR 2.61, 95%CI 1.55-4.38, postreperfusion syndrome (OR 2.96, 95%CI 1.55-4.38, mean blood glucose during the day of surgery >150 mg/dl (OR 1.66, 95%CI 1.01-2.70, cryoprecipitate > 6 units (OR 4.96, 95%CI 2.84-8.64, blood loss/body weight >60 ml/kg (OR 4.05, 95%CI 2.28-7.21, and calcineurin inhibitor use without combined mycophenolate mofetil (OR 1.87, 95%CI 1.14-3.06. Our risk models performed better than did a previously reported score by Utsumi et al. in our study cohort. Doses of calcineurin inhibitor should be reduced by combined use of mycophenolate mofetil to decrease postoperative AKI. Prospective randomized trials are required to address whether artificial modification of hypoalbuminemia, hyperglycemia

  2. Mathematical evaluation of the influence of multiple factors on implant stability quotient values in clinical practice : A retrospective study

    NARCIS (Netherlands)

    Huang, H.; Wismeijer, D.; Shao, X.; Wu, G.

    2016-01-01

    Objectives: The objective of this study is to mathematically evaluate the influence of multiple factors on implant stability quotient values in clinical practice. Patients and methods: Resonance frequency analysis was performed at T1 (measured immediately at the time of implant placement) and at T2

  3. Cold antibody autoimmune hemolytic anemia and lymphoproliferative disorders: a retrospective study of 20 patients including clinical, hematological, and molecular findings.

    Science.gov (United States)

    Arthold, Cathrin; Skrabs, Cathrin; Mitterbauer-Hohendanner, Gerlinde; Thalhammer, Renate; Simonitsch-Klupp, Ingrid; Panzer, Simon; Valent, Peter; Lechner, Klaus; Jäger, Ulrich; Sillaber, Christian

    2014-06-01

    A total of 20 patients with cold antibody hemolytic anemia were evaluated in a retrospective study of them, 15 had a monoclonal gammopathy of unknown significance (MGUS): 14 with MGUS of immunoglobulin M (IgM) subtype and 1 with immunoglobulin G subtype. One patient had smoldering Waldenström's macroglobulinemia, but four patients had no monoclonal protein and no evidence of lymphoma. However, in three of these patients, we were able to demonstrate a (mono-)clonal rearrangement of their immunoglobulin heavy and/or light chains. Of the 20 patients, 5 had IgHV34 nucleotide sequence indicating that the antibody was directed against the "I" antigen. Two patients exhibited a progressive increase of IgM over time, however without increasing hemolytic activity. Moreover, in two patients with long-term follow-up, we were able to correlate recurrent hemolytic activity with low environmental temperatures. Among four patients treated with rituximab, all four responded to treatment. However, treatment effect was only transient in all of them.

  4. Antidepressant monotherapy and combination of antidepressants in the treatment of resistant depression in current clinical practice: A retrospective study.

    Science.gov (United States)

    Bares, Martin; Novak, Tomas; Kopecek, Miloslav; Stopkova, Pavla; Höschl, Cyril

    2010-11-01

    Abstract Objectives. The aim of this study was to compare efficacy of antidepressant monotherapies and combinations of antidepressants in the treatment of resistant patients in current clinical practice. Methods. We reviewed chart documents of resistant depressive inpatients treated at least 4 weeks with a new treatment. Depressive symptoms and clinical status were assessed using Montgomery and Åsberg Depression Rating Scale (MADRS), Beck Depression Inventory-Short Form and Clinical Global Impression at the baseline, week 2 and in the end of treatment. Results. We identified 81 patients (27 with combinations and 51 with monotherapies) that were suitable for analyses. The combination group achieved higher reduction of MADRS score (14.6 vs 10.2 pts., p=0.02) and response rate (≥ 50% reduction of MADRS, 67% vs 39%, p=0.03). Number needed to treat for response was 4. Conclusions. Based on our results, we suggest that combination of antidepressants might be more effective than monotherapy in clinical practice.

  5. Clinical investigation of mucosal thickness stability after soft tissue grafting around implants: A 3-year retrospective study

    OpenAIRE

    Speroni Stefano; Cicciù Marco; Maridati Paolo; Grossi Giovanni; Maiorana Carlo

    2010-01-01

    Purpose: To assess the long-term stability of gingival grafts placed around dental implants at the time of second surgery uncovering and to further investigate the association between mucosal thickness (MTh) by demographic variables and clinical investigation. Materials and Methods: Fourteen patients with submerged dental implants covered by inadequate keratinized mucosa were studied. The subjects underwent a periimplant plastic surgery (PPS) at the second-stage dental implant surgery and fr...

  6. Long-Term Clinical Outcome after Treatment for High-Grade Cervical Lesions: A Retrospective Monoinstitutional Cohort Study

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    Annarosa Del Mistro

    2015-01-01

    Full Text Available Background. The aim of this retrospective observational study of women treated for cervical intraepithelial neoplasia grade 2 or worse (CIN2+ was to assess the long-term risk of residual/recurrent high-grade CIN. Materials and Methods. We evaluated 760 women treated by loop electrosurgical excision procedure (684 or conization (76 between 2000 and 2009, and followed up to June 30, 2014 (median follow-up 6.7 years, range 4–14. Visits every 6 months for the first year after treatment and yearly for up to the following 10 years included cytology, colposcopy when indicated, and HPV testing (search and typing. Results. CIN2+ or vaginal intraepithelial neoplasia grade 2 or worse (VAIN2+ was detected in 67 cases (8.8%, 39 at first follow-up and 28 after one/more negative visits. The risk of CIN2+ was higher in case of positive margins (odds ratio (OR 8.04, 95% CI 4.31–15.0, type 3 transformation zone (OR for CIN3 27.7, 95% CI 2.07–36.9, CIN3+ excision (OR 6.02, 95% CI 1.73–20.9, and positive high-risk HPV test at first follow-up (OR for HPV16: 20.6, 95% CI 6.8–62.6; OR for other hrHPV types: 18.3, 95% CI 5.9–57.0. Conclusion. Residual/recurrent high-grade CIN occurred in <9% cases, and the risk was associated with transformation zone type, lesion grade, margins status, and hrHPV test result at 6–12 months of follow-up.

  7. Mucin pattern reflects the origin of the adenocarcinoma in Barrett's esophagus: a retrospective clinical and laboratorial study

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    Corbett Carlos

    2009-03-01

    Full Text Available Abstract Background Mucin immunoexpression in adenocarcinoma arising in Barrett's esophagus (BE may indicate the carcinogenesis pathway. The aim of this study was to evaluate resected specimens of adenocarcinoma in BE for the pattern of mucins and to correlate to the histologic classification. Methods Specimens were retrospectively collected from thirteen patients who underwent esophageal resection due to adenocarcinoma in BE. Sections were scored for the grade of intestinal metaplasia. The tissues were examined by immunohistochemistry for MUC2 and MUC5AC antibodies. Results Eleven patients were men. The mean age was 61 years old (varied from 40 to 75 years old. The tumor size had a mean of 4.7 ± 2.3 cm, and the extension of BE had a mean of 7.7 ± 1.5 cm. Specialized epithelium with intestinal metaplasia was present in all adjacent mucosas. Immunohistochemistry for MUC2 showed immunoreactivity in goblet cells, while MUC5AC was extensively expressed in the columnar gastric cells, localizing to the surface epithelium and extending to a variable degree into the glandular structures in BE. Tumors were classified according to the mucins in gastric type in 7/13 (MUC5AC positive and intestinal type in 4/13 (MUC2 positive. Two tumors did not express MUC2 or MUC5AC proteins. The pattern of mucin predominantly expressed in the adjacent epithelium was associated to the mucin expression profile in the tumors, p = 0.047. Conclusion Barrett's esophagus adenocarcinoma shows either gastric or intestinal type pattern of mucin expression. The two types of tumors developed in Barrett's esophagus may reflect the original cell type involved in the malignant transformation.

  8. Analysis of the relationship between occlusal and clinical parameters and the need for incisor reduction in confined horses - a retrospective study

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    Luiz Fernando Rapp de Oliveira Pimentel

    2014-11-01

    Full Text Available The purpose of this retrospective study was to evaluate the relationship between occlusal and clinical parameters and the need for incisor shortening in horses. It was based on the retrospective analysis of the dental charts of 75 confined horses. Body condition score, shape of incisors, presence of dysmastication, excursion to molar contact (EMC distance before and after cheek teeth occlusal adjustment were evaluated. History of difficult to riding, dysmastication and digestive problems was also considered. The initial measurement of lateral excursion to molar contact (EMC revealed incisor occlusal surface abnormalities in 45 (60% horses and long incisors (EMC>15mm in five (6.6% horses. Considering clinical examination and history data the need for reduction of incisor length was significant when EMC exceeded 15mm (P<0.0001 and when based on dental shape, clinical history of dysmastication and/or digestive problems or body condition score was also significant (P<0.05. In confined horses, the decision to shorten and align the incisor teeth should be based on observation and history of dysmastication and digestive problems, body condition score, incisors shape and EMC distance. The need for incisor reduction should be determined before dental intervention and reassessed following cheek teeth oclusal adjustment

  9. Periodontal pathogens participate in synovitis in patients with rheumatoid arthritis in clinical remission: a retrospective case-control study.

    Science.gov (United States)

    Kimura, Yuko; Yoshida, Shuzo; Takeuchi, Tohru; Kimura, Motoshi; Yoshikawa, Ayaka; Hiramatsu, Yuri; Ishida, Takaaki; Makino, Shigeki; Takasugi, Yoshihiro; Hanafusa, Toshiaki

    2015-12-01

    The objective of this study was to investigate the role of periodontal pathogens in RA in remission. Twenty-one patients with active RA and 70 patients in clinical remission, including 48 patients with synovitis [US power Doppler (USPD)(+) group] and 22 patients without synovitis [USPD(-) group] were clinically assessed by US. CRP, ESR, haemoglobin, MMP-3, RF and ACPA were measured. Antibody titres against four types of periodontal pathogen [Aggregatibacter actinomycetemcomitans, Eikenella corrodens (Ec), Porphyromonas gingivalis and Prevotella intermedia (Pi)] were analysed using ELISA. Musculoskeletal US examination showed that 68.6% of patients with RA in clinical remission exhibited synovitis. CRP, ESR, haemoglobin, MMP-3 and RF levels in both the USPD(+) and USPD(-) groups were clearly lower compared with the RA group in non-remission. The IgG serum antibody titre against Ec in the non-remission RA(+) group was significantly greater than that in the USPD(+) group, and the IgG antibody titre against Pi in the non-remission RA and USPD(+) groups was greater than in the USPD(-) group. More than half of RA patients in remission showed persistent synovitis. This synovitis may be associated with periodontal disease-causing Pi. Thus, treating periodontal disease should also be considered in order to achieve more profound remission of RA. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. The utilisation and diagnostic yield of radiological imaging in a specialist functional GI disorder clinic: an 11-year retrospective study

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    Breen, Micheal; O' Neill, Siobhan B.; O' Donovan, Joanne P.; McWilliams, Sebastian [Cork University Hospital, Department of Radiology, Cork (Ireland); Murphy, Kevin P.; Maher, Michael M. [Cork University Hospital, Department of Radiology, Cork (Ireland); University College Cork, Department of Radiology, Cork (Ireland); Desmond, Alan N. [Cork University Hospital, Department of Medicine, Cork (Ireland); Shanahan, Fergus; Quigley, Eamonn M. [Cork University Hospital, Department of Medicine, Cork (Ireland); University College Cork, Alimentary Pharmabiotic Center, Cork (Ireland)

    2014-12-15

    The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs. We investigated the utilisation of AIS (site, modality, diagnostic yield/significance) at a tertiary FGID clinic over an 11-year period. Of 1,621 patients, 507 (31 %; 67.5 % women, mean age 43.9 ± 17.37 years) referred from primary care had 997 AIS (1.7 per patient): ultrasonography (US) 36.1 %, fluoroscopy (FLS) 28.8 %, computed tomography (CT) 19.6 %, plain radiography (PR) 13.5 %, nuclear medicine (NM) 1 %. Of the 997 AIS, 55.6 % (554/997) were normal. Of the AIS with positive findings, 9.9 % (62/625) were deemed 'probably significant' and 14.7 % (92/625) 'significant'. Of the CT and FLS studies, 12.3 % and 13.6 %, respectively, yielded 'significant' abnormalities compared to 2.2 % of the US studies and 2.1 % of the PR studies. CT identified five of seven neoplasms, associated with male sex, increasing age and symptom onset after age 50 years. This study confirmed low use of AIS in tertiary FGID clinics and a high proportion of normal studies. Barium swallow/meal and CT were more likely to identify 'probably significant' or 'significant' findings, including neoplasms. (orig.)

  11. Clinical evaluation of chitotriosidase enzyme activity in Gaucher and Niemann Pick A/B diseases: A retrospective study from India.

    Science.gov (United States)

    Kadali, Srilatha; Kolusu, Anusha; Sunkara, Satish; Gummadi, Maheshwar Reddy; Undamatla, Jayanthi

    2016-06-01

    Plasma chitotriosidase originates from activated macrophages and is reported to be elevated in many Lysosomal Storage Disorders. Measurement of this enzyme activity has been an available tool for monitoring therapy of Gaucher disease. The degree of elevation of chitotriosidase is useful for differential diagnosis of Gaucher disease and Niemann Pick A/B. However the potential utility of this chitotriosidase assay depends on the frequency of deficient chitotriosidase activity in a particular population. We therefore aim to study the clinical utility of this assay Gaucher and Niemann Pick A/B diseases in the backdrop of chitotriosidase deficiency in our population. The study comprises 173 patients with clinical suspicion of either Gaucher disease (n=108) or Niemann Pick A/B (n=65) and 92 healthy controls. The plasma samples of controls, Gaucher disease, and Niemann Pick A/B showed chitotriosidase deficiency of 12%, 25% and 27% respectively. The degree of elevation of chitotriosidase in Gaucher disease and Niemann Pick A/B patients is 40-326 (11,325.7±6395.4nmol/h/ml) and 7-22 folds (1192.5±463.0nmol/h/ml) respectively. In view of these findings of distinguishable fold elevation of chitotriosidase in Gaucher disease or Niemann Pick A/B, it can be a potential surrogate differential diagnostic marker for these groups of diseases, except in the patients in whom this enzyme is deficient.

  12. A retrospective, multi-center cohort study evaluating the severity- related effects of cerebrolysin treatment on clinical outcomes in traumatic brain injury.

    Science.gov (United States)

    Muresanu, Dafin F; Ciurea, Alexandru V; Gorgan, Radu M; Gheorghita, Eva; Florian, Stefan I; Stan, Horatiu; Blaga, Alin; Ianovici, Nicolai; Iencean, Stefan M; Turliuc, Dana; Davidescu, Horia B; Mihalache, Cornel; Brehar, Felix M; Mihaescu, Anca S; Mardare, Dinu C; Anghelescu, Aurelian; Chiparus, Carmen; Lapadat, Magdalena; Pruna, Viorel; Mohan, Dumitru; Costea, Constantin; Costea, Daniel; Palade, Claudiu; Bucur, Narcisa; Figueroa, Jesus; Alvarez, Anton

    2015-01-01

    Traumatic brain injury (TBI) is a leading cause of death and disability for which there is currently no effective drug therapy available. Because drugs targeting a single TBI pathological pathway have failed to show clinical efficacy to date, pleiotropic agents with effects on multiple mechanisms of secondary brain damage could represent an effective option to improve brain recovery and clinical outcome in TBI patients. In this multicenter retrospective study, we investigated severity-related efficacy and safety of the add-on therapy with two concentrations (20 ml/day or 30 ml/day) of Cerebrolysin (EVER Neuro Pharma, Austria) in TBI patients. Adjunctive treatment with Cerrebrolysin started within 48 hours after TBI and clinical outcomes were ranked according to the Glasgow Outcome Scale and the Modified Rankin Disability Score at 10 and 30 days post-TBI. Analyses of efficacy were performed separately for subgroups of patients with mild, moderate or severe TBI according to Glasgow Coma Scale scores at admission. Compared to standard medical care alone (control group), both doses of Cerebrolysin were associated with improved clinical outcome scores at 10 days post-TBI in mild patients and at 10 and 30 days in moderate and severe cases. A dose-dependent effect of Cerebrolysin on TBI recovery was supported by the dose-related differences and the significant correlations with treatment duration observed for outcome measures. The safety and tolerability of Cerebrolysin in TBI patients was very good. In conclusion, the results of this large retrospective study revealed that early Cerebrolysin treatment is safe and is associated to improved TBI outcome.

  13. Surgical treatment for septic arthritis of the knee joint in elderly patients: a 10-year retrospective clinical study.

    Science.gov (United States)

    Chen, Chao-Ming; Lin, Hsi-Hsien; Hung, Shih-Chieh; Huang, Tung-Fu; Chen, Wei-Ming; Liu, Chien-Lin; Chen, Tain-Hsiung

    2013-04-01

    Septic arthritis is the most rapidly destructive joint disease, but its early diagnosis remains challenging; delayed or inadequate treatment, even by expert physicians, can lead to irreversible joint destruction. Between 25% and 50% of patients develop irreversible loss of joint function, which is especially concerning in elderly patients. To understand the factors influencing the outcome of septic arthritis, the authors reviewed patients aged older than 50 years who had undergone debridement surgery for primary septic arthritis at their institution between 1998 and 2008. Ninety-two patients (92 knees) were enrolled in the study; 14 did not meet inclusion criteria and were excluded from the final analysis. Of the 78 included patients, 7 underwent arthrodesis, 22 underwent total knee arthroplasty, 19 were indicated for total knee arthroplasty for severe knee joint osteoarthritis but did not undergo surgery by the end of this study, and the remaining 30 had no or mild symptoms of osteoarthrosis and did not receive any surgical procedure. Staphylococcus aureus was the most common pathogenic agent (38%), followed by mixed bacterial infection (10%). Several factors negatively influenced the final clinical outcome, including delayed treatment, advanced macroscopic staging made during debridement surgery, performing multiple debridement surgeries, and a larger Lysholm score difference pre- and posttreatment. More antibiotics administered, longer duration of antibiotic treatment, and more pathogenic agents present were also significantly correlated with poor outcome. These findings shed new light on the management of septic arthritis. Accurate diagnoses and effective treatments are important for the clinical outcome of knee joint bacterial infection in elderly patients.

  14. Clinical and Etiological Characteristics of Atypical Hand-Foot-and-Mouth Disease in Children from Chongqing, China: A Retrospective Study

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    Xiang Yan

    2015-01-01

    Full Text Available Background. Hand-foot-and-mouth disease (HFMD is a disease that had similar manifestations to chickenpox, impetigo, and measles, which is easy to misdiagnose and subsequently causes delayed therapy and subsequent epidemic. To date, no study has been conducted to report the clinical and epidemiological characteristics of atypical HFMD. Methods. 64 children with atypical HFMD out of 887 HFMD children were recruited, stool was collected, and viral VP1 was detected. Results. The atypical HFMD accounted for 7.2% of total HFMD in the same period (64/887 and there were two peaks in its prevalence in nonepidemic seasons. Ten children (15.6% had manifestations of neurologic involvement, of whom 4 (6.3% were diagnosed with severe HFMD and 1 with critically severe HFMD, but all recovered smoothly. Onychomadesis and desquamation were found in 14 patients (21.9% and 15 patients (23.4%, respectively. The most common pathogen was coxsackievirus A6 (CV-A6 which accounted for 67.2%, followed by nontypable enterovirus (26.6%, enterovirus 71 (EV-A71 (4.7%, and coxsackievirus A16 (A16 (1.5%. Conclusions. Atypical HFMD has seasonal prevalence. The manifestations of neurologic involvement in atypical HFMD are mild and usually have a good prognosis. CV-A6 is a major pathogen causing atypical HFMD, but not a major pathogen in Chongqing, China.

  15. Mathematical evaluation of the influence of multiple factors on implant stability quotient values in clinical practice: a retrospective study

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    Huang H

    2016-10-01

    Full Text Available Hairong Huang,1 Daniel Wismeijer,1 Xianhong Shao,2 Gang Wu1 1Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA, MOVE Research Institute, VU University Amsterdam and University of Amsterdam, Amsterdam, Nord-Holland, the Netherlands; 2Best & Easy Dental Clinic, Hangzhou, Zhejiang Province, People’s Republic of China Objectives: The objective of this study is to mathematically evaluate the influence of multiple factors on implant stability quotient values in clinical practice.Patients and methods: Resonance frequency analysis was performed at T1 (measured immediately at the time of implant placement and at T2 (measured before dental restoration in 177 patients (329 implants. Using a multivariate linear regression model, we analyzed the influence of the following eleven candidate factors: sex, age, maxillary/mandibular location, bone type, immediate/delayed implantation, bone grafting (presence or absence, insertion torque, I-/II-stage healing pattern, implant diameter, implant length, and T1–T2 time interval.Results: The following factors were identified to significantly influence the implant stability quotient (ISQ values at T1: insertion torque, bone grafting, I-/II-stage healing pattern, immediate/delayed implantation, maxillary/mandibular location, implant diameter, and sex. In contrast, the ISQ values at T2 were significantly influenced only by three factors: implant diameter, T1–T2 time interval, and insertion torque.Conclusion: Among the eleven candidate factors, seven key factors were found to influence the T1-ISQ values, while only three key factors influenced the T2-ISQ values. Both T1 and T2-ISQ values were found to be influenced by implant diameter and insertion torque. T1 was influenced specifically by the sex of the patient, the location (maxillary or mandibular, the implantation mode (immediate/delayed implantation, the healing stage, and the absence or presence of bone

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

    Science.gov (United States)

    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.

  17. A 5 year retrospective study of biopsied jaw lesions with the assessment of concordance between clinical and histopathological diagnoses

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    Elif Peker

    2016-01-01

    Full Text Available Introduction: The jaw can be affected by several lesions that manifest in the oral cavity, but little is known about their distribution patterns in various populations. Aims and Objectives: This study presents the frequency and distribution of biopsied jaw lesions recorded in Faculty of Dentistry and gathers the information including provisional and final diagnosis of the lesions. Material and Methods: Biopsy of 1938 lesions (2008-2013 was reviewed and 1473 lesions were included in this study. The provisional diagnosis and histopathological validations of lesions were compared. Data on the location of the lesion, as well as patient demographics, were also evaluated. The lesions were divided into three major groups as 1 - developmental/reactive and inflammatory lesions of the jaw, 2 - cystic lesion and 3 - tumor and tumor-like lesions. Statistical Analysis: The variables were recorded and analysed using descriptive statistics. Results and Observations: Three hundred and ninety-six lesions were in Group 1 and periapical granuloma was the most frequent diagnosis. Seven hundred and eighty-nine lesions were in Group 2 and the radicular cyst was the most frequent diagnosis. Two hundred and eighty-eight lesions were in Group 3 and the keratocystic odontogenic tumor was the most frequent. Two hundred and ninety-one biopsied lesions were in disagreement with respect to the diagnoses on clinical and histopathological examination. Conclusion: Consequently, a provisional diagnosis of some of the malignant lesions was reactive, inflammatory, cystic or benign lesions, therefore the importance of evaluation of the specimen is emphasized.

  18. Clinical Effectiveness of Board-certificated Physiatrists on Functional Recovery in Elderly Stroke Patients During Convalescence: A Retrospective Cohort Study

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    Ryo Momosaki

    2017-03-01

    Conclusions: Our results suggest that clinical management provided to elderly stroke patients by board-certificated physiatrists is associated with good functional improvement. Board certification should be encouraged to improve the quality of rehabilitative management of post-stroke patients.

  19. Clinical profiles of patients colonized or infected with extended-spectrum beta-lactamase producing Enterobacteriaceae isolates: a 20 month retrospective study at a Belgian University Hospital

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    Jamart Jacques

    2011-01-01

    Interval 95%: 7-19. Escherichia coli, by far, accounted as the most common ESBL-producing Enterobacteriaceae species (77/114; [68%] while CTX-M-1 group was by far the most prevalent ESBL enzyme (n = 56. Conclusion In this retrospective study, the clinical profiles of patients carrying healthcare-associated ESBL-producing Enterobacteriacae is characterized by a high prevalence rate of several major co-morbidities and potential known risk factors. Both, the length of hospital stay and overall hospital mortality rates were particularly high. A prospective case-control matched study should be designed and performed in order to control for possible inclusion bias.

  20. Mathematical evaluation of the influence of multiple factors on implant stability quotient values in clinical practice: a retrospective study

    Science.gov (United States)

    Huang, Hairong; Wismeijer, Daniel; Shao, Xianhong; Wu, Gang

    2016-01-01

    Objectives The objective of this study is to mathematically evaluate the influence of multiple factors on implant stability quotient values in clinical practice. Patients and methods Resonance frequency analysis was performed at T1 (measured immediately at the time of implant placement) and at T2 (measured before dental restoration) in 177 patients (329 implants). Using a multivariate linear regression model, we analyzed the influence of the following eleven candidate factors: sex, age, maxillary/mandibular location, bone type, immediate/delayed implantation, bone grafting (presence or absence), insertion torque, I-/II-stage healing pattern, implant diameter, implant length, and T1–T2 time interval. Results The following factors were identified to significantly influence the implant stability quotient (ISQ) values at T1: insertion torque, bone grafting, I-/II-stage healing pattern, immediate/delayed implantation, maxillary/mandibular location, implant diameter, and sex. In contrast, the ISQ values at T2 were significantly influenced only by three factors: implant diameter, T1–T2 time interval, and insertion torque. Conclusion Among the eleven candidate factors, seven key factors were found to influence the T1-ISQ values, while only three key factors influenced the T2-ISQ values. Both T1 and T2-ISQ values were found to be influenced by implant diameter and insertion torque. T1 was influenced specifically by the sex of the patient, the location (maxillary or mandibular), the implantation mode (immediate/delayed implantation), the healing stage, and the absence or presence of bone graft materials. PMID:27785040

  1. Early permanent disappearance of abnormal muscle response during microvascular decompression for hemifacial spasm: a retrospective clinical study.

    Science.gov (United States)

    Jiang, Chengrong; Xu, Wu; Dai, Yuxiang; Lu, Tianyu; Jin, Wei; Liang, Weibang

    2016-12-15

    The objective of this study is to explore the cause of early abnormal muscle response (AMR) disappearance during microvascular decompression for hemifacial spasm and the clinical outcomes of these patients. Three hundred seventy-two patients received microvascular decompression (MVD) under intraoperative electrophysiological monitoring in Nanjing Drum Tower Hospital in 2014; the characteristic AMR of HFS was observed in 359 patients during the operation. And the 359 patients were divided into two groups based on whether AMR had remained before the beginning of the decompression procedure for offending vessels. Thirty-three patients who showed a permanent disappearance of AMR before the beginning of decompression were regarded as group I. Dural opening and the succeeding CSF drainage produced a permanent disappearance of AMR in 13. During the dissection of lateral cerebellomedullary cistern, a permanent disappearance of AMR was found in 20 patients. Thirty-two patients were cured immediately; delayed resolution (7 days after surgery) was found in one patient. No complications were observed and no recurrence was found during the follow-up period in the 33 patients. In the other 326 patients (group II), AMR disappeared temporarily before the beginning of the decompression procedure for offending vessels in 42 patients. After decompression, AMR disappeared completely in 305 patients. Two hundred sixty-seven patients were cured immediately and 57 patients got a delayed resolution (2 days to 45 weeks after surgery). The two left did not get a complete abolition of spasm. Three cases of hearing loss, one hoarseness, and nine delayed facial paralysis were observed. The reason of early abnormal muscle response disappearance may be that the degree of neurovascular compression was not serious; these patients were more likely to get an immediate cure. Continuous intraoperative electrophysiological monitoring of AMR is necessary.

  2. [Surgical intervention in severe acute pancreatitis--retrospective study of 79 patients of the RWTH Aachen Surgical Clinic].

    Science.gov (United States)

    Lohmann, A; Kasperk, R; Schumpelick, V

    1998-01-01

    This is a report on the surgical intervention in 79 patients with acute pancreatitis, who were operated in the Department of Surgery of the University Clinic RWTH Aachen in the period from 1986 to 1993. The main objective was the stratification of pancreatitis according to the Ranson-Score, the analysis of the surgical treatment and the timing of operation depending on the clinical condition. The average Ranson-score was 3.3 (median 3). 56 patients had necroses, which were removed because of the deteriorating clinical condition. In these cases the average Ranson-score was 4.2 (median 4). Seven patients (8.9% of the total number and 12.5% of the patients with necroses of the pancreas) died. This small number is the result of a severity-adapted management in a modern intensive care-unit and the good cooperation with the Department of Internal Medicine.

  3. Retrospective study of the occurrence of Cyclospora cayetanensis at Clinical Hospital of the University of São Paulo Medical School, SP

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    Gonçalves Elenice Messias do Nascimento

    2005-01-01

    Full Text Available Cyclospora cayetanensis causes watery diarrhea in tropical countries, among travelers and after ingestion of contaminated water and food. Very little is known about its epidemiology, pathogenic aspects and reservoirs. In Brazil, its prevalence is unknown and to date there have been reports of three outbreaks. We report here a retrospective study of 5,015 stool samples from 4,869 patients attended at Clinical Hospital of the University of São Paulo Medical School, SP, Brazil between April 1996 and January 2002, with 14 cases of Cyclospora cayetanensis being detected there was a prevalence of 0.3%. Of the 14 infected patients, the mean age was 38 years and 71.4% were female. Ten patients presented symptoms; six presented levels of immunological markers and five patients were immunodeficient.

  4. Does Clinical Staging and Histological Grading Show Parallelism In Oral Submucous Fibrosis? A Retrospective Study from an Indian City

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    Manish Narayan

    2014-06-01

    Conclusions: There was no correlation between clinical staging and histopathological grading of oral submucous fibrosis. The test results were statistically not significant. (p=0.635 This may be due to difference in severity and extent of fibrosis in different parts of the oral mucosa. [J Interdiscipl Histopathol 2014; 2(3.000: 145-149

  5. Mental Health Services in a Rural Clinic: A Retrospective Study of Length of Stay and Premature Termination in Psychotheraphy.

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    Scogin, Forrest; And Others

    1986-01-01

    Examines relationship of client and therapist characteristics to length of stay and premature treatment termination in 595 psychotherapy cases at a rural Arizona community health clinic. Finds results similar to those obtained in urban settings: small number of psychotherapy sessions attended and tendency to premature termination unrelated to…

  6. The comparison of grey-scale ultrasonic and clinical features of hepatoblastoma and hepatocellular carcinoma in children: a retrospective study for ten years

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    Luo Yan

    2011-06-01

    Full Text Available Abstract Background Hepatoblastoma (HBL and hepatocellular carcinoma (HCC are respectively the first and the second most common pediatric malignant liver tumors. The purpose of this study was to evaluate the combined use of the ultrasound examination and the assessment of the patients' clinical features for differentiating HBL from HCC in children. Methods Thirty cases of the confirmed HBL and 12 cases of the confirmed HCC in children under the age of 15 years were enrolled into our study. They were divided into the HBL group and the HCC group according to the histological types of the tumors. The ultrasonic features and the clinical manifestations of the two groups were retrospectively analyzed, with an emphasis on the following parameters: onset age, gender (male/female ratio, positive epatitis-B-surface-antigen (HBV, alpha-fetoprotein increase, and echo features including septa, calcification and liquefaction within the tumors. Results Compared with the children with HCC, the children with HBL had a significantly younger onset age (8.2 years vs. 3.9 years, P Conclusion Ultrasonic features combined with clinical manifestations are valuable for differentiating HBL from HCC in children.

  7. Direct anterior composite veneers in vital and non-vital teeth: A retrospective clinical evaluation

    NARCIS (Netherlands)

    Coelho-de-Souza, F.H.; Goncalves, D.S.; Sales, M.P.; Erhardt, M.C.; Correa, M.B.; Opdam, N.J.M.; Demarco, F.F.

    2015-01-01

    OBJECTIVES: This retrospective, longitudinal clinical study investigated the performance of direct veneers using different composites (microfilledxuniversal) in vital or non-vital anterior teeth. METHODS: Records from 86 patients were retrieved from a Dental School clinic, comprising 196 direct vene

  8. Clinical and Pathological Features of Pheochromocytoma in the Horse: A Multi-Center Retrospective Study of 37 Cases (2007-2014).

    Science.gov (United States)

    Luethy, D; Habecker, P; Murphy, B; Nolen-Walston, R

    2016-01-01

    Pheochromocytoma is the most common adrenal medullary neoplasm of domestic animals, but it is rare in horses. Antemortem diagnosis in horses is difficult, with clinical signs often being vague or non-specific. The objective of this study was to describe the clinical, laboratory, and pathologic findings of pheochromocytoma in horses. Thirty-seven horses diagnosed with pheochromocytoma based on postmortem examination from 2007 to 2014. Retrospective case series. Pheochromocytoma was identified in 37/4094 horses during postmortem examination. Clinical signs consistent with pheochromocytoma had been observed antemortem in only 7 cases, with the remainder being incidental findings. Colic was the most common presenting complaint (13 of 37 cases) and tachycardia was noted in 95% of cases (median heart rate of 86 bpm in clinical cases). Hyperlactatemia (median, 4.9 mmol/L) and hyperglycemia (median, 184 mg/dL) were the most common clinicopathologic abnormalities. Hemoperitoneum caused by rupture of pheochromocytoma was noted in 4/7 clinical cases. Concurrent endocrine abnormalities (eg, thyroid adenoma, adrenal hyperplasia, pituitary pars intermedia hyperplasia or adenoma, parathyroid C-cell carcinoma) were found in 27/37 horses, with 8/37 horses having lesions consistent with multiple endocrine neoplasia syndrome as described in humans. Pheochromocytoma was diagnosed in 0.95% of horses presented for necropsy. The majority of these were incidental findings, but pheochromocytoma was thought to contribute to clinical findings in 19% of cases, and multiple endocrine neoplasms were commonly seen. Usually an incidental finding at necropsy, pheochromocytoma may cause acute death from intraperitoneal exsanguination and should be considered in horses presenting with colic, tachycardia, and hemoperitoneum. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  9. Influence of the bacterial phenotypes on the clinical manifestations in Klebsiella pneumoniae bacteremia patients: A retrospective cohort study.

    Science.gov (United States)

    Togawa, Atsushi; Toh, Hiromi; Onozawa, Kyoko; Yoshimura, Michinobu; Tokushige, Chiemi; Shimono, Nobuyuki; Takata, Tohru; Tamura, Kazuo

    2015-07-01

    Ninety-four episodes of Klebsiella pneumoniae bloodstream infection were identified at a university hospital in Japan. After excluding extended-spectrum beta lactamase-producing strains, 83 blood isolates from these patients were assayed in terms of their bacterial phenotypes such as the mucoid and hypermucoviscosity phenotypes. Bacterial phenotypes were correlated with the patients' clinical manifestations. The hypermucoviscosity phenotype was significantly associated with septic shock at the onset of infections (odds ratio, 15.92; 95% confidence interval, 1.27-468.12), but was not associated with liver abscess formation. Mortality was determined by the presence of septic shock. RmpA gene was associated with the induction of the hypermucoviscosity phenotype. These results reveal unique roles of bacterial phenotypes on the patient's clinical condition in K. pneumoniae bacteremia.

  10. VENOUS AIR-EMBOLISM, PRESERVATION REPERFUSION INJURY, AND THE PRESENCE OF INTRAVASCULAR AIR COLLECTIONS IN HUMAN DONOR LIVERS - A RETROSPECTIVE CLINICAL-STUDY

    NARCIS (Netherlands)

    WOLF, RFE; SLUITER, WJ; BALLAST, A; VANDAM, RM; SLOOFF, MJH

    In human liver transplantation, air embolism is seldom encountered after graft reperfusion. Nevertheless, despite adequate flushing and clamping routines, air emboli have been reported in transesophageal echocardiography (TEE) studies performed during the reperfusion phase, We retrospectively

  11. VENOUS AIR-EMBOLISM, PRESERVATION REPERFUSION INJURY, AND THE PRESENCE OF INTRAVASCULAR AIR COLLECTIONS IN HUMAN DONOR LIVERS - A RETROSPECTIVE CLINICAL-STUDY

    NARCIS (Netherlands)

    WOLF, RFE; SLUITER, WJ; BALLAST, A; VANDAM, RM; SLOOFF, MJH

    1995-01-01

    In human liver transplantation, air embolism is seldom encountered after graft reperfusion. Nevertheless, despite adequate flushing and clamping routines, air emboli have been reported in transesophageal echocardiography (TEE) studies performed during the reperfusion phase, We retrospectively invest

  12. A retrospective clinical and epidemiological study on feline coronavirus (FCoV) in cats in Istanbul, Turkey.

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    Tekelioglu, B K; Berriatua, E; Turan, N; Helps, C R; Kocak, M; Yilmaz, H

    2015-04-01

    The presence of antibodies to feline coronavirus (FCoV) and feline immunodeficiency virus (FIV), together with feline leukemia virus (FeLV) antigen was investigated in 169 ill household and stray cats attending a veterinary surgery in Istanbul in 2009-14. The estimated FCoV and FIV seroprevalence (95% confidence intervals) were 37% (30-45%) and 11% (6-16%), respectively and FeLV prevalence was 1% (0-3%). FCoV seroprevalence increased until 2 years of age, was highest in 2014 and among household cats living with other cats and with outdoor access, and was lower in FIV seropositive compared to seronegative cats. Symptoms typically associated with wet feline infectious peritonitis (FIP) including ascites, abdominal distention or pleural effusion, coupled in many cases with non-antibiotic responsive fever, were observed in 19% (32/169) of cats, and 75% (24/32) of these cats were FCoV seropositive. FCoV seropositivity was also associated with a high white blood cell count, high plasma globulin, low plasma albumin and low blood urea nitrogen. The percentage of FCoV seropositive and seronegative cats that died in spite of supportive veterinary treatment was 33% (21/63) and 12% (13/106), respectively. These results indicate that FCoV is widespread and has a severe clinical impact in cats from Istanbul. Moreover, the incidence of FCoV infections could be rising, and in the absence of effective vaccination cat owners need to be made aware of ways to minimize the spread of this virus.

  13. The clinical characteristics and direct medical cost of influenza in hospitalized children: a five-year retrospective study in Suzhou, China.

    Directory of Open Access Journals (Sweden)

    Tao Zhang

    Full Text Available BACKGROUND: There have been few studies on children hospitalized with influenza published from mainland China. We performed a retrospective review of medical charts to describe the epidemiology, clinical features and direct medical cost of laboratory-proven influenza hospitalized children in Suzhou, China. METHODS: Retrospective study on children with documented influenza infection hospitalized at Suzhou Children Hospital during 2005-2009 was conducted using a structured chart review instrument. RESULTS: A total of 480 children were positive by immuno-fluorescent assay for influenza during 2005-2009. The hospitalizations for influenza occurred in 8-12 months of the year, most commonly in the winter with a second late summer peak (August-September. Influenza A accounted for 86.3%, and of these 286 (59.6% were male, and 87.2% were 60 months old had shorter hospital stay (OR = 0.45; children with oxygen treatment tended to have longer hospital stays than those without oxygen treatment (OR = 2.14. The mean cost of each influenza-related hospitalization was US$ 624 (US$ 1323 for children referred to ICU and US$ 617 for those cared for on the wards. High risk children had higher total cost than low-risk patients. CONCLUSION: Compared to other countries, in Suzhou, children hospitalized with influenza have longer hospital stay and higher percentage of pneumonia. The direct medical cost is high relative to family income. Effective strategies of influenza immunization of young children in China may be beneficial in addressing this disease burden.

  14. Association of heart rate variability with clinical outcome in Parkinsonian patients after subthalamic deep brain stimulation: A retrospective cohort study

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    Shin-Yuan Chen

    2011-09-01

    Conclusion: Our study showed an improvement in autonomic cardiovascular regulation in Parkinsonian patients with >50% improvement in rating scale after STN-DBS, which implied morbidity reduction in nonmotor symptoms among such patients.

  15. Clinical Analysis of Parotid Tumors in Patients Over 60-year-old: A Retrospective Study of 78 Cases

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    Dong Hoon Lee

    2017-06-01

    Conclusions: Warthin tumor was the most common benign tumor, and salivary duct carcinoma was the most frequent malignant tumor in this study. Surgical treatment is the mainstay treatment for benign and malignant parotid tumors.

  16. The utilisation and diagnostic yield of radiological imaging in a specialist functional GI disorder clinic: an 11-year retrospective study.

    LENUS (Irish Health Repository)

    Breen, Micheal

    2014-07-25

    The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs.

  17. A retrospective study of 100 cases of ectopic pregnancy: clinical presentation, site of ectopic and diagnosis evaluation

    Directory of Open Access Journals (Sweden)

    Manthan Patel

    2016-12-01

    Conclusions: Ampullary part of the fallopian tube is the most common site of ectopic pregnancy observed during our study. Complex adnexal mass was the most common finding on ultrasound. Surgical management by laparotomy and salpingectomy continues to be the preferred mode of management of ectopic pregnancy in our institution. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4313-4316

  18. Lenalidomide monotherapy in heavily pretreated patients with non-Hodgkin lymphoma: an Italian observational multicenter retrospective study in daily clinical practice.

    Science.gov (United States)

    Zinzani, Pier Luigi; Rigacci, Luigi; Cox, Maria Cristina; Devizzi, Liliana; Fabbri, Alberto; Zaccaria, Alfonso; Zaja, Francesco; Di Rocco, Alice; Rossi, Giuseppe; Storti, Sergio; Fattori, Pier Paolo; Argnani, Lisa; Tura, Sante; Vitolo, Umberto

    2015-06-01

    Clinical trial results indicate that lenalidomide, an immunomodulatory drug, is a promising treatment in relapsed/refractory non-Hodgkin lymphoma (NHL). This retrospective multicenter study was conducted in patients with relapsed/refractory NHL treated with lenalidomide monotherapy through a Named Patient Program in Italy. Principal endpoints were overall response rate (ORR), safety and overall survival (OS). The ORR in 64 evaluable patients was 42.2% and was similar among patients receiving 10, 15 or 25 mg/day lenalidomide. Response rates in patients with mantle cell, diffuse large B-cell and follicular lymphoma were 45.5%, 42.1% and 20%, respectively. Among patients who responded to most recent prior therapy, ORR was 50.0% versus 36.8% in patients with refractory NHL. Mean duration of response in patients receiving any lenalidomide dose was 10.5 months; 1-year progression-free survival and OS were 50.3% and 82.6%, respectively. These findings suggest that lenalidomide is effective and safe for heavily pretreated patients with NHL in the clinical setting.

  19. Alvarado score: A valuable clinical tool for diagnosis of acute appendicitis –a retros-pective study

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    Swagata Brahmachari1 and Ashwini B. Jajee2

    2013-08-01

    Full Text Available Appendicitis is a common surgical emergency and diagnosis is still a great challenge. Accurate diagnosis and timely intervention re-duces morbidity and mortality. The present study was conducted to evaluate Alvarado scoring system for diagnosis of acute appen-dicitis in Indian set up. The study was carried out on 200 patients admitted in Surgery ward between January 2009 and December 2010 with right lower quadrant abdominal pain. Alvarado score was calculated and all patients were divided in three groups. Mean age of presentation was 29.12 years and male to female ratio was 1.27:1. Higher the Alvarado score, more is the sensitivity. So pa-tients having score 7 or above had sensitivity of 66%. We con-clude that Alvarado score is unique since it incorporates signs, symptoms and laboratory findings of suspicious patients. Alvarado score can be utilized safely for diagnosis of acute appendicitis.

  20. Influence of HIV infection on the clinical presentation and outcome of adults with acute community-acquired pneumonia in Yaounde, Cameroon: a retrospective hospital-based study

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    Yone Eric Walter

    2012-08-01

    Full Text Available Abstract Background The impact of HIV infection on the evolution of acute community-acquired pneumonia (CAP is still controversial. The aim of this study was to investigate possible differences in the clinical presentation and in-hospital outcomes of patients with CAP with and without HIV infection in a specialised service in Yaounde. Methods Medical files of 106 patients (51 men aged 15 years and above, admitted to the Pneumology service of the Yaounde Jamot Hospital between January 2008 and May 2012, were retrospectively studied. Results Sixty-two (58.5% patients were HIV infected. The median age of all patients was 40 years (interquartile range: 31.75-53 and there was no difference in the clinical and radiological profile of patients with and without HIV infection. The median leukocyte count (interquartile range was 14,600/mm3 (10,900-20,600 and 10,450/mm3 (6,400-16,850 respectively in HIV negative and HIV positive patients (p = 0.002. Median haemoglobin level (interquartile range was 10.8 g/dl (8.9-12 in HIV negative and 9.7 g/dl (8–11.6 in HIV positive patients (p = 0.025. In-hospital treatment failure on third day (39.5% vs. 25.5.1%, p = 0.137 and mortality rates (9% vs. 14.5%, p = 0.401 were similar between HIV negative and HIV positive patients. Conclusion Clinical and radiological features as well as response to treatment and in hospital fatal outcomes are similar in adult patients hospitalised with acute community-acquired pneumonia in Yaounde. In contrast, HIV infected patients tend to be more anaemic and have lower white cell counts than HIV negative patients. Larger prospective studies are needed to consolidate these findings.

  1. Comparison of Existing Clinical Scoring Systems in Predicting Severity and Prognoses of Hyperlipidemic Acute Pancreatitis in Chinese Patients: A Retrospective Study.

    Science.gov (United States)

    Qiu, Lei; Sun, Rui Qing; Jia, Rong Rong; Ma, Xiu Ying; Cheng, Li; Tang, Mao Chun; Zhao, Yan

    2015-06-01

    It is important to identify the severity of acute pancreatitis (AP) in the early course of the disease. Clinical scoring systems may be helpful to predict the prognosis of patients with early AP; however, few analysts have forecast the accuracy of scoring systems for the prognosis in hyperlipidemic acute pancreatitis (HLAP). The purpose of this study was to summarize the clinical characteristics of HLAP and compare the accuracy of conventional scoring systems in predicting the prognosis of HLAP. This study retrospectively analyzed all consecutively diagnosed AP patients between September 2008 and March 2014. We compared the clinical characteristics between HLAP and nonhyperlipidemic acute pancreatitis. The bedside index for severity of acute pancreatitis (BISAP), Ranson, computed tomography severity index (CTSI), and systemic inflammatory response syndrome (SIRS) scores were applied within 48 hours following admission. Of 909 AP patients, 129 (14.2%) had HLAP, 20 were classified as severe acute pancreatitis (SAP), 8 had pseudocysts, 9 had pancreatic necrosis, 30 had pleural effusions, 33 had SIRS, 14 had persistent organ failure, and there was 1 death. Among the HLAP patients, the area under curves for BISAP, Ranson, SIRS, and CTSI in predicting SAP were 0.905, 0.938, 0.812, and 0.834, 0.874, 0.726, 0.668, and 0.848 for local complications, and 0.904, 0.917, 0.758, and 0.849 for organ failure, respectively. HLAP patients were characterized by younger age at onset, higher recurrence rate, and being more prone to pancreatic necrosis, organ failure, and SAP. BISAP, Ranson, SIRS, and CTSI all have accuracy in predicting the prognosis of HLAP patients, but each has different strengths and weaknesses.

  2. Intraspinal synovial cysts: A retrospective study

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    Acharya R

    2006-01-01

    Full Text Available Background: We report the clinical presentation, radiographic studies, intraoperative findings, histopathological analysis, and post-treatment outcome in 26 patients diagnosed with spinal synovial cysts (SSCs. Aims: To describe the clinical presentation, radiographic studies, operative findings, and postoperative follow-up in 26 patients with SSCs. Settings and Design: The study was retrospective in design, involving chart review. Individual patient data was tabulated and patterns were recognized. Materials and Methods: The charts for 26 patients who underwent surgical extirpation of SSC between April 1993 and October 2002 were retrospectively reviewed. Specifically, initial clinical presentation, pertinent radiographs (X-rays, magnetic resonance imaging, computed tomography, intraoperative findings, histopathology, and postoperative follow-up were noted. Statistical Analysis Used: Patient data was tabulated and analyzed for patterns in demographics, symptoms and histopathology. Results: SSCs were more common in females than males (17:9 ratio. Presenting symptoms were back pain with radiculopathy in 13 (50%, radicular pain in the absence of back pain in 10 (38%, and back pain without radicular pain in three (11%. In addition, 17 patients (65% had sensory deficit, and 9 (35% had motor deficit. Most SSCs occurred at the lumbar (19/26 or lumbosacral (5/26 regions, with only 2 (2/26 in the thoracic region. One patient had bilateral SSC at the L4-5 level. Intraoperatively, each cyst was located adjacent to a degenerated facet joint. These lesions could grossly be identified intraoperatively and histopathological confirmation was achieved in all the cases. Conclusions: SSCs are important lesions to consider in the differential diagnosis of lumbar epidural masses and surgical resection leads to significant improvement in the majority of cases.

  3. Odontoma: a retrospective study of 73 cases

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    An, Seo Young; An, Chang Hyeon; Choi, Karp Shik [School of Dentistry, Kyungpook National University, Daegu (Korea, Republic of)

    2012-06-15

    The purpose of the present study was to retrospectively evaluate the clinical findings and treatment results for impacted permanent teeth associated with odontomas. We retrospectively investigated 73 odontomas in 72 patients who visited Kyungpook National University Dental Hospital from April 2004 through November 2011. The study was performed using medical records, panoramic radiographs, and pathological reports. Data gathered included age, gender, location, chief complaints, effects on dentition, and treatment of odontoma and the impacted tooth associated with odontoma. Most compound odontomas (46.7%) were found in the second decade and complex odontomas were not related to age. Odontomas showed no gender predilection. Fifty-five cases (75.3%) of odontomas were detected on routine dental radiographs. Sixty percent of compound odontomas occurred in the canine area and 57.1% of complex odontomas in the molar areas. Impaction of permanent teeth (61.6%) was the most common complication on the adjacent teeth. Most odontomas (84.9%) were removed surgically and impacted permanent teeth were managed by surgical removal (53.2%), orthodontic treatment (25.5%), or surgical repositioning (6.4%). There was a statistically significant relation between age and preservation of the impacted permanent teeth associated with odontomas (p<0.01). Early detection and treatment of odontomas increase the possibility of preservation of the impacted tooth. Therefore, it would be suggested that periodic panoramic examination during the first and second decade of life might be beneficial for the early detection and better prognosis of odontomas.

  4. A HOSPITAL-BASED RETROSPECTIVE COMPARATIVE STUDY OF COMPLICATIONS, OUTCOMES, CLINICAL AND LABORATORY PARAMETERS OF MALARIA WITH AND WITHOUT NEUROLOGICAL INVOLVEMENT

    Directory of Open Access Journals (Sweden)

    Sohaib Ahmad

    2017-01-01

    Full Text Available Background & Objectives: Classically associated with Plasmodium falciparum, neurological complications in severe malaria is associated with increased morbidity and mortality. However, reports implicate the long considered benign Plasmodium vivax for causing severe malaria as well. We aimed to analyze the cerebral complications in malaria, and study if there is a specie-related difference in the presentation and outcomes. Methods: We retrospectively compared patients of malaria hospitalised from 2009-15, with (n=105 and without (n=1155 neurological involvement in terms of outcomes, complications, demographic attributes, clinical features, and laboratory parameters. Subsequently, the same parameters were studied in those with cerebral malaria due to mono-infections of vivax or falciparum and their co-infection. Results: Cerebral malaria was observed in 8.3% (58/696, 7.4% (38/513 and 17.6% (6/51 of vivax, falciparum and combined plasmodial infections respectively. Those with cerebral malaria had significantly (p0.05. P. vivax emerged as the predominant cause of cerebral malaria and its virulence was comparable to P. falciparum.

  5. Analysis of Prevalence and Clinical Features of Ameloblastoma and its Histopathological Subtypes in Southeast Myanmar and Lower Northern Thailand Populations: A 13-Year Retrospective Study

    Science.gov (United States)

    2017-01-01

    Introduction Prevalence of ameloblastomas has been established worldwide but collective data of ameloblastoma in Southeast Asian countries has not been well analyzed. Aim Aim of this study was to report analysis and comparison of the prevalence and demographic data of clinical features of ameloblastoma and its histopathological variants in Southeast Myanmar and lower Northern Thailand populations. Materials and Methods A retrospective study on ameloblastoma was performed based on the availability of oral biopsy specimens in Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand, between January 2002 and August 2015. The collected data were subjected to descriptive statistical analyses with the SPSS version 17.0 statistical software package (SPSS Inc., Chicago, USA). Pearson’s chi square (χ2) test and t-test were employed. The critical level of significance was set at pameloblastoma with male:female ratio of 1.14:1. The mean age of the patients was 31.3±15.6 years. The predominance anatomical distribution was observed in the mandible (86.7%). Posterior body-ramus-angle region was the most common site. Almost all cases were asyptomatic and most common clinical manifestation was swelling of affected region. Multilocular radiolucency was observed in 70% of cases, whereas 30% were unilocular. Three subtypes of ameloblastomas were diagnosed: unicystic ameloblastoma (20%), conventional solid/multicystic ameloblastoma (70%), and desmoplastic ameloblastoma (10%). The most common histologic pattern was the plexiform type (57.2%) followed by follicular type (23.8%). Conclusion Prevalence of ameloblastoma in Southeast Myanmar and lower Northern Thailand populations correspond with data from other geographic areas of Thailand and other Asian countries. However, some demographic and histopathological profiles are different, with plexiform ameloblastoma being the most common subtype in this study. PMID:28274056

  6. A nation-wide multicenter retrospective study of the epidemiological, pathological and clinical characteristics of breast cancer in situ in Chinese women in 1999 - 2008.

    Directory of Open Access Journals (Sweden)

    Yanan Kong

    Full Text Available BACKGROUND: Compared with invasive breast cancer, breast cancer in situ (BCIS is seldom life threatening. However, an increasing incidence has been observed in recent years over the world. The purpose of our study is to investigate the epidemiological, clinical and pathological profiles of BCIS in Chinese women from 1999-2008. METHODS: Four thousand and two hundred-eleven female breast cancer (BC patients were enrolled in this hospital-based nation-wide and multi-center retrospective study. Patients were randomly selected from seven hospitals in seven representative geographical regions of China between 1999 and 2008. The epidemiological, clinical and pathological data were collected based on the designed case report form (CRF. RESULTS: There were one hundred and forty-three BCIS cases in four thousand and two hundred-eleven BC patients (3.4%. The mean age at diagnosis was 48.3 years and BCIS peaked in age group 40-49 yrs (39.9%. The most common subtype was ductal carcinoma in situ (DCIS (88.0%. 53.8% were positive for estrogen receptor (ER. Human epidermal growth factor receptor 2 (HER2 positive status was observed in 23.8% of patients. All patients underwent surgeries and 14.7% of them had breast conservation therapies (BCT (21/143, but 41.9% accepted chemotherapy (64/143. Much less patients underwent radiotherapy (16.0%, 23/143 and among patients who had BCT, 67% accepted radiotherapy (14/21. Endocrine therapy was taken in 44.1% patients (63/143. CONCLUSIONS: The younger age of BCIS among Chinese women than Western countries and increasing number of cases pose a great challenge. BCT and endocrine therapy are under great needs.

  7. Comparison of clinical outcome of periapical surgery in endodontic and oral surgery units of a teaching dental hospital: a retrospective study.

    Science.gov (United States)

    Rahbaran, S; Gilthorpe, M S; Harrison, S D; Gulabivala, K

    2001-06-01

    The aims of this retrospective study were (1) to compare the outcome of periapical surgery performed in endodontic and in oral surgery units of a teaching dental hospital and (2) to evaluate the influence of factors affecting outcome. A total of 176 teeth (endodontic unit, 83; oral surgery unit, 93) surgically treated more than 4 years previously were examined clinically and radiographically by means of strict criteria. Multiple logistic regression analysis was used. The rate of complete healing for patients treated in the endodontic unit (37.4%) was significantly (P = .009) higher than that for patients treated in the oral surgery unit (19.4%). The technical quality of surgery (P < .001), placement of root-end filling (P = .039), absence of a preoperative periapical lesion (P = .042), absence of a post (P = .047), and presence of an adequate coronal restoration (P = .056, odds ratio = 3.71) had significant effects on treatment outcome. The technical quality of periapical surgery, the presence of a periapical lesion, and adequate apical and coronal seal are important prognostic determinants of successful periapical surgery.

  8. Prevalence of preoperative anaemia in patients having first-time cardiac surgery and its impact on clinical outcome. A retrospective observational study.

    Science.gov (United States)

    Kim, C J; Connell, H; McGeorge, A D; Hu, R

    2015-05-01

    The prevalence of anaemia is increasing globally. It has a close association with perioperative blood transfusion which, in turn, results in an increased risk of postoperative complications. Undesirable effects are not only limited to short-term, but also have long-term implications. Despite this, many patients undergo cardiac surgery with undiagnosed and untreated anaemia. We designed a retrospective, observational study to estimate the prevalence of anaemia in patients having cardiac surgery in Auckland District Health Board, blood transfusion rates and associated clinical outcome. Two hundred of seven hundred and twelve (28.1%) patients were anaemic. Red blood cell (RBC) transfusion rates were significantly higher in the anaemic group compared to the non-anaemic group (160 (80%) vs. 192 (38%), p-value Anaemia was significantly associated with the development of new infection (14 (7%) vs. 15 (2.9%), p-value 0.0193, RR (CI 95%) 2.389 (1.175-4.859)), prolonged ventilation time (47.01 hours vs. 23.59 hours, p-value 0.0076) and prolonged intensive care unit (ICU) stay (80.23 hours vs. 50.27, p-value 0.0011). Preoperative anaemia is highly prevalent and showed a clear link with significantly higher transfusion rates and postoperative morbidity. It is vital that a preoperative management plan for the correction of anaemia should be sought to improve patient safety and outcome.

  9. Diagnosis of right-sided varicocele: A retrospective comparative study between clinical examination, Doppler findings, US imaging and vascular anatomy at phlebography

    Energy Technology Data Exchange (ETDEWEB)

    Cariati, Maurizio, E-mail: davide.candito@libero.it [U.O.C. Radiologia, A.O. San Carlo Borromeo, via Pio II 3, 20153 Milan (Italy); Pieri, Stefano, E-mail: stefano.pieri@scamilloforlanini.rm.it [U.O.C. Diagnostica per Immagini Cardioscienze, A.O. San Camillo - Forlanini, Piazza Carlo Forlanini 1, 00151 Rome (Italy); Agresti, Paolo, E-mail: paolo.agresti@scamilloforlanini.rm.it [U.O.C. Diagnostica per Immagini Cardioscienze, A.O. San Camillo - Forlanini, Piazza Carlo Forlanini 1, 00151 Rome (Italy); Cariati, Massimiliano, E-mail: massimiliano.cariati@kcl.ac.uk [Department of Academic Oncology, King' s College London, 3rd Floor Bermondsey Wing, Guy' s Hospital, Great Maze Pond, London SE1 9RT (United Kingdom); Candito, Davide Fabio, E-mail: davide.candito@yahoo.it [Scuola di Specializzazione in Radiodiagnostica, Facoltà di Medicina e Chirurgia, Università degli studi di Milano, via Festa del Perdono 7, 20122 Milan (Italy); Damiani, Giovanni, E-mail: damiani_giovanni@libero.it [Scuola di Specializzazione in Radiodiagnostica, Facoltà di Medicina e Chirurgia, Università degli studi di Milano, via Festa del Perdono 7, 20122 Milan (Italy); Marzano, Domenico, E-mail: domenico.marzano@scamilloforlanini.rm.it [U.O.C. Urologia, A.O. San Camillo - Forlanini, Piazza Carlo Forlanini 1, 00151 Rome (Italy)

    2012-09-15

    Historically varicocele is diagnosed almost exclusively on the left side. The introduction of new imaging techniques has allowed the identification and characterization of right varicocele. This study aims to compare the diagnostic accuracy of various imaging techniques to data obtained using phlebography in the diagnosis of right varicocele. Patients treated for isolated right varicocele between 1992 and 2010 were retrospectively identified. Data from clinical examination, Doppler-USS, Color-Doppler-USS and Retrograde Phlebography were collected for each patient. 133 out of 4305 patients (3.1%) presented with an isolated right varicocele. 34 of these patients (25.6%) presented with palpable right varicocele. Doppler-USS identified various degrees of type I right venous reflux in 90 patients (67.7%). Phlebography showed venous reflux in all the patients (133), although with variability in terms of internal spermatic vein anatomy. Right varicocele is characterized by predictable anatomic features. Identification and characterization of these features is useful in guiding percutaneous treatment, allowing to optimize radiological display and reducing failure rate.

  10. Clinical and radiological outcome of anterior–posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients

    Science.gov (United States)

    Schwender, James D.; Safriel, Yair; Gilbert, Thomas J.; Mehbod, Amir A.; Denis, Francis; Transfeldt, Ensor E.; Wroblewski, Jill M.

    2009-01-01

    Abundant data are available for direct anterior/posterior spine fusion (APF) and some for transforaminal lumbar interbody fusion (TLIF), but only few studies from one institution compares the two techniques. One-hundred and thirty-three patients were retrospectively analyzed, 68 having APF and 65 having TLIF. All patients had symptomatic disc degeneration of the lumbar spine. Only those with one or two-level surgeries were included. Clinical chart and radiologic reviews were done, fusion solidity assessed, and functional outcomes determined by pre- and postoperative SF-36 and postoperative Oswestry Disability Index (ODI), and a satisfaction questionnaire. The minimum follow-up was 24 months. The mean operating room time and hospital length of stay were less in the TLIF group. The blood loss was slightly less in the TLIF group (409 vs. 480 cc.). Intra-operative complications were higher in the APF group, mostly due to vein lacerations in the anterior retroperitoneal approach. Postoperative complications were higher in the TLIF group due to graft material extruding against the nerve root or wound drainage. The pseudarthrosis rate was statistically equal (APF 17.6% and TLIF 23.1%) and was higher than most published reports. Significant improvements were noted in both groups for the SF-36 questionnaires. The mean ODI scores at follow-up were 33.5 for the APF and 39.5 for the TLIF group. The patient satisfaction rate was equal for the two groups. PMID:19125304

  11. Can neuroimaging differentiate PFO and AF-related cardioembolic stroke from the other embolic sources? Clinical-radiological correlation on a retrospective study.

    Science.gov (United States)

    Stecco, Alessandro; Quagliozzi, Martina; Soligo, Eleonora; Naldi, Andrea; Cassarà, Alessia; Coppo, Lorenzo; Rosso, Roberta; Bongo, Angelo Sante; Amatuzzo, Paola; Buemi, Francesco; Guenzi, Elena; Carriero, Alessandro

    2017-06-01

    The aim of this retrospective study was to map the specific ischemic lesion patterns of distribution in patent foramen ovale-related stroke (PFO-stroke) and atrial fibrillation-related stroke (AF-stroke) in patients with idiopatic ischemic stroke. 750 ischaemic strokes were screened on basis of diagnostic imaging and tests: patients with known causes were excluded. 171 patients with unknown cause were selected and divided in two groups: AF-stroke (43 patients) and PFO-stroke (128 patients). Vascular territories of ischemic involvement were divided into four classes in each group: the anterior cerebral artery, the middle cerebral artery, the vertebro-cerebral artery (including the posterior cerebral artery) and multisite (MS) involvement. Infarcts in vertebro-basilar territory and multisite represented each one about 32% of infarcts in PFO-stroke group and their involvement are more frequent than AF-stroke group (p = 0.03). Ischemic lesions in PFO-group were predominantly cortical (34.3%), and in AF-group cortical-subcortical (60.4%). Multisite pattern of ischemic lesion was more frequent in patients with severe degree of right to left shunts (37.5%). In clinical practice, PFO may be considered a cause of cortical stroke on the basis of radiological findings, when VB vascular territory or MS brain involvement is present in younger patients (<50 age).

  12. Pheochromocytoma in Indian patients: A retrospective study

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    R Krishnappa

    2012-01-01

    Full Text Available Aim: To review the clinical experience on pheochromocytoma in Indian subset of patients. Materials and Methods: Ten patients diagnosed with pheochromocytoma between 2001 and 2010 at our institute were retrospectively studied for clinical, laboratory, radiological and surgical data. Results: A total of 10 patients (5 females and 5 males aged between 23 and 64 years diagnosed as pheochromocytoma were managed at our institute. The most frequent symptoms were abdominal pain (90% and hypertension (50%. The tumor was intra-adrenal in 70% and extra-adrenal in 30%. 20% were on right side and 50% on left side. CT scan of abdomen was the most widely used method for tumor localization. Among laboratory assays, 24-h urinary vanillylmandelic acid (VMA was the most widely used. None of our patients were found to be associated with hereditary pheochromocytoma syndrome. All hypertensive patients were preoperatively treated with phenoxybenzamine and propranolol. All underwent explorative laparotomy and adrenelectomy. Malignancy was reported in 40% of cases and these received adjuvant radiotherapy. Among hypertensive patients, surgery caused remission of hypertension in 60%. All patients were followed up with 24-h urinary VMA levels and CT scan of abdomen regularly. Survival ranged from 1 to 9 years. Conclusions: The present study confirms that the clinical presentation of pheochromocytoma is variable and non-specific. Often the tumor is discovered incidentally. Though pheochromocytoma is a rare tumor, proper evaluation, preoperative preparation and complete surgical excision are important for its management.

  13. Diagnostic accuracy of MRI in adults with suspect brachial plexus lesions: A multicentre retrospective study with surgical findings and clinical follow-up as reference standard

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    Tagliafico, Alberto, E-mail: alberto.tagliafico@unige.it [Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Largo Rosanna Benzi 8, 16132 Genoa (Italy); Succio, Giulia; Serafini, Giovanni [Department of Radiology, Santa Corona Hospital, Pietra Ligure, Italy via XXV Aprile, 38- Pietra Ligure, 17027 Savona (Italy); Martinoli, Carlo [Radiology Department, DISC, Università di Genova, Largo Rosanna Benzi 8, 16138 Genova (Italy)

    2012-10-15

    Objective: To evaluate brachial plexus MRI accuracy with surgical findings and clinical follow-up as reference standard in a large multicentre study. Materials and methods: The research was approved by the Institutional Review Boards, and all patients provided their written informed consent. A multicentre retrospective trial that included three centres was performed between March 2006 and April 2011. A total of 157 patients (men/women: 81/76; age range, 18–84 years) were evaluated: surgical findings and clinical follow-up of at least 12 months were used as the reference standard. MR imaging was performed with different equipment at 1.5 T and 3.0 T. The patient group was divided in five subgroups: mass lesion, traumatic injury, entrapment syndromes, post-treatment evaluation, and other. Sensitivity, specificity with 95% confidence intervals (CIs), positive predictive value (PPV), pre-test-probability (the prevalence), negative predictive value (NPV), pre- and post-test odds (OR), likelihood ratio for positive results (LH+), likelihood ratio for negative results (LH−), accuracy and post-test probability (post-P) were reported on a per-patient basis. Results: The overall sensitivity and specificity with 95% CIs were: 0.810/0.914; (0.697–0.904). Overall PPV, pre-test probability, NPV, LH+, LH−, and accuracy: 0.823, 0.331, 0.905, 9.432, 0.210, 0.878. Conclusions: The overall diagnostic accuracy of brachial plexus MRI calculated on a per-patient base is relatively high. The specificity of brachial plexus MRI in patients suspected of having a space-occupying mass is very high. The sensitivity is also high, but there are false-positive interpretations as well.

  14. White spot lesions after orthodontic treatment assessed by clinical photographs and by quantitative light-induced fluorescence imaging; a retrospective study

    NARCIS (Netherlands)

    Beerens, M.W.; Boekitwetan, F.; van der Veen, M.H.; ten Cate, J.M.

    2015-01-01

    Objective. White spot lesions (WSL) are an important side-effect of orthodontic multi-bracket (MB) treatment. Standardized monitoring of such WSL may help in caries management. Materials and methods. In this retrospective study the discriminatory power of caries assessment on routine digital oral ph

  15. 偏头痛临床特点回顾性分析%A retrospective study of clinical features of migraine

    Institute of Scientific and Technical Information of China (English)

    邱恩超; 于生元; 郭艳娥; 周志彬; 姜磊; 董钊

    2008-01-01

    目的 分析门诊偏头痛的临床特征,为偏头痛的正确诊治提供帮助.方法 回顾性分析309例偏头痛的临床特点,比较不同性别、类型之间的异同,以及总结偏头痛发生药物过量性头痛(MOH)的危险因素.结果 女性与男性之比约为3:1,76.1%的患者有诱因,最常见的头痛特点是中到重度疼痛(97.7%)、日常体力活动加剧头痛(75.1%)及伴有恶心(90.9%)或呕吐(70.6%);不同性别、类型之间临床特点不全相同;偏头痛发生MOH的危险因素是发病年龄大、发作频率高和频繁使用止痛药缓解头痛.结论 详细询问患者头痛特点、诱因、治疗史是正确诊治偏头痛的基础.%Objective To observe the clinical features of migraine based on out-patient clinic data and provide help for the diagnosis and treatment of migraine. Methods In a retrospective study of 309 patients with migraine, we investigated the clinical characteristics of migraine of both genders and different types, and the risk factors for MOH transformed from migraine. Results The female to male ratio was about 3:1,76.1% of the patients had triggering factors. The most common characteristics of headache were moderate to severe intensity of the pain (97.7%), aggravation by routine physical activity (75.1%), and association with nausea (90.9%) and/or vomiting (70.6%). There were significant differences in some clinical characteristics of migraine in females as compared with these in males and in patients with migraine without aura (MWOA) as compared with those with aura (MWA). The risk factors for MOH transformed from migraine were elder age of onset, high attack frequency and the analgesics frequently used (P < 0.05).Conclusion It is suggested that carefully collecting the characteristics of headache, triggering factors and therapeutic history is the foundation of correct diagnosis and effective treatment for migraine.

  16. Clinical features and survival in individuals with trisomy 18: A retrospective one-center study of 44 patients who received intensive care treatments.

    Science.gov (United States)

    Imataka, George; Suzumura, Hiroshi; Arisaka, Osamu

    2016-03-01

    Trisomy 18 syndrome is a common autosomal aneuploidy chromosomal abnormality caused by the presence of extra chromosome 18 that leads to malformations of various parts of the body. In this study, we retrospectively investigated the effect of the medical progression and prognosis of 44 cases of trisomy 18, admitted to our neonatal intensive care unit between 1992 and 2013. The patients were divided into group A (n=20, 1992‑2002) and group B (n=24, 2003‑2012). Following delivery, karyotype, gender, gestational weeks, birth place, cesarean section, Apgar score and birth weight were analyzed using the Fisher's exact test, unpaired t‑test and Mann‑Whitney U test. Based on the statistical results, a comparison was made of the two groups and no significant differences were observed. Clinical data of major complications, mechanical ventilation, discharge from hospital and survival days were reviewed for the cases of trisomy 18. Of the 44 patients, 42 had cardiac anomaly, 16 had esophageal atresia, and 3 patients had brain anomaly. Ventilation treatment was performed in 29 cases (65.9%) and an increased percentage was identified in group B patients. The percentage survival was estimated using Kaplan‑Meier curves and the two groups were analyzed using the generalized Wilcoxon test. Improvement in life prognosis was observed in group B as compared to group A. The log‑rank test was used to assess survey periods of 180 days, 1 year, and the entire observation period. Although significant differences were observed for the prognosis of trisomy 18 at 180 days after birth, after 1 year and the entire survey period after birth, the significant differences were not confirmed. In conclusion, results of the present study provide information concerning genetic counseling for parents/guardians and life prognosis, prior to applying intensive management to newborns with trisomy 18.

  17. [Comparison of dignity determination of mammographic microcalcification with two systems for digital full-field mammography with different detector resolution: a retrospective clinical study].

    Science.gov (United States)

    Schulz-Wendtland, R; Hermann, K-P; Adamietz, B; Meier-Meitinger, M; Wenkel, E; Lell, M; Anders, K; Uder, M

    2011-02-01

    The aim of this retrospective clinical study was to compare the diagnostic accuracy of the novel 50 µm FFDM (full-field digital mammography) system (DR) with an established 70 µm system (DR) in the differential diagnosis between benign and malignant clusters of microcalcification (n=50) (BI-RADS™ classification 4/5) and to assess the possible incremental value of the 50 µm pixel-pitch on specificity. From March 2009 to September 2009, 50 patients underwent full-field digital mammography (FFDM) (detector resolution 70 µm) (Novation, Siemens, Erlangen, Germany). As there were suspicious signs of microcalcification classified with BI-RADS™ 4/5 after diagnosis and preoperative wire localization, control images were made with the new FFDM system (detector: resolution 50 µm) (Amulet, Fujifilm, Tokyo, Japan) with the same exposure parameters. The diagnosis was determined after the operation by five radiologists with different experience in digital mammography from randomly distributed mediolateral views (monitor reading) whose results were correlated with the final histology of all lesions. Histopathology revealed 19 benign and 31 malignant lesions in 50 patients after open biopsy. The results of the five readers showed a higher sensitivity of the new FFDM system (80.0%) in the ability to recognize malignant microcalcification in comparison to the established system (74.8%). The specificity (75.8 versus 71.6%) was slightly higher for the new system but these results were not statistically significant (p<0.001). Considering the diagnostic accuracy, the new system (detector: resolution 50 µm) was also slightly superior to the well-known system (detector: resolution 70 µm) (80.1% versus 76.4%). Our study has shown that the new full-field digital mammography system using the novel detector compared with the already established FFDM system with respect to the assessment of microcalcification is at least equivalent.

  18. Use of basal insulin and the associated clinical outcomes among elderly nursing home residents with type 2 diabetes mellitus: a retrospective chart review study

    Directory of Open Access Journals (Sweden)

    Davis KL

    2014-10-01

    Full Text Available Keith L Davis,1 Wenhui Wei,2 Juliana L Meyers,1 Brett S Kilpatrick,3 Naushira Pandya4 1RTI Health Solutions, Research Triangle Park, NC, USA; 2Sanofi US, Inc, Bridgewater, NJ, USA; 3AnalytiCare, LLC, Glenview, IL, USA; 4Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA Background: The management of type 2 diabetes mellitus in long-term care (LTC settings can be complex as a result of age-related complications. Despite guideline recommendations, sliding scale insulin remains commonplace in the LTC setting and data on basal insulin use are lacking.Methods: This retrospective study used medical chart data and the Minimum Data Set from elderly LTC facility patients who received basal insulin (insulin glargine, insulin detemir, or neutral protamine Hagedorn insulin for the treatment of diabetes, to investigate the practice patterns and associated clinical outcomes.Results: A total of 2,096 elderly, insulin-treated patients in LTC were identified, with 59.5% of them (N=1,247 receiving basal insulin. Of these, more than 50% of patients received sliding scale insulin in co-administration with basal insulin. Despite its ease of use, insulin pen use was very low, at 14.6%. Significant differences were observed between the basal insulin groups for glycated hemoglobin level and dosing frequency. Hypoglycemia was uncommon -17.2% of patients experienced at least one event, and there was no significant difference in the prevalence of hypoglycemia between the groups.Conclusion: These data suggest the underutilization of basal insulin in the LTC setting and worryingly high combinational use with sliding scale insulin. Differences in glycated hemoglobin and dosing frequencies between types of basal insulin warrant further comparative effectiveness studies. Keywords: long-term care, nursing homes, type 2 diabetes mellitus, insulin detemir, insulin glargine, NPH insulin

  19. Association between secure patient-clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study.

    Science.gov (United States)

    Meng, Di; Palen, Ted E; Tsai, Joanne; McLeod, Melanie; Garrido, Terhilda; Qian, Heather

    2015-11-09

    To assess associations between secure patient-clinician email use and clinical services utilisation over time. Retrospective cohort study between July 2010 and December 2013. Controlling for a utilisation surge around first secure email use, we analysed difference of differences between propensity score-matched groups of secure patient-clinician email users and non-users for utilisation 1-12 months before and 7-18 months after first email (users) or a randomly assigned index date (non-users). US integrated healthcare delivery system. 9345 adults with first secure email use between July 2011 and July 2012 and continuous enrolment for ≥30 months and 9345 adults without secure email use between July 2010 and July 2012 matched to users on demographics, health status, and baseline utilisation. Rates of office visits, patient-initiated phone calls, scheduled telephone visits, after-hours clinic visits, emergency department visits, and hospitalisations. After controlling for multiple factors, no statistically significant differences in utilisation between secure email users and non-users occurred. Utilisation transiently increased by 88-237% around first email use. Annual rates of patient-initiated phone calls decreased among secure email users, 0.2 fewer calls per person (95% CI -0.3 to -0.1), from a mean of 4.1 calls per person 1-12 months before first use to a mean of 3.8 calls per person 7-18 months after first use. Rates of patient-initiated phone calls also decreased among non-users, 0.1 fewer calls per person (95% CI -0.2 to 0.0), from a mean of 4.2 calls per person 1-12 months before the index date to mean of 4.1 calls per person 7-18 months after the index date. Compared with non-users, patient use of secure email with clinicians was not associated with statistically significant differences in clinical services utilisation 7-18 months after first use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  20. Association between secure patient–clinician email and clinical services utilisation in a US integrated health system: a retrospective cohort study

    Science.gov (United States)

    Meng, Di; Palen, Ted E; Tsai, Joanne; McLeod, Melanie; Garrido, Terhilda; Qian, Heather

    2015-01-01

    Objective To assess associations between secure patient–clinician email use and clinical services utilisation over time. Design Retrospective cohort study between July 2010 and December 2013. Controlling for a utilisation surge around first secure email use, we analysed difference of differences between propensity score-matched groups of secure patient–clinician email users and non-users for utilisation 1–12 months before and 7–18 months after first email (users) or a randomly assigned index date (non-users). Setting US integrated healthcare delivery system. Participants 9345 adults with first secure email use between July 2011 and July 2012 and continuous enrolment for ≥30 months and 9345 adults without secure email use between July 2010 and July 2012 matched to users on demographics, health status, and baseline utilisation. Primary Outcome Measures Rates of office visits, patient-initiated phone calls, scheduled telephone visits, after-hours clinic visits, emergency department visits, and hospitalisations. Results After controlling for multiple factors, no statistically significant differences in utilisation between secure email users and non-users occurred. Utilisation transiently increased by 88–237% around first email use. Annual rates of patient-initiated phone calls decreased among secure email users, 0.2 fewer calls per person (95% CI −0.3 to −0.1), from a mean of 4.1 calls per person 1–12 months before first use to a mean of 3.8 calls per person 7–18 months after first use. Rates of patient-initiated phone calls also decreased among non-users, 0.1 fewer calls per person (95% CI −0.2 to 0.0), from a mean of 4.2 calls per person 1–12 months before the index date to mean of 4.1 calls per person 7–18 months after the index date. Conclusions Compared with non-users, patient use of secure email with clinicians was not associated with statistically significant differences in clinical services utilisation 7–18

  1. Retrospective analysis of phone queries to an epilepsy clinic hotline.

    Science.gov (United States)

    Laforme, Anny; Jubinville, Suzie; Gravel, Micheline; Cossette, Patrick; Nguyen, Dang K

    2014-01-01

    We undertook a retrospective study of 5,189 telephone calls made between January 2004 and June 2011 through our adult epilepsy clinic hotline to a single epileptologist initially and two epileptologists from June 2010 onwards. The majority of calls were made by patients themselves (72%), followed by family members (16%) and health care providers (11%). Half of the calls originated from outside the city limits. Most were related to medication (25%), notification of seizures (23%), appointments or tests (12%), and side effects (9%). Half of the workload was generated by 10% of patients. The hotline service appears to respond to needs, with most calls requiring rapid intervention. It is desirable to develop novel approaches to address the needs of high-frequency callers.

  2. Clinical characteristics and outcomes of Pseudomonas aeruginosa bacteremia in febrile neutropenic children and adolescents with the impact of antibiotic resistance: a retrospective study.

    Science.gov (United States)

    Kim, Hyo Sup; Park, Bo Kyoung; Kim, Seong Koo; Han, Seung Beom; Lee, Jae Wook; Lee, Dong-Gun; Chung, Nack-Gyun; Cho, Bin; Jeong, Dae Chul; Kang, Jin Han

    2017-07-17

    Although the proportion of Pseudomonas aeruginosa infections has reduced after the introduction of antibiotics with anti-pseudomonal effects, P. aeruginosa bacteremia still causes high mortality in immunocompromised patients. This study determined the clinical characteristics and outcomes of P. aeruginosa bacteremia and the antibiotic susceptibilities of strains isolated from febrile neutropenic patients. Thirty-one febrile neutropenic children and adolescents with underlying hematologic/oncologic disorders diagnosed with P. aeruginosa bacteremia between 2011 and 2016 were enrolled in the study. Their medical records were retrospectively reviewed to evaluate the demographic and clinical characteristics. Antibiotic susceptibility rates of the isolated P. aeruginosa to eight antibiotic categories (anti-pseudomonal penicillin, anti-pseudomonal penicillin and β-lactamase inhibitor combination, anti-pseudomonal cephalosporin, monobactam, carbapenem, aminoglycoside, fluoroquinolone, and colistin) were also determined. Among the investigated factors, risk factors for mortality and infections by a multidrug-resistance (MDR) strain were determined. Thirty-six episodes of P. aeruginosa bacteremia were identified. The mean age of the enrolled patients was 9.5 ± 5.4 years, and 26 (72.2%) episodes occurred in boys. Acute myeloid leukemia (41.7%) and acute lymphoblastic leukemia (33.3%) were the most common underlying disorders. The 30-day mortality was 38.9%, and 36.1% of the episodes were caused by MDR strains. The deceased patients were more likely to experience breakthrough infection (P = 0.036) and bacteremia (P = 0.005) due to MDR strains when compared with the patients who survived. The survived patients more likely received appropriate empirical antibiotic therapy (P = 0.024) and anti-pseudomonal β-lactam and aminoglycoside combination therapy (P = 0.039) compared with the deceased patients. The antibiotic susceptibility rates of the isolated P. aeruginosa

  3. Cryptococcal Neoformane Meningitis: A Retrospective Clinical Study%新型隐球菌性脑膜炎15例临床分析

    Institute of Scientific and Technical Information of China (English)

    丛树艳; 吕丹; 赵秀兰; 黄达; 佡剑非; 宋利春

    2012-01-01

    Objective To retrospectively analyze the clinical information of a series of patients with cryptococcal neoformans meningitis in order to improve the diagnosis and treatment level. Methods Fifteen patients with etiological diagnosis as cryptococcal neoformans meningitis from January 2004 to December 2009 in the Affiliated Shengjing Hospital of China Medical University were included in the study. The clinical manifestations, treatment and prognosis of those patients were retrospectively analyzed. Results Seven of the total 15 patients were misdiagnosed with misdiagnosis rate of 46.7%. Twelve patients were treated by combination of amphotericin B/Lipo-AMB and fluconazole intravenously infusion, and then followed by the maintenance therapy of fluconazole orally administration, of which 7 were cured, 3 were improved, and 2 died. Five patients undergoing lumbar cisterna drainage were all cured. The follow-up study showed that 4 cases were accompanied by auditory or/and visual dysfunction within 1 to 5 years after hospital discharge. Three cases died that were not treated with anti-fungal drugs. Conclusion The misdiagnosis rate of cryptococcal neoformans meningitis is high. The keys to reduce mortality are raising vigilance, early diagnosis, rational use of antifungal drugs, and effectively lowering the intracranial pressure. The integrated therapy of amphotericin B/Lipo-AMB and fluconazole is effective and safe. Lumbar cisterna drainage can effectively lower the intracranial hypertension, quickly relieve symptoms and improve prognosis.%目的 回顾性分析15例新型隐球菌性脑膜炎的临床资料,以提高对新型隐球菌性脑膜炎的诊治水平.方法 对2004~2009年期间在我院经临床和病原学确诊的15例新型隐球菌性脑膜炎患者的临床特征、治疗情况及转归进行回顾性分析.结果 15例患者中有7例曾被误诊,误诊率达46.7%.3例未应用抗真菌治疗患者全部死亡;其余12例患者首先联合应用两

  4. Did the temporary shortage in supply of imiglucerase have clinical consequences? Retrospective observational study on 34 italian Gaucher type I patients.

    Science.gov (United States)

    Deroma, Laura; Sechi, Annalisa; Dardis, Andrea; Macor, Daniela; Liva, Giulia; Ciana, Giovanni; Bembi, Bruno

    2013-01-01

    Background. Enzyme Replacement Therapy (ERT) is the standard of care in Gaucher disease. The effects of withdrawal or reduced doses are debated, thus a retrospective cohort study was conducted to investigate clinical and laboratory differences in 34 Gaucher type 1 patients experiencing an ERT dosage reduction after the forced temporary imiglucerase shortage in 2009. Methods. Haemoglobin concentration, leukocytes and platelets counts, and chitotriosidase activity were assessed at baseline and after 6 and 12 months (t0, t6, t12), while bone pain, energy, work or school performance, concentration, memory and social life every 3 months. Results. The cohort was made up of 18 males and 16 females (medians: age 41.8 years, therapy duration 14.1 years, dosage reduction 35.5%). Haemoglobin, leukocytes and platelets remained substantially stable, while chitotriosidase activity showed an increase, especially after t6. Age, splenectomy or genotype were not associated with laboratory parameters changes, except for a significant median increase of chitotriosidase activity in non-splenectomised patients after 12 months (p = 0.01). At 3, 6, 9 and 12 months, more than 50% patients reported at least one problem in subjective well-being (56%, 65%, 70%, 58%, respectively), while bone pain occurred or worsened in 13/33, 13/32, 7/28 and 5/26 patients, respectively. No bone crises were reported. Conclusions. Drug reduction did not induce substantial modification in the laboratory values but seems to have influenced the well-being perception of some Gaucher patients. Thus, bone pain, general health and quality of life should be carefully monitored during ERT reductions.

  5. Retention in care among HIV-positive patients initiating second-line antiretroviral therapy: a retrospective study from an Ethiopian public hospital clinic

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    Sten Wilhelmson

    2016-01-01

    Full Text Available Background: Access to second-line antiretroviral therapy (ART for HIV-positive patients remains limited in sub-Saharan Africa. Furthermore, outcomes of second-line ART may be compromised by mortality and loss to follow-up (LTFU. Objective: To determine retention in care among patients receiving second-line ART in a public hospital in Ethiopia, and to investigate factors associated with LTFU among adults and adolescents. Design: HIV-positive persons with documented change of first-line ART to a second-line regimen were retrospectively identified from hospital registers, and data were collected at the time of treatment change and subsequent clinic visits. Baseline variables for adults and adolescents were analyzed using multivariate Cox proportional hazards models comparing subjects remaining in care and those LTFU (defined as a missed appointment of ≥90 days. Results: A total of 383 persons had started second-line ART (330 adults/adolescents; 53 children and were followed for a median of 22.2 months (the total follow-up time was 906 person years. At the end of study follow-up, 80.5% of patients remained in care (adults and adolescents 79.8%; children 85.7%. In multivariate analysis, LTFU among adults and adolescents was associated with a baseline CD4 cell count <100 cells/mm3 and a first-line regimen failure that was not confirmed by HIV RNA testing. Conclusions: Although retention in care during second-line ART in this cohort was satisfactory, and similar to that reported from first-line ART programs in Ethiopia, our findings suggest the benefit of earlier recognition of patients with first-line ART failure and confirmation of suspected treatment failure by viral load testing.

  6. HRCT evaluation of microtia: A retrospective study

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    Aruna R Patil

    2012-01-01

    Full Text Available Purpose: To determine external, middle, and inner ear abnormalities on high-resolution computed tomography (HRCT of temporal bone in patients with microtia and to predict anatomic external and middle ear anomalies as well as the degree of functional hearing impairment based on clinical grades of microtia. Materials and Methods: It was a retrospective study conducted on Indian population. Fifty-two patients with microtia were evaluated for external, middle, and inner ear anomalies on HRCT of temporal bone. Clinical grading of microtia was done based on criteria proposed by Weerda et al. in 37 patients and degree of hearing loss was assessed using pure tone audiometry or brainstem-evoked response in 32 patients. Independent statistical correlations of clinical grades of micotia with both external and middle ear anomalies detected on HRCT and the degree of hearing loss were finally obtained. Results: The external, middle, and inner ear anomalies were present in 93.1%, 74.5%, and 2.7% patients, respectively. Combined cartilaginous and bony external auditory canal atresia (EAC was the most common anatomic abnormality in our group of microtia patients. Hypoplastic mesotympanum represented the commonest middle ear anomaly. The incidence of combined ossicular dysplasia and facial canal anomalies was lower as compared to other population groups; however, we recorded a greater incidence of cholesteatoma. Both these factors can have a substantial impact on outcome of patients planned for surgery. We found no significant association between grades of microtia and external or middle ear anomalies. Similarly, no significant association was found between lower grades of microtia (grade I and II and degree of hearing loss. However, association between grade III microtia and degree of hearing loss was significant. A significant association between congenital cholesteatoma and degree of pneumatization of atretic plate and mastoid process not previously studied

  7. 掌腱膜挛缩症的临床回顾性研究%Dupuytren's disease: a clinical retrospective study

    Institute of Scientific and Technical Information of China (English)

    李秀存; 路来金; 崔建礼; 孙希光; 刘红霞; 张颖; 王维

    2015-01-01

    Objective To introduce the clinical experiences of treating Dupuytren's disease.Methods A retrospective study was conducted of 78 cases of Dupuytren' s disease treated from October 2004 to December 2013 to analyze the clinical characteristics,surgical methods,postoperative complications,and long-term results.Results Of the 111 hands in this group,99 hands had primary healing of the wound,while 12 had various degrees of early postoperative complicatiom.The incidence of complications was 10.81%.Among them,98 hands of 68 patients were follow-up for a mean of 3.9 years after the surgery.Recurrence of Dupuytren' s was seen in 6 hands,the rate of postoperative recurrence being 6.12%.According to the upper limb functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association,the results were excellent in 81 hands,good in 11 hands and poor in 6 hands.The overall satisfactory rate was 93.88%.Conclusion Early surgery and careful operation will significantly reduce the incidence of early postoperative and long-term comphcations in the treatment of Dupuytren's contracture.%目的 探讨掌腱膜挛缩症的治疗体会.方法 对我院2004年10月至2013年12月收治的78例掌腱膜挛缩症患者的发病特点、手术方法、术后并发症及远期疗效进行回顾性分析.结果 本组患者111只手,99只手Ⅰ期愈合,12只手术后出现不同程度的早期并发症,发生率10.81%.其中68例患者98只手术后平均随访3.9年,6只手复发,术后复发率为6.12%.依据中华医学会手外科学会上肢部分功能评定试用标准评定:优81只手,良11只手,差6只手;优良率为93.88%.结论 早期手术、精细操作将极大降低掌腱膜挛缩症术后出现早期及远期并发症的机会.

  8. The Retrospective Evaluation of Childhood Psoriasis Clinically and Demographic Features

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    Ayşe Serap Karadağ

    2013-03-01

    Full Text Available Objective: This study was aimed to define the clinical and demographic findings of psoriasis in childhood. Methods: In this retrospective study, the data from 64 children with psoriasis admitted at the our dermatology clinic between January 2007 and January 2011 were included whose data were fully. Results: Of the patients, 37 (57.8% were boys and 27 (42.2% were girls. Mean age of the children was 10.08 ±3.98 years (3-16. In 10 (15% cases, a positive family history was detected. The most frequent localizations at onset were trunk (46.9%, scalp (28.1%, knee-elbow (10.9% and extremities (7.9%, respectively. The most commonly seen clinical types were plaque (68.8%, guttate (20.3%, palmoplantar (9.4%, pustular (1.6%, respectively. Nine children had nail involvement. Out of all patients, 21.9% had upper respiratory tract infections and 9.4% had emotional stres. Four cases were diagnosed with depression. Of the cases, two cases were on non-steroid anti-inflammatory medication, and 4 of them were on antibiotics. Systemic treatments were given to 21.9% of the cases besides topical treatments. Conclusion: The epidemiological studies of psoriasis during childhood period for different countries have been reported. In this study, the ratio shows differences when compared to those previous studies. There are few epidemiologic studies for Turkey. We believe that further epidemiological studies including large number of patients' groups will contribute the diagnosis and treatment of the disease.

  9. Interruptions of antiretroviral therapy in children and adolescents with HIV infection in clinical practice: a retrospective cohort study in the USA

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    Natella Rakhmanina

    2016-10-01

    Full Text Available Introduction: Changes in combination antiretroviral therapy (cART throughout childhood challenge the continuity of paediatric HIV treatment. This study aimed to evaluate the prevalence of treatment interruption (TI, including lamivudine (3TC monotherapy, and the relationship of TI to virologic and immunologic parameters in HIV-infected paediatric patients. Methods: Nested within a prospective observational study of a city-wide cohort of HIV-infected persons in the District of Columbia, this sub-study collected retrospective data on antiretroviral therapy, enrolment (endpoint and historic (lifelong CD4 counts and HIV RNA viral load (VL of the paediatric cohort. TI was defined as interruption of cART ≥4 consecutive weeks. Data on TI, including 3TC monotherapy TI (MTI, were collected. Descriptive statistics and univariate testing were used to compare children with TI and MTI to children on continuous treatment (CT. Results: Thirty-eight (28% out of 136 enrolled children (median age=12.9 years experienced TI, with 14 (37% of those placed on 3TC MTI. Significantly lower endpoint median CD4 counts (598 cells/mm3 vs. 815 cells/mm3; p=0.003 and CD4% (27.5% vs. 33%; p=0.006 were observed in the TI cohort as compared to the CT cohort. The median endpoint VL in the overall TI cohort was ~4 times higher than among the CT cohort (1427 copies/mL vs. 5581 copies/mL; p<0.0001. After a median TI duration of one year, a majority (n=31; 82% of patients with TI restarted cART, including 100% of those with total TI and 53% of those on MTI, respectively. Conclusions: In our study, we observed high frequency of the TI in HIV in paediatric HIV clinical practice. All TIs, including 3TC MTI, were associated with significantly lower endpoint median CD4 counts and higher median VLs, as compared to CT in paediatric patients. The high frequency of TI and associated poor outcomes suggest a need for a better strategy in managing the course of the paediatric and adolescent cART.

  10. Tinnitus: A hospital-based retrospective study

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    Hanifa Akhtar Laskar

    2015-01-01

    Full Text Available Aims and Objectives: To find out age, sex, laterality distribution of patients with tinnitus, to investigate the type and characteristics of associated hearing loss and to find different etiology causing tinnitus. Materials and Methods: Retrospective hospital-based study. Data collected for 154 patients who attended tinnitus clinic of Department of ENT of our institute during the year 2013. Patients with incomplete data were excluded from the study. Results: Among 154 patients included for study, 73 were male and 81 were female. The highest percentage of patients were in the middle age group of 41-50 years (27.9% followed by 31-40 years (18.83% and 51-60 years (16.2% with decreasing number of patients in both younger and elderly age group. Conclusion: Tinnitus can affect any age group but its prevalence increases with age without any gender predilection. Left ear involvement is slightly more common among unilateral tinnitus. Sensorineural hearing loss is most common factor associated but in one-sixth of the cases no cause has been found for tinnitus.

  11. Relationship between clinical and BK virological response in patients with late hemorrhagic cystitis treated with cidofovir: a retrospective study from the European Group for Blood and Marrow Transplantation.

    Science.gov (United States)

    Cesaro, S; Pillon, M; Tridello, G; Aljurf, M; Martino, R; Schroyens, W; Nozzoli, C; Barba, P; Faraci, M; Fagioli, F; Cappelli, B; Cordonnier, C; Al-Mohareb, F; Floisand, Y; Greil, J; Panizzolo, I S; Santarone, S

    2013-06-01

    To investigate the relationship between clinical response and modification of BK viremia, we assessed retrospectively 32 cases of hemorrhagic cystitis (HC) after allogeneic hematopoietic SCT that were treated with i.v. cidofovir (CDV). They were 22 men (69%) and 10 women (31%) with a median age of 24 years, range 3-62. The median number of CDV doses was 3, range 1-8, and the treatment lasted for a median of 3 weeks, range 1-10. Clinical improvement of HC was observed in 27 patients (84%). In 12 of 32 episodes (37.5%), BK viremia was determined before every CDV administration and a complete clinical response was observed in 10 of 12 patients (83%), the reduction of BK viremia load being 1 log by 2 weeks after starting CDV. Nephrotoxicity related to CDV was observed in nine patients. Among 26 patients with 100-day follow-up, 4 of 4 patients who had a complete clinical response by 30 days were alive vs 16 of 22 (73%) who did not have the resolution of HC in this time frame. We conclude that in patients with HC, the response to CDV treatment is usually associated with a significant reduction of BK viremia load.

  12. The clinical features, management and prognosis of primary and secondary indolent lymphoma of the bone: a retrospective study of the International Extranodal Lymphoma Study Group (IELSG #14 study).

    Science.gov (United States)

    Govi, Silvia; Christie, David; Mappa, Silvia; Marturano, Emerenziana; Bruno-Ventre, Marta; Messina, Carlo; Medina, Elías A Gracia; Porter, David; Radford, John; Heo, Dae Seog; Park, Yeon; Pro, Barbara; Jayamohan, Jayasingham; Pavlakis, Nick; Zucca, Emanuele; Gospodarowicz, Mary; Ferreri, Andrés J M

    2014-08-01

    Indolent lymphomas primarily involving the skeleton (iPBL) represent management and prognosis have not been previously described. Patients with primary and secondary iPBL were selected from an international database of 499 patients with a histopathological diagnosis of non-Hodgkin lymphoma and skeleton involvement, and clinical features, management and prognosis were analyzed. Twenty-six (5%) patients had an iPBL. Ten patients had small lymphocytic lymphoma, 10 had follicular lymphoma and six had lymphoplasmacytic lymphoma. Eleven patients had limited stage and 15 had advanced disease. The overall response rate was 73% (95% confidence interval [CI] = 57-89%). Median follow-up was 58 months, and the 5- and 10-year progression-free survival (PFS) rates were 37 ± 10% and 25 ± 12%, respectively. Nine patients are alive, with 5- and 10-year overall survival (OS) rates of 46 ± 10% and 29 ± 11%, respectively. Patients with small lymphocytic lymphoma showed significantly better outcome than patients with follicular lymphoma. Performance status and stage of disease were independently associated with OS. The prognosis of patients with primary bone lymphoplasmacytic or follicular lymphoma was less favorable.

  13. A RETROSPECTIVE STUDY ON PENETRATING INJURIES ABDOMEN

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    Alli Muthiah

    2017-02-01

    Full Text Available BACKGROUND Penetrating abdominal injuries forms an important component of surgical emergencies. It remains one of the commonest reasons for preventable deaths in any trauma systems. 1 Abdominal injuries may be parietal or visceral or perforating through and through injury. Unnecessary exploration leads to increased morbidity. The goal in managing penetrating abdominal injuries is to identify and treat all the damages caused by the weapon and to reduce negative laparotomy and avoid missed injuries. MATERIALS AND METHODS A retrospective study that was carried out in 53 patients in Government Kilpauk Medical College and Government Royapettah Hospital from May 2007 to July 2009 on penetrating injuries abdomen. RESULTS Among 53 patients, maximum number of cases were in the age group of 30-40 years. Assault injuries account for 87% of cases of penetrating abdominal injuries. Small bowel was the commonly injured organ in this study. Laparotomy was therapeutic in 94% of the cases (64% of the cases underwent laparotomy. CONCLUSION Careful and serial clinical examination and appropriate diagnostic investigations leads to successful treatment in these patients. Computed tomography is highly sensitive in predicting both peritoneal penetration and intra-abdominal visceral injuries.

  14. Clinical importance of the drug interaction between statins and CYP3A4 inhibitors: a retrospective cohort study in The Health Improvement Network

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    Rowan, Christopher G.; Brunelli, Steven M.; Munson, Jeffrey; Flory, James; Reese, Peter P.; Hennessy, Sean; Lewis, James; Mines, Daniel; Barrett, Jeffrey S.; Bilker, Warren; Strom, Brian L.

    2014-01-01

    Objective To compare the relative hazard of muscle toxicity, renal dysfunction, and hepatic dysfunction associated with the drug interaction between statins and concomitant medications that inhibit the CYP3A4 isoenzyme. Background Although statins provide important clinical benefits related to mitigating the risk of cardiovascular events, this class of medications also has the potential for severe adverse reactions. The risk for adverse events may be potentiated by concomitant use of medications that interfere with statin metabolism. Methods Data from The Health Improvement Network (THIN) from 1990 to 2008 were used to conduct a retrospective cohort study. Cohorts were created to evaluate each outcome (muscle toxicity, renal dysfunction, and hepatic dysfunction) independently. Each cohort included new statin initiators and compared the relative hazard of the outcome. The interaction ratio (I*R) was the primary contrast of interest. The I*R represents the relative effect of each statin type (statin 3A4 substrate vs. statin non-3A4 substrate) with a CYP3A4 inhibitor, independent of the effect of the statin type without a CYP3A4 inhibitor. We adjusted for confounding variables using the multinomial propensity score. Results The median follow-up time per cohort was 1.5 years. There were 7889 muscle toxicity events among 362 809 patients and 792 665 person-years. The adjusted muscle toxicity I*R was 1.22 (95% confidence interval [CI] = 0.90–1.66). There were 1449 renal dysfunction events among 272,099 patients and 574 584 person-years. The adjusted renal dysfunction I*R was 0.91 (95%CI = 0.58–1.44). There were 1434 hepatic dysfunction events among 367 612 patients and 815 945 person-years. The adjusted hepatic dysfunction I*R was 0.78 (95%CI = 0.45–1.31). Conclusions Overall, this study found no difference in the relative hazard of muscle toxicity, renal dysfunction, or hepatic dysfunction for patients prescribed a statin 3A4 substrate versus a statin non-3A4

  15. Clinical impact and risk stratification of balloon angioplasty for femoropopliteal disease in nitinol stenting era: Retrospective multicenter study using propensity score matching analysis

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    Taketsugu Tsuchiya

    2016-07-01

    Full Text Available Objective: Nitinol stenting could bring the better outcome in endovascular therapy for femoropopliteal disease. However, it might be expected that recent marked advances in both device technology and operator technique had led to improved efficacy of balloon angioplasty even in this segment. The aims of this study were to evaluate the clinical impact of balloon angioplasty for femoropopliteal disease and make risk stratification clear by propensity score matching analysis. Methods: Based on the multicenter retrospective data, 2758 patients (balloon angioplasty: 729 patients and nitinol stenting: 2029 patients, those who underwent endovascular therapy for femoropopliteal disease, were analyzed. Results: The propensity score matching procedure extracted a total of 572 cases per group, and the primary patency rate of balloon angioplasty and nitinol stenting groups after matching was significantly the same (77.2% vs 82.7% at 1 year; 62.2% vs 64.3% at 3 years; 47.8% vs 54.3% at 5 years. In multivariate Cox hazard regression analysis, significant predictors for primary patency were diabetes mellitus, regular dialysis, cilostazol use, chronic total occlusion, and intra-vascular ultra-sonography use. The strategy of balloon angioplasty was not evaluated as a significant predictor for the primary patency. After risk stratification using five items (diabetes mellitus, regular dialysis, no use of intra-vascular ultra-sonography, chronic total occlusion, and no use of cilostazol: the DDICC score, the estimated primary patency rates of each group (low, DDICC score 0–2; moderate, DDICC score 3; high risk, DDICC score 4–5 were 88.6%, 78.3%, and 63.5% at 1 year; 75.2%, 60.7%, and 39.8% at 3 years; and 66.0%, 47.1%, and 26.3% at 5 years (p < 0.0001. The primary patency rate of balloon angioplasty and nitinol stenting groups was significantly the same in each risk stratification. Conclusion: This study suggests that balloon angioplasty does

  16. Pre-dementia clinical stages in presenilin 1 E280A familial early-onset Alzheimer's disease: a retrospective cohort study.

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    Acosta-Baena, Natalia; Sepulveda-Falla, Diego; Lopera-Gómez, Carlos Mario; Jaramillo-Elorza, Mario César; Moreno, Sonia; Aguirre-Acevedo, Daniel Camilo; Saldarriaga, Amanda; Lopera, Francisco

    2011-03-01

    Mild cognitive impairment (MCI) and pre-MCI have been proposed as stages preceding Alzheimer's disease (AD) dementia. We assessed descendants of individuals with a mutation in presenilin 1 (PSEN1) that causes familial AD, with the aim of identifying distinct stages of clinical progression to AD dementia. We retrospectively studied a cohort of descendants of carriers of the PSEN1 E280A mutation. Pre-dementia cognitive impairment was defined by a score 2 SD away from normal values in objective cognitive tests, and was subdivided as follows: asymptomatic pre-MCI was defined by an absence of memory complaints and no effect on activities of daily living; symptomatic pre-MCI was defined by a score on the subjective memory complaints checklist higher than the mean and no effect on activities of daily living; and MCI was defined by a score on the subjective memory complaints checklist higher than the mean, with no effect on basic activities of daily living and little or no effect on complex daily activities. Dementia was defined according to the diagnostic and statistical manual of mental disorders, fourth edition. Reference mean scores were those of participants who did not carry the PSEN1 E280A mutation. We used the Turnbull survival analysis method to identify ages at onset of each stage of the disease. We measured the time from birth until onset of the three pre-dementia stages, dementia, and death, and assessed decline in cognitive domains for each stage. Follow-up was from Jan 1, 1995, to Jan 27, 2010. 1784 patients were initially identified, 449 of whom were PSEN1 E280A carriers who had complete clinical follow-up. Median age at onset was 35 years (95% CI 30-36) for asymptomatic pre-MCI, 38 years (37-40) for symptomatic pre-MCI, 44 years (43-45) for MCI, and 49 years (49-50) for dementia. The median age at death was 59 years (95% CI 58-61). The median time of progression from asymptomatic to symptomatic pre-MCI was 4 years (95% CI 2-8), from symptomatic pre-MCI to

  17. Clinical importance of cine-MRI assessment of small bowel motility in patients with chronic intestinal pseudo-obstruction: a retrospective study of 33 patients.

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    Fuyuki, Akiko; Ohkubo, Hidenori; Higurashi, Takuma; Iida, Hiroshi; Inoh, Yumi; Inamori, Masahiko; Nakajima, Atsushi

    2017-05-01

    Although chronic intestinal pseudo-obstruction (CIPO) is a rare and extremely severe functional digestive disorder, its clinical course and severity show various patterns. We assessed small bowel peristalsis in CIPO patients using cine-MRI (video-motion MRI) and their clinical characteristics to evaluate the clinical importance of performing cine-MRI in patients with this intractable disease. The medical records of 131 patients referred to our institution with a suspected diagnosis of CIPO between 2010 and 2015 were retrospectively evaluated. Thirty-three patients (22 female/11 male; age range 16-79 years) who met the criteria for CIPO and underwent cine-MRI were enrolled. Mean luminal diameter (MLD), contraction ratio (CR), and contraction cycle (CC) were determined and compared with these parameters in healthy volunteers. Clinical outcomes in patients with CIPO were also evaluated. The median follow-up time was 25.2 months (range, 1-65 months). Of the 33 patients with CIPO, 23 (70 %) showed apparently disturbed small intestinal peristalsis, whereas 10 (30 %) did not. The percentage of patients requiring intravenous alimentation was significantly higher (p = 0.03), and the mean serum albumin level was significantly lower (p = 0.04), in patients with than without impaired small intestinal peristalsis. Although both cine-MRI and CT findings in the latter ten cases were within the normal range, MLD and CR differed significantly from healthy volunteers. Cine-MRI is useful in predicting severe clinical features in patients with CIPO, and in detecting slightly impaired small contractility that cannot be detected on CT.

  18. Radiographic analysis of ameloblastoma: a retrospective study.

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    More, Chandramani; Tailor, Mansi; Patel, Hetul J; Asrani, Mukesh; Thakkar, Krushna; Adalja, Chhaya

    2012-01-01

    Ameloblastoma is benign odontogenic tumor, usually affecting the posterior region of mandible. It is seen in the third to fifth decades of life. Radiographically the lesion is variable in appearance and may be unilocular or multilocular, with well-defined cortical borders in the mandible and ill-defined margins in the maxilla. To analyze cases of ameloblastoma, with emphasis on the radiographic findings. We also review the current literature briefly and discuss the clinical and radiographic findings. The present hospital-based retrospective study was conducted by reviewing the clinical and radiographic records of ameloblastoma cases from 2009 to 2011, available in the archives of the department. The data of a total of 14 patients were analyzed. We observed that the patients affected with ameloblastoma were in the age-group of 19-68 years. The male: female ratio was 1.3:1. The mandible (78.57%) was more commonly affected than the maxilla (14.28%). Six patients (42.86%) had unilateral involvement and eight cases (57.14%) had bilateral involvement. The multilocular and unilocular types of ameloblastoma were noted in 12 (85.72%) and 2 cases (14.28%), respectively. The soap-bubble (50.00%), spider-web (21.43%), and honeycomb (14.28%) appearances were seen in the multilocular variety. Root resorption of variable degree was distinctly observed in 11 cases (78.57%). Radiographs are an important aid for the diagnosis of oral lesions of various types, especially those that involve bone. It is important for the practicing clinicians to know the salient features of ameloblastoma which are peculiar to the local population.

  19. Childhood Maltreatment in South Korea: Retrospective Study

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    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…

  20. Mesiodens: a retrospective study of fifty teeth.

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    Roychoudhury, A; Gupta, Y; Parkash, H

    2000-12-01

    A retrospective study of 30 cases of mesiodens is presented. male preponderance of 1.5:1. was 64% mesiodens were impacted and 36% erupted. Inverted impacted mesiodens was seen in 62.5% of the impacted mesiodens. 66.6% cases had 2 mesiodens per case. The harmful effects on the dentition were mostly crowding, rotation, diastema and impacted permanent incisor.

  1. Incidence of surgery related to problems with peri-implantitis: a retrospective study on patients followed up between 2003 and 2010 at one specialist clinic.

    Science.gov (United States)

    Jemt, Torsten; Gyzander, Victoria; Britse, Anna Örnhall

    2015-04-01

    Little knowledge is available on incidence of patients treated for peri-implantitis problems in routine follow-up protocols. The aim was to report the incidence, and clinical and radiographic characteristics related to routine follow-up patients who are surgically treated for peri-implantitis problems during 8 years of inclusion. Patients with a history of peri-implantitis surgery were identified from patients examined on routine basis at one clinic (Brånemark clinic) between January 2003 and December 2010. Data on included patients were retrospectively retrieved and reported from dental records and radiographs. On an average, 1,294 patients per year (SD 96) were followed up during inclusion period. Altogether, 134 patients had surgery related to peri-implantitis problems, corresponding to an average of 1.2% of followed-up patients per year. No prosthesis was completely lost, but altogether, 37 implants (6% of included implants) were removed in 34 patients (25%) during these surgical interventions. Peri-implantitis surgery was observed more often in the edentulous upper jaw (p implant surfaces. Incidence of peri-implantitis surgery was on an average 1.2% of followed-up patients per year during an 8 years period of inclusion. As no data were available on patient compliance, it could be assumed that the result may underscore the clinical need. Significantly, more edentulous upper jaws were included compared with other treated jaw situations. Data also indicated that the need for surgery may increase by time of follow-up, but no significant differences were observed between patients provided with machined and medium-rough implant surfaces. © 2013 Wiley Periodicals, Inc.

  2. Thrombocytosis: a retrospective study of 165 dogs.

    Science.gov (United States)

    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

  3. [A retrospective controlled clinical study of single-incision plus one port laparoscopic surgery for sigmoid colon and upper rectal cancer].

    Science.gov (United States)

    Li, G X; Li, J M; Wang, Y N; Deng, H J; Mou, T Y; Liu, H

    2017-07-01

    Objective: To evaluate the short-term and oncologic outcomes of single-incision plus one port laparoscopic surgery (SILS+ 1) for sigmoid colon and upper rectal cancer. Methods: The clinic data of 46 patients with sigmoid colon and upper rectal cancer underwent SILS+ 1 at Department of General Surgery, Nanfang Hospital, Southern Medical University from September 2013 to September 2014 were retrospectively reviewed (SILS+ 1 group). After generating 1∶1 ration propensity scores given the covariates of age, gender, body mass index, American Society of Anesthesiologists score, surgeons, tumor location, the distance of tumor from anal, tumor diameter, and pathologic TNM stage, 46 patients with sigmoid colon and upper rectal cancer underwent conventional laparoscopic surgery (CLS) in the same time were matched as CLS group. The baseline characteristics and short-term outcomes were compared using t test, χ(2) test or Wilcoxon signed ranks test. Kaplan-Meier survival curves and Log-rank tests demonstrated the distribution of disease free survival. Results: The two study groups were well balanced with respect to the baseline characteristics of the propensity score derivation model. As compared to the CLS group, patients in SILS+ 1 group had a smaller incision ((6.9±1.1) cm vs. (8.4±1.2) cm, t=6.502, P=0.000), less estimated blood loss (20(11) ml vs. 50(30) ml, Z=2.414, P=0.016), shorter intracorporeal operating time ((67.0±25.8) minutes vs. (75.5±27.7) minutes, t=2.062, P=0.042) and significantly faster recovery course including shorter time to first ambulation ((46.7±20.3) hours vs. (78.6±28.0) hours, t=6.255, P=0.000), shorter time to first oral diet ((64.7±28.8) hours vs. (77.1±30.0) hours, t=2.026, P=0.047), shorter time of postoperative hospital stay ((7.8±2.2) days vs. (6.5±2.2) days, t=2.680, P=0.009), and lower postoperative visual analogue scale scores (F=4.721, P=0.032). No significant difference was observed in total operating time, postoperative

  4. Clinical Features, Morbidity, and Risk Factors of Intestinal Pseudo-obstruction in Systemic Lupus Erythematosus: A Retrospective Case-control Study.

    Science.gov (United States)

    Zhang, Lingling; Xu, Dong; Yang, Hong; Tian, Xinping; Wang, Qian; Hou, Yong; Gao, Na; Zhang, Li; Li, Mengtao; Zeng, Xiaofeng

    2016-03-01

    To analyze the epidemiology, clinical characteristics, and risk factors for systemic lupus erythematosus-related intestinal pseudo-obstruction (SLE-IPO). We retrospectively examined 85 patients with SLE with IPO as the case group and 255 randomly matched patients with SLE without any gastrointestinal manifestations as the control group, out of 4331 inpatients at the Peking Union Medical College Hospital (PUMCH) from 2003 to 2014. Over the last 11 years at PUMCH, the prevalence of IPO in patients with SLE was 1.96% and the in-hospital fatality rate was 7.1%. Of these patients, 57.6% presented with IPO as the initial affected system of SLE, and the rate of misdiagnosis was about 78%. Pyeloureterectasis was the most common complication (58.9%) in patients with SLE-IPO and the incidence of biliary tract dilation was 7.1%. Patients with SLE with IPO were always diagnosed at an earlier stage of SLE with a higher frequency of hematological disturbance, polyserositis, and hypocomplementemia. Pyeloureterectasis, hypocomplementemia, and elevated C-reactive protein levels in serum were independent risk factors for IPO in SLE disease. Patients with SLE-IPO with long IPO duration and those diagnosed during late stages of SLE or concurrent with pyeloureterectasis and megacholedochus always had an unfavorable outcome. IPO is a rare complication, but commonly presents as the initial affected system of SLE, which can lead to a difficult diagnosis and delayed treatment. SLE-IPO occurrence concomitantly with pyeloureterectasis and megacholedochus showed a severe clinical situation in our cohort. Thus, patients with SLE-IPO with systemic smooth muscular involvement should be diagnosed early and treated aggressively.

  5. Retrospective analysis of idiopathic scoliosis medical records coming from one out-patient clinic for compatibility with Scoliosis Research Society criteria for brace treatment studies

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    Krzysztof Korbel

    2016-10-01

    Full Text Available Abstract Background First author attempted to analyse medical records of patients with idiopathic scoliosis for compliance with the Scoliosis Research Society brace studies criteria. A retrospective analysis of medical records of 2705 girls treated from 1989 to 2002 was carried out. Methods Age, Cobb, Risser and menarchal status were analyzed for compliance with the Scoliosis Research Society brace studies criteria: a age ≥10 years, b Risser 0–2, c 25–40° Cobb angle, d no earlier treatment, e patients before first menses or not more than one year from first menses. Results It has been found that 183 girls out of 2705 were ≥10 years old and in the range 25–40° Cobb angle. One hundred two out of 2705 patients revealed eligible for brace effectiveness study according to SRS 2005 criteria. 120 out of 2705 patients revealed eligible for brace brace effectiveness study according to SRS-SOSORT 2014 criteria. Conclusion The excluded patients revealed too old or with too significant Cobb angles. This indicates the changing criteria for scoliosis brace treatment over the time. Direct comparison of current results of brace treatment with historical series of cases turns out to be very difficult.

  6. Lateral periodontal cysts: a retrospective study of 11 cases

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    Formoso Senande, María Florencia; Barbosa de Figueiredo, Rui Pedro; Berini Aytés, Leonardo; Gay Escoda, Cosme

    2008-01-01

    Objective: To describe the clinical, radiological and histopathological features of lateral periodontal cysts among patients diagnosed in different centers (Vall d"Hebron General Hospital, Granollers General Hospital, the Teknon Medical Center, and the Master of Oral Surgery and Implantology of the University of Barcelona Dental School; Barcelona, Spain). Study design: A retrospective observational study was made of 11 lateral periodontal cysts, all of which were diagnosed following a thoroug...

  7. Long-term clinical outcome in patients with stage-i nonseminomatous germ cell cancer: a critical review of own treatment modalities in a retrospective study

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    Sandra Seseke

    2008-12-01

    Full Text Available PURPOSE: The optimal management of patients with clinical stage I non-seminomatous germ cell testicular cancer (NSGCT I was considered controversial until the European Germ Cell Cancer Consensus Group determined unambiguous treatment strategies. In order to assess the long-term outcome we evaluated the data of patients with NSGCT I. MATERIALS AND METHODS: In a retrospective evaluation, we included 52 patients with a mean age of 26 years (range 15-58 who were treated with different modalities at our department between 1989 and 2003. Mean follow-up was 5.9 years (range 2-14 years. After orchiectomy, 39 patients were treated with chemotherapy, 7 patients underwent retroperitoneal lymph node dissection and 6 men were managed using a surveillance strategy. Survival, recurrence rate and time of recurrence were evaluated. The histological staging and treatment modality was related to the relapse. RESULTS: Tumor specific overall mortality was 3.8%. The mortality and relapse rate of the surveillance strategy, retroperitoneal lymph node dissection and chemotherapy was 16.7% / 50%, 14.3% / 14.3% and 0% / 2.5% respectively. All relapsed patients in the surveillance group as well as in the RPLND group had at least one risk factor for developing metastatic disease. CONCLUSIONS: Following the European consensus on diagnosis and treatment of germ cell cancer in patients with NSGCT Stage I any treatment decision must be individually related to the patient according to prognostic factors and care capacity of the treating centre. In case of doubt, adjuvant chemotherapy should be the treatment of choice, as it provides the lowest risk of relapse or tumor related death.

  8. Utility of Clinical Risk Stratification in the Selection of Muscle-Invasive Bladder Cancer Patients for Neoadjuvant Chemotherapy: A Retrospective Cohort Study

    Science.gov (United States)

    von Rundstedt, Friedrich-Carl; Mata, Douglas A.; Kryvenko, Oleksandr N.; Shah, Anup A.; Jhun, Iny; Lerner, Seth P.

    2016-01-01

    Introduction: Level I evidence supports the use of cisplatin-based neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer prior to radical cystectomy (RC). On average, 30–40% of patients achieve a complete pathologic response (i.e., stage pT0) after receiving NAC. Some centers risk-stratify patients, suggesting that there may be a higher-risk population that would derive the most benefit from NAC. Recently, a risk-stratification model developed at M.D. Anderson Cancer Center (MDACC) specified criteria for clinical staging and patient selection for NAC. We applied this model to our own RC patient cohort and evaluated our own experience with clinical risk stratification and the effect of NAC on post treatment risk categories. Methods: We retrospectively reviewed the charts of consecutive patients who underwent RC at two institutions between 2004 and 2014 and noted whether or not they received NAC. We determined the clinical stage by reviewing the exam under anesthesia, transurethral resection biopsy (TURBT) pathology, and preoperative imaging. Patients with cT2-T4a node-negative disease were included. Those with sarcomatoid features or adenocarcinoma were excluded. Patients were classified as high risk if they had tumor-associated hydronephrosis, clinical stage≥T3b-T4a disease, variant histology (i.e., micropapillary or small cell), or lymphovascular invasion (LVI), as specified by the MDACC model. Variables were examined for associations with cancer-specific survival (CSS), overall survival (OS), and risk-category reclassification. Results: We identified 166 patients with a median follow-up time of 22.2 months. In all, 117 patients (70.5%) did not receive NAC, 68 (58.1%) of whom we classified as high risk. Among patients not receiving NAC, CSS and OS were significantly decreased in high-risk patients (log-rank test p = 0.01 for both comparisons). The estimated age-adjusted hazard ratios of high-risk classification for cancer-specific and overall

  9. Clinical analysis of 61 systemic lupus erythematosus patients with intestinal pseudo-obstruction and/or ureterohydronephrosis: a retrospective observational study.

    Science.gov (United States)

    Xu, Na; Zhao, Jiuliang; Liu, Jinjing; Wu, Di; Zhao, Lidan; Wang, Qian; Hou, Yong; Li, Mengtao; Zhang, Wen; Zeng, Xuejun; Fang, Weigang; Huang, Xiaoming; Zhang, Xuan; Tian, Xinping; Zhao, Yan; Zeng, Xiaofeng; Zhang, Fengchun

    2015-01-01

    The objective of this article is to investigate the clinical features of intestinal pseudo-obstruction (IPO) and/or ureterohydronephrosis in systemic lupus erythematosus (SLE). Sixty-one SLE patients with IPO and/or ureterohydronephrosis were analyzed retrospectively. A total of 183 cases were randomly selected as controls from 3840 SLE inpatients without IPO and ureterohydronephrosis during the same period. Patients were assigned to 1 of the 3 groups (SLE with IPO and ureterohydronephrosis, SLE with IPO, and SLE with ureterohydronephrosis). The clinical characteristics, treatments, and prognosis were compared between the 3 groups. There were 57 females and 4 males, with a mean age of 32.0 years. IPO was the initial manifestation of SLE in 49.1% of the cases, whereas ureterohydronephrosis in 32.5%. All patients were initially treated with a high-dose steroid. Thirty-one of these patients (50.8%) also received intravenous methylprednisolone pulse therapy. Two patients died of bowel perforation and lupus encephalopathy, and the other 59 patients (96.7%) achieved remission after treatment. The incidences of fever, glomerulonephritis, nervous system involvement, serositis, erythrocyte sedimentation rate elevation, hypoalbuminemia, hypocomplementemia, and anti-SSA antibody positivity were significantly higher in patients with IPO and/or ureterohydronephrosis than in the control group (without IPO and ureterohydronephrosis). Also, patients with IPO and/or ureterohydronephrosis had higher SLE Disease Activity Index scores than control patients. Compared with SLE patients with IPO, the patients with IPO and ureterohydronephrosis had a significantly higher incidence of gallbladder wall thickening, biliary tract dilatation, and serositis, whereas the patients with ureterohydronephrosis had less mucocutaneous involvement and serositis. Eight of the 47 IPO patients who initially responded well to immunotherapy relapsed; however, all responded well to retreatment with adequate

  10. Retrospective Analysis of Discrepancies between Clinical and Histopathological Diagnoses in Head and Neck Lesions: An Institutional Study with 10 Years Database

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    Ketki P Kalele

    2016-01-01

    Full Text Available Introduction: Oral and maxillofacial lesions present a wide spectrum of clinical manifestations ranging from an asympto - matic small lesion to a large destructive one. Several lesions mimic each other in their clinical presentation posing a diag - nostic dilemma. Due to interoperator subjectivity and lack of defined objective diagnostic criteria, histopathological investi - gation, most of the times, plays a vital role in final diagnosis. Many studies have reported the concordance rates among the clinical and histopathological diagnoses of oral lesions, however, there are very few studies which have highlighted the discrepancies in them that have led to drastic changes in the lines of diagnoses and treatment. This institutional retro - spective descriptive study intended to highlight this lacuna by going through histopathological registry to study such cases with discrepancies in clinical and histopathological diagnoses in last 10 years. The aim of this study was to systematically analyze the discrepancies in clinical and histopathological diagnoses of various oral lesions with an emphasis on malig - nant and nonmalignant groups so as to stress the importance of histopathological examination to ultimately minimize the risk of inadvertent inappropriate treatment. Materials and methods: A total of 1570 cases that were reported to our institute over a period of 10 years were evaluated from the histopathology registry. Out of these, 1300 cases met our inclusion criteria. Discrepancies were charted as major and minor discrepancies and discrepancy indices were calculated. Lesions were divided into malignan t and nonmalignant groups and were subjected to d i agnostic-screening test evaluation to assess the discrepancies. Results: Total discrepancy value (discrepancy index obtained was 12.9%, out of which 9.23% showed major discrepancies and 3.69% showed minor discrepancies. Ninety-five percent confidence interval (CI was calculated, and was found in

  11. The prevalance of patients according to angle classifıcation that came to our our clinic with orthodontic treatment needs(a retrospective study

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    Seher Gündüz Arslan

    2003-03-01

    Full Text Available The aim of this study is, to classify the patients according to Angle classification that came to our clinic with orthodontic treatment needs.Our study consists of patients that came to our clinic between 13.04.1999 and 21.04.2003. Their ages are between 7 and 25. 1310 male and 987 female totally 2297 patients were classified into three groups which were Class I, Class II and Class III according to Angle classification. Among 2297 individuals that were taken into consideration 1100 individual were Class I, 887 individual were Class II and 310 individual were Class III. Subgroups of these individuals were classified according to their ages and sexes.In this respective study which comprise our regional individuals have shown that Angle Class I discrepancy were find more than the other anomalies. According to sex Angle Calss I anomalies were find 11-15 years old womens more than the other ages.

  12. A retrospective study of the clinical hematology and the serum biochemistry tests made on canine dirofilariasis cases in an animal hospital population in Bangkok, Thailand.

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    Niwetpathomwat, Anuchai; Kaewthamasorn, Morakot; Tiawsirisup, Sonthaya; Techangamsuwan, Somporn; Suvarnvibhaja, Siram

    2007-06-01

    Heartworm disease, caused by the filarial nematode, Dirofilaria immitis, is a major, potentially life-threatening disease of dogs, with worldwide distribution and global significance. It is not only of veterinary importance but it also has zoonotic potential in many regions. It is considered as an endemic disease in Thailand, although clinical data about the disease is rarely reported. The objectives of this study were to characterize the clinical hematology and the biochemistry of canine dirofilariasis cases admitted to Chulalongkorn University, Small Animal Teaching Hospital in Bangkok, Thailand, from 2001-2003. All hematology and serum biochemistry parameter interpretations were based on reference values. A total of 1023 dogs were evaluated in this study. Dogs were divided into three groups based on their heartworm classification (microfilaremic, occult and negative). The major hematological findings in microfilaremic dogs were a mild to moderate anemia, mild to severe thrombocytopenia, marked leukocytosis, moderate to marked neutrophilia, eosinophilia and monocytosis. The most common serum biochemical abnormalities in microfilaremic dogs included increased alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase with a mean+/-SD of 311+/-299, 82+/-76 and 50+/-38 IU/L, respectively. It is likely that this parasitic infection led to the impairment of the hematological and biochemical status of the infected dogs. We believe that investigation of these laboratory based parameters, when associated with the clinical signs, is a very important approach to be considered in the routine clinical follow up, as well as being important for therapeutic evaluations.

  13. Clinical features of clear cell meningioma: a retrospective study of 36 cases among 10,529 patients in a single institution.

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    Li, Peng; Yang, Zhijun; Wang, Zhenmin; Zhou, Qiangyi; Li, Shiwei; Wang, Xingchao; Wang, Bo; Zhao, Fu; Liu, Pinan

    2016-01-01

    Clear cell meningioma (CCM) is a rare subtype of meningioma. We present the largest series of 36 CCMs and evaluate several prognostic factors of patient's clinical outcome. Thirty-six patients with pathologically confirmed CCM among a total of 10,529 meningioma patients were retrospectively reviewed. CCM constituted 0.3 % of the intracranial meningiomas and 1.4 % of the intraspinal meningiomas. The male-to-female ratio (36 vs 64 %) for CCMs was similar to that for total meningiomas (28 vs 72 %) patients (chi-squared test, p = 0.3). The mean age at diagnosis of CCM patients (29.3 ± 18.4 years) was significantly younger than that of total meningiomas (49.8 ± 11.9 years) patients (t-test, p = 0). During the follow-up, 15 patients (42 %) suffered from tumor recurrence. The recurrence time ranged from 10 months to 12 years, with a median time of 29 months. Kaplan-Meier survival analysis showed that patients after total resection (Simpson grades I and II) had significantly longer progression-free survival (PFS) time than those after subtotal resection (Simpson grades III and IV) (log-rank test, p = 0.006). However, age (≤20 years or >20 years, p = 0.9), gender (p = 0.3), postoperative radiotherapy (p = 0.4), progesterone receptor staining (positivity or negativity, p = 0.2), and Ki-67 index (≤5 % or >5 %, p = 0.4) did not have significant effects on patients' PFS time. The proportion of CCM in spinal meningiomas is likely to be much larger than that in intracranial meningiomas. CCMs should be resected totally when possible to decrease the risk of recurrence or prolong patient's PFS time.

  14. Overview of Implant Infections in Orthopaedics Department: Retrospective Study

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    Tugrul Bulut

    2014-12-01

    Full Text Available In this study, our aim was to evaluate the antibiotic susceptibility of bacteria isolated from orthopedic implant infections. Within two years operated 1996 patients in an orthopedics and traumatology clinic were retrospectively investigated. Seventy-six (76/1996, 3.8% orthopedic implant infections were detected. Isolated bacteria and their antibiotic susceptibility patterns were analyzed. The bacteries isolated from implant related infections and antibiotic sensitivity patterns were evaluated retrospectively in our orthopaedics and traumatology clinic. Staphylococcus aureus was the predominant organism (30.3%. Gram negative bacterias were isolated in 65.8% of our patients. No resistance was determined against vancomycin and linezolid in gram positive bacterias. Imipenem, amicasin and cefepim was seen as the most effective antibiotics for gram negative bacterias.

  15. Retrospective Clinical Analysis of 38 Cases of Pulmonary Embolism

    Institute of Scientific and Technical Information of China (English)

    Ruiyun Liang; Wei Zhang; Wei Wu; Shanping Jiang; Zhiqiang Lü

    2007-01-01

    To investigate the clinical feature of acute pulmonary embolism.Methods Retrospective clinical analysis was performed according to the data of 38 cases of pulmonary embolism.Results There were ground diseases and predisposing factors in 36 cases of pulmonary embolism among 38 cases,the ratio was 94.7 %,among the total predisposing factors,tumor,cardiovascular disease,venous thrombosis of lower extremity,smoking and long-term bed were common.There was no specificity in clinical feature,physical sign and rout chest X ray,electrocardiography,and their appearances were diversified.There were specificity and sensitivity in echocardiogram (UCG) and D-dimer to some extent.But,the final diagnosis must depend on some special examinations,such as selective pulmonary arteriography,CTPA,MRA and so on.Conclusions The special examinations must be done to make a definite diagnosis to confirm pulmonary embolism when the high risk factors and ground diseases are existing.It is necessary to some cases when the clinical feature can not be explained by other diseases.

  16. Incidence, risk factors and clinical outcomes of acute kidney injury associated with scrub typhus: a retrospective study of 510 consecutive patients in South Korea (2001–2013)

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    Hwang, Kyungo; Jang, Ha Nee; Lee, Tae Won; Cho, Hyun Seop; Bae, Eunjin; Chang, Se-Ho; Park, Dong Jun

    2017-01-01

    Objectives Renal involvement in scrub typhus ranges from simple urinary abnormalities to acute kidney injury (AKI) leading to death. This study evaluated the incidence, predictors and prognosis of AKI associated with scrub typhus according to the RIFLE (risk, injury, failure, loss, end-stage kidney disease) criteria. Methods We retrospectively evaluated the medical records of patients diagnosed with scrub typhus from January 2001 to November 2013 in Gyeongsang National University Hospital. Results During the study period, 510 patients were diagnosed with scrub typhus and the incidence of AKI was 35.9%. There were 132 (25.9%) patients at risk, 37 (7.3%) with injury and 14 (2.7%) with failure. In comparison with the non-AKI group, the AKI group was older (73.9 vs 63.4 years, pIntensive care unit admission and death were more frequent in the AKI group. The renal function of most patients with AKI recovered without sequelae, except for 1 patient who had underlying CKD. Multivariate analysis showed that age, presence of CKD, serum albumin level and time to hospital presentation after symptom onset were independent predictors of AKI in patients with scrub typhus. Conclusions Our current results suggest that the presence of underlying CKD, older age, lower serum albumin level and time to hospital presentation after symptom onset were important risk factors to determine occurrence of AKI. Whether earlier diagnosis and treatment in patients with the above risk factors reduce the incidence and severity of AKI deserves to be investigated. PMID:28298367

  17. Clinical risk factors for life-threatening lower respiratory tract infections in children: a retrospective study in an urban city in Malaysia.

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    Anna Marie Nathan

    Full Text Available AIM: Lower respiratory tract infections (LRTIs are an important cause of morbidity and mortality, especially in low income countries. The aim of this study was to determine risk factors of life-threatening LRTIs in hospitalised children in Malaysia. METHODS: This retrospective study included children aged less than 18 years admitted for LRTIs over 13 months in a tertiary referral centre in Kuala Lumpur, Malaysia. Neonates, children with asthma and those with either no or a normal chest radiograph were excluded. Life-threatening infection was defined as that needing non-invasive ventilation or admission to the paediatric intensive care unit. Routine blood investigations and nasopharyngeal secretion results (bacterial and viral were obtained. Chest radiographs were reviewed by a designated radiologist. Environmental data (rainfall, particulate matter ≤ 10 µm [PM10] and air pollution index [API] was obtained from the respective government departments. RESULTS: Three hundred and ninety-one episodes of LRTIs were included. Viruses were implicated in 48.5% of LRTIs, with respiratory syncytial virus (RSV being detected in 44% of viral LRTIs. Forty-six (11.8% children had life-threatening disease and the overall mortality rate was 1.3% (5 children. RSV was detected in 26% of children with life-threatening LRTIs. In multivariate logistic regression, chronic lung disease, presenting history of apnoea and signs of hypoxia, was associated with life threatening LRTIs. Increased LRTI admissions were associated with low rainfall but not PM10 nor API. Of those on follow-up, 39% had persistent respiratory symptoms. CONCLUSION: One in nine children admitted with LRTI had a life-threatening LRTI. The aetiology was viral in almost half of admitted children. RSV was detected in a quarter of children with life-threatening LRTIs. Children who present with LRTIs and either have chronic lung disease, presenting history of apnoea or signs of hypoxia, should be

  18. 32例严重尿脓毒血症的临床分析%A Retrospective Clinical Study of 32 Severe Urosepsis Patients

    Institute of Scientific and Technical Information of China (English)

    朱鑫

    2016-01-01

    目的:探讨严重尿脓毒血症患者的临床特点,为早期发现、及时诊治尿脓毒血症提供策略。方法回顾性分析我院2011年3月~2016年8月收治并确诊为严重尿脓毒血症患者的临床资料,分析尿脓毒血症发生原因并比较不同干预时机、不同治疗方案对患者预后的影响。结果共计32例严重尿脓毒血症患者纳入本项研究,其中男性8例,女性24例,平均年龄47岁。病因包括上尿路结石24例、肾脓肿2例、气肿性肾盂肾炎2例及肿瘤化疗术后继发复杂性尿路感染4例。24例上尿路结石患者中,20例患者术前明确诊断为严重尿脓毒血症而行外科引流,其中13例行患侧输尿管支架置入术,成功率为53.8%,7例直接行经皮肾穿刺造瘘术,成功率71.4%。结论尿脓毒症状仍是不容忽视的危重症,在临床工作中,既要及时有效并有效处理尿脓毒血症,又要求在围手术期警惕该危重症的发生。%Objective To evaluate clinical charateristics of severe urosepsis patients in a retrospetive analysis and to provide strategies for effective diagnosis and therapy of urosepsis. Methods We assessed retrospectively all patients who were diagnosed as severe urosepsis in our hospital between March 2011 and August 2016 . Results In 32 patients with severe urosepsis (24 women and 8 men; mean age 47 years) , Patient characteristics and therapeutic interventions were were evaluated. The pathological mechanism leading to severe urosepsis included 24 cases of upper urinary stone,2 cases of renal abscess,2 cases of emphysematous pyelonephritis, and 4 cases of complicated urinary infection secondary to chemotherapy for urological cancer. In 20 cases of upper urinary stone who were diagnosed as severe urosepsis pre-operatively, 13 patients recieved ureteric stent with a success rate of 53.8% and ultrasound-guided percutaneous nephrostomy were performed in 7 cases with a success rate of 71

  19. Does plate type influence the clinical outcomes and implant removal in midclavicular fractures fixed with 2.7-mm anteroinferior plates? A retrospective cohort study.

    Science.gov (United States)

    Gilde, Alex K; Jones, Clifford B; Sietsema, Debra L; Hoffmann, Martin F

    2014-07-04

    The purpose of this study was to evaluate surgical healing rates, implant failure, implant removal, and the need for surgical revision with regards to plate type in midshaft clavicle fractures fixed with 2.7-mm anteroinferior plates utilizing modern plating techniques. This retrospective exploratory cohort review took place at a level I teaching trauma center and a single large private practice office. A total of 155 skeletally mature individuals with 156 midshaft clavicle fractures between March 2002 and March 2012 were included in the final results. Fractures were identified by mechanism of injury and classified based on OTA/AO criteria. All fractures were fixed with 2.7-mm anteroinferior plates. Primary outcome measurements included implant failure, malunion, nonunion, and implant removal. Secondary outcome measurements included pain with the visual analog scale and range of motion. Statistically significant testing was set at 0.05, and testing was performed using chi-square, Fisher's exact, Mann-Whitney U, and Kruskall-Wallis. Implant failure occurred more often in reconstruction plates as compared to dynamic compression plates (p = 0.029). Malunions and nonunions occurred more often in fractures fixed with reconstruction plates as compared to dynamic compression plates, but it was not statistically significant. Implant removal attributed to irritation or implant prominence was observed in 14 patients. Statistically significant levels of pain were seen in patients requiring implant removal (p = 0.001) but were not associated with the plate type. Anteroinferior clavicular fracture fixation with 2.7-mm dynamic compression plates results in excellent healing rates with low removal rates in accordance with the published literature. Given higher rates of failure, 2.7-mm reconstruction plates should be discouraged in comparison to stiffer and more reliable 2.7-mm dynamic compression plates.

  20. Progression and regression of cervical pap test lesions in an urban AIDS clinic in the combined antiretroviral therapy era: a longitudinal, retrospective study.

    Science.gov (United States)

    Lofgren, Sarah M; Tadros, Talaat; Herring-Bailey, Gina; Birdsong, George; Mosunjac, Marina; Flowers, Lisa; Nguyen, Minh Ly

    2015-05-01

    Our objective was to evaluate the progression and regression of cervical dysplasia in human immunodeficiency virus (HIV)-positive women during the late antiretroviral era. Risk factors as well as outcomes after treatment of cancerous or precancerous lesions were examined. This is a longitudinal retrospective review of cervical Pap tests performed on HIV-infected women with an intact cervix between 2004 and 2011. Subjects needed over two Pap tests for at least 2 years of follow-up. Progression was defined as those who developed a squamous intraepithelial lesion (SIL), atypical glandular cells (AGC), had low-grade SIL (LSIL) followed by atypical squamous cells-cannot exclude high-grade SIL (ASC-H) or high-grade SIL (HSIL), or cancer. Regression was defined as an initial SIL with two or more subsequent normal Pap tests. Persistence was defined as having an SIL without progression or regression. High-risk human papillomavirus (HPV) testing started in 2006 on atypical squamous cells of undetermined significance (ASCUS) Pap tests. AGC at enrollment were excluded from progression analysis. Of 1,445 screened, 383 patients had over two Pap tests for a 2-year period. Of those, 309 had an intact cervix. The median age was 40 years and CD4+ cell count was 277 cells/mL. Four had AGC at enrollment. A quarter had persistently normal Pap tests, 64 (31%) regressed, and 50 (24%) progressed. Four developed cancer. The only risk factor associated with progression was CD4 count. In those with treated lesions, 24 (59%) had negative Pap tests at the end of follow-up. More studies are needed to evaluate follow-up strategies of LSIL patients, potentially combined with HPV testing. Guidelines for HIV-seropositive women who are in care, have improved CD4, and have persistently negative Pap tests could likely lengthen the follow-up interval.

  1. Analysis of warning letters issued by the US Food and Drug Administration to clinical investigators, institutional review boards and sponsors: a retrospective study.

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    Shetty, Yashashri C; Saiyed, Aafreen A

    2015-05-01

    The US Food and Drug Administration (FDA) issues warning letters to all research stakeholders if unacceptable deficiencies are found during site visits. Warning letters issued by the FDA between January 2011 and December 2012 to clinical investigators and institutional review boards (IRBs) were reviewed for various violation themes and compared to similar studies in the past. Warning letters issued to sponsors between January 2005 and December 2012 were analysed for the first time for a specific set of violations using descriptive statistics. Failure to protect subject safety and to report adverse events to IRBs was found to be significant compared to prior studies for clinical investigators, while failure to follow standard operating procedures and maintain documentation was noted as significant in warning letters to IRBs. Failure to maintain minutes of meeting and to follow written procedures for continuing review were new substantial violations in warning letters issued to IRBs. Forty-six warning letters were issued to sponsors, the most common violations being failure to follow a monitoring schedule (58.69%), failure to obtain investigator agreement (34.78%), failure to secure investigators' compliance (30.43%), and failure to maintain data records and ship documents to investigators (30.43%). Appropriate methods for handling clinical trial procedural violations should be developed and implemented worldwide.

  2. A retrospective clinical analysis of moderate to severe athletic concussions.

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    Cantu, Robert C; Guskiewicz, Kevin; Register-Mihalik, Johna K

    2010-12-01

    To investigate differences in clinical outcomes on the basis of gender and age after a moderate or severe concussion in a cohort of physically active subjects examined by a single clinician. A descriptive, cross-sectional, retrospective chart review of consecutive patients. Outpatient assessments by a single clinician with expertise in sports concussion. Physically active subjects seen for evaluation after a concussion experienced while participating in sports (N = 194; 215 concussions; age mean ± standard deviation = 19.19 ± 8.53 years) were included. INTERVENTIONS (INDEPENDENT VARIABLES): Intergroup differences and associations were examined by gender, age group (grade for all outcome measures. Separate χ² tests were used to assess associations between gender, age group, and symptom duration group (≤ 7 days, 8-90 days, > 90 days), the presence of depression, the presence of loss of consciousness, altered school or work, and concussion grade. Separate independent samples t-tests was used to examine differences in symptom reporting and time to recovery. No association was observed between gender and any measured characteristics (P > .05). Subjects 18 years or older took longer to recover (315.77 days), compared with younger subjects (91.31 days) (t₂₁₃ = -2.01, P = .049). Older subjects also reported more concussions than did younger ones, 4.33 and 2.37, respectively (t₂₁₃ = -3.77, P < .001). All concussions included in this study were moderate to severe in nature as defined by the Revised Cantu Grading Scale. Contrary to existing literature regarding gender differences in concussion of a lesser severity, no gender differences were observed in this sample. Age differences were observed, with the population of subjects who were 18 years and older experiencing a greater number and duration of concussion symptoms than the younger group. Developing evidence-based return-to-play progressions and rehabilitation strategies in this population is the next

  3. Differences in in-hospital clinical course, management and outcome between stroke with and without atrial fibrillation. A retrospective analysis from the SETI (Studio Epidemiologico Toscano Ictus study

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    P. Biagi

    2013-05-01

    Full Text Available BACKGROUND Stroke in patients with Atrial Fibrillation (AF differs from Not Atrial Fibrillation Strokes (NAFS in severity of onset and outcome but other variables may worsen the clinical scenario. MATERIALS AND METHODS We studied 738 patients (430 females and 308 males, with mean age 78.7 ± 9.9 years (female 81.0 ± 8.9; male 75.2 ± 10.2; p < 0.001 consecutively admitted for stroke to the Internal Medicine Departments of Tuscany in a three months period (March 1 to May 31, 2003 in order to ascertain if the in-hospital burden of Atrial Fibrillation Strokes (AFS was different from that of NAFS. Demographic data, clinical conditions before admission, the mode and timing of hospital admission, clinical presentation, treatment, complications, and outcome and the mode of discharge were examined. RESULTS AFS were 205 (27.8% and NAFS 533 (72.2%. Mean age of AFS was significantly higher (p < 0.001. Heart failure, ischemic heart disease, dilatative cardiomyopaties and chronic renal insufficiency were more prevalent in the AFS. The clinical presentation with a lower (3-6 Glasgow Coma Scale (GCS score (p < 0.01 prevailed in AFS patients. The in-hospital therapy showed a greater use of antiplatelet agents in the NAFS (97.1% vs 63%, p < 0.001 and oral anticoagulants in AFS (11% vs 1.3%, p < 0,001. AFS patients showed much complications, higher degree of disability at discharge and mortality (47 AFS = 23% vs 67 NAFS = 12.8%, p < 0.001. Multivariate analysis confirms that AFS is more serious than NAFS owing to pathogenetic mechanisms: this results in a higher number of complications, a longer hospitalisation and a worse prognosis in terms of survival and disability. This dycothomy begins early as the symptoms start.

  4. A nation-wide multicenter 10-year (1999-2008 retrospective clinical study of endocrine therapy for Chinese females with breast cancer.

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    Can Zhou

    Full Text Available Endocrine therapy (ET is one of the main systemic treatments for patients with breast cancer. To our knowledge, few studies have addressed the performance of ET or relevant influencing factors in cancer treatment in China. By retrospectively analyzing the clinicopathological data on breast cancer collected from representative hospitals of 7 traditional areas in China in one random month from each year between year 1999 and 2008, we found that: 1 The rate of the use of hormone receptor (HR testing was 83.8% (3529/4211, with the estrogen receptor-positive (ER+ rate and/or the progesterone receptor-positive (PR+ rate being 67.9% (2395/3529, and the ER-PR rate being 32.1% (1134/3529. 2 Of the 1599 patients who had received ET, 999 patients (58.3% were premenopausal while 600 (41.7% were postmenopausal; 1598 patients received adjuvant hormonal therapy (AHT, whereas only 1 patient received palliative therapy. The medications mainly administered to patients were anti-estrogen agents (80.3% [1283/1598], followed by AIs (15.5% [248/1598]. Of the 1598 patients receiving AHT, 1416 patients (88.6% were positive for ER and/or PR, while 75 (4.7% were negative for both and 108 patients (6.7% had unknown HR status. The ratio of the use of endocrine therapy for breast cancer patients with ER+ and/or PR+ status was 60.0% (1416/2395. 3 Results from the logistic regression analysis revealed that geography, occupations, and history of chemotherapy and surgery were dependent factors affecting the application of ET in breast cancer treatment in China (P<0.001. In conclusion, the use of ET on Chinese women with breast cancer is increasingly and gradually accounted into the standardized process. Economic status, occupations, and history of chemotherapy and surgery were key factors affecting the application of ET. People residing in developed areas, engaging in mental labour, having history of chemotherapy and surgery are susceptible to accept ET.

  5. Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study

    Science.gov (United States)

    van der Linden, Vanessa; Brainer-Lima, Alessandra Mertens; Coeli, Regina Ramos; Rocha, Maria Angela; Sobral da Silva, Paula; Durce Costa Gomes de Carvalho, Maria; van der Linden, Ana; Cesario de Holanda, Arthur; Valenca, Marcelo Moraes

    2016-01-01

    Objective To report radiological findings observed in computed tomography (CT) and magnetic resonance imaging (MRI) scans of the first cases of congenital infection and microcephaly presumably associated with the Zika virus in the current Brazilian epidemic. Design Retrospective study with a case series. Setting Association for Assistance of Disabled Children (AACD), Pernambuco state, Brazil. Participants 23 children with a diagnosis of congenital infection presumably associated with the Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Types of abnormalities and the radiological pattern of lesions identified on CT and MRI brain scans. Results Six of the 23 children tested positive for IgM antibodies to Zika virus in cerebrospinal fluid. The other 17 children met the protocol criteria for congenital infection presumably associated with the Zika virus, even without being tested for IgM antibodies to the virus—the test was not yet available on a routine basis. Of the 23 children, 15 underwent CT, seven underwent both CT and MRI, and one underwent MRI. Of the 22 children who underwent CT, all had calcifications in the junction between cortical and subcortical white matter, 21 (95%) had malformations of cortical development, 20 (91%) had a decreased brain volume, 19 (86%) had ventriculomegaly, and 11 (50%) had hypoplasia of the cerebellum or brainstem. Of the eight children who underwent MRI, all had calcifications in the junction between cortical and subcortical white matter, malformations of cortical development occurring predominantly in the frontal lobes, and ventriculomegaly. Seven of the eight (88%) children had enlarged cisterna magna, seven (88%) delayed myelination, and six each (75%) a moderate to severe decrease in brain volume, simplified gyral pattern, and abnormalities of the corpus callosum (38% hypogenesis and 38% hypoplasia). Malformations were symmetrical in 75% of the cases. Conclusion Severe cerebral damage was

  6. Are the opportunities to prevent alcohol related liver deaths in the UK in primary or secondary care? A retrospective clinical review and prospective interview study

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    Sheron Nick

    2006-06-01

    Full Text Available Abstract Background Deaths from liver cirrhosis have increased at least 8 fold since the 1970's in the UK and further increases are anticipated, whereas in the rest of Europe liver deaths are decreasing. In the UK, we urgently need strategies to detect those who misuse alcohol and are at risk of developing alcoholic liver disease before they get to that point. One potential strategy is to screen admissions to hospital with alcohol related conditions for evidence of alcohol misuse. Surprisingly, there has been no research into the important question of where the opportunities are to detect those who misuse alcohol – primary or secondary care. We attempted to answer this firstly by conducting a retrospective analysis of the medical notes of 94 patients diagnosed with alcohol induced liver cirrhosis between 1st January 1995 and 31st December 2000 at Southampton General Hospital with the purpose of identifying admissions to hospital prior to a diagnosis of alcoholic liver disease. In the second part of the study, we interviewed patients with alcoholic liver disease about their contact with health services. Results Before diagnosis of alcoholic liver disease, 33% (31/94 of the patients had had an admission to hospital for an alcohol related condition. There was a mean of 7 years and 1 month (SD 6 years 3 months between the first alcohol-related admission and presentation with alcoholic liver disease (in those who had had admissions. The commonest reason for alcohol related admission was falls/fractures/injuries, followed by non-variceal gastro-intestinal bleeds. Patients with alcoholic liver disease who were interviewed had seen their General Practitioner on average at least 2 times per year. Conclusion Most patients who develop alcohol-induced cirrhosis do not have an admission to hospital with an alcohol related condition before developing alcoholic liver disease. Therefore, if we screen patients admitted to hospital with alcohol related

  7. Associated Clinical Disorders Diagnosed by Medical Specialists in 188 FMR1 Premutation Carriers Found in the Last 25 Years in the Spanish Basque Country: A Retrospective Study

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    Merino, Sonia; Ibarluzea, Nekane; Maortua, Hiart; Prieto, Begoña; Rouco, Idoia; López-Aríztegui, Maria-Asunción; Tejada, Maria-Isabel

    2016-01-01

    Fragile X-associated tremor/ataxia syndrome (FXTAS) and fragile X-associated primary ovarian insufficiency (FXPOI) are definitely related to the fragile X mental retardation 1 (FMR1) premutation (PM). Additional medical problems have also been associated with the PM, such as fibromyalgia, endocrine, and psychiatric disorders. To improve our understanding in the field, we reviewed all PM carriers and their reasons for any medical referrals from 104 fragile X families molecularly diagnosed in our laboratory and living in the Spanish Basque Country. After signing the written informed consent, we studied their electronic medical records in order to identify the disorders associated with the PM and their frequencies. We obtained clinical data in 188 PM carriers (147 women and 41 men). In women, the frequency of FXPOI (22.61%) was similar to that previously reported in PM carriers. In men, the frequency of definite FXTAS (28.57%) was lower than reported elsewhere. Furthermore, thyroid pathology was associated with the PM, the frequency of hypothyroidism being much higher in the studied region than in the general population (8.84% vs. 0.93%). Finally, we found no association with fibromyalgia or psychiatric problems. These findings represent another population contribution in this field and may be useful for the clinical management of PM carriers. PMID:27775646

  8. Space Adaptation Back Pain: A Retrospective Study

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    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.

  9. Reassessment of patients with Eating Disorders after moving from DSM-IV towards DSM-5: a retrospective study in a clinical sample.

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    Gualandi, Malvina; Simoni, Marzia; Manzato, Emilia; Scanelli, Giovanni

    2016-12-01

    To compare the relative prevalence of eating disorders moving from DSM-IV to DSM-5, and to reassess the overall medical impairment in the revised diagnostic classes. We applied DSM-5 to 206 patients (age 15-56 years) previously studied and classified according to DSM-IV. Medical impairment was classified as low, medium, or high, based on a cumulative score of clinical severity (SCS), computed as the sum of specific weights assigned to different pathological conditions and their ascertained prognostic impact. Application of DSM-5 produced a decrease in Eating Disorders Not Otherwise Specified (EDNOS) by 17 %, an increase in anorexia (AN) by 14 % and bulimia (BN) by 2.4 %; 44.6 % of EDNOS migrated to AN, 8 % to BN, and 30.8 % was reclassified as Other Specified Feeding and Eating Disorders (OSFED). Mean SCS was higher in AN than in other diagnoses independent of classification. Differently from EDNOS, no high score was found in OSFED. BMI (OR 0.74, 95 % CI 0.56-0.98) and duration of amenorrhea >1 year (OR 6.63, 95 % CI 1.29-34.16) resulted significantly associated with the risk for medium-high SCS level in AN classified with DSM-5. The results confirmed that DSM-5 reduces the number of EDNOS. DSM-5 seems to better represent the clinical picture in OSFED than in EDNOS. The clinical relevance of BMI and duration of amenorrhea should be considered even more now that they are no longer used as diagnostic hallmarks of AN.

  10. Incidence and clinical characteristics of unexpected uterine sarcoma after hysterectomy and myomectomy for uterine fibroids: a retrospective study of 10,248 cases

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    Zhao WC

    2015-10-01

    Full Text Available Wan-Cheng Zhao,1 Fang-Fang Bi,1 Da Li,2 Qing Yang11Department of Obstetrics and Gynecology, 2Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of ChinaBackground: Uterine fibroids often require a hysterectomy or myomectomy via laparotomy or laparoscopy. Morcellation is often necessary to perform a laparoscopic surgery. The objective of this study is to determine the incidence of unexpected uterine sarcomas (UUSs after hysterectomy and myomectomy for uterine fibroids and to reduce the occurrence and avoid the morcellation of UUSs by analyzing their characteristics.Methods: Women who had a hysterectomy or myomectomy for uterine fibroids in Shengjing Hospital of China Medical University between November 2008 and November 2014 were selected for the study, and their clinical characteristics were analyzed.Results: During the period, 48 UUSs were found in 10,248 cases, and the overall incidence was 0.47%. There was no statistical difference (P=0.449 regarding the incidence (0.50% vs 0.33% between 42 UUSs in 8,456 cases undergoing laparotomy and six UUSs in 1,792 cases undergoing laparoscopy. Most of the UUSs were stage I (89.58%, which occurred more commonly (56.25% in women aged 40–49. Abnormal uterine bleeding (39.58% was the main clinical manifestation. Rapidly growing pelvic masses (12.5%, rich blood flow signals (18.75%, and degeneration of uterine fibroids (18.75% prompted by ultrasonography may suggest the possibility of UUSs. The margins of most UUSs (93.75% were regular, which may cause UUSs to be misdiagnosed as uterine fibroids. Fifteen cases underwent magnetic resonance imaging examinations. Approximately 73.33% showed heterogeneous and hypointense signal intensity on T1-weighted images, and 80% showed intermediate-to-high signal intensity on T2-weighted images, with necrosis and hemorrhage in 40% of cases. After contrast administration, 80% presented early heterogeneous

  11. [Patent ductus arteriosus in the dog: a retrospective study of clinical presentation, diagnostics and comparison of interventional techniques in 102 dogs (2003-2011)].

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    Meijer, M; Beijerink, N J

    2012-06-01

    A left-to-right shunting patent ductus arteriosus (PDA) is a common congenital heart defect in dogs. If it is left uncorrected, life expectancy in most cases is decreased due to the development of left-sided congestive heart failure. The aim of this study was to describe the dogs diagnosed with PDA in the Utrecht University Companion Animal Clinic from 2003 to 2011. The medical records of 102 patients were retrieved, and the clinical presentation and outcome of PDA closure by surgical ligation or transarterial catheter occlusion (TCO) were reviewed. In the TCO group, the result of coiling was compared with the placement of an Amplatz Canine Duct Occluder (ACDO). A predisposition to PDA was found in the German Brak, Stabyhoun, and Schapendoes. Dogs treated with surgical ligation were significantly older and heavier than those treated with TCO; within the TCO group, dogs treated with ACDO were significantly older and heavier The initial success rate (complete disappearance of the audible murmur in a patient that survived the procedure) was not significantly different between the different treatment modalities. Major complications were more common with surgical ligation, but the incidence of minor complications was not significantly different. There was no diference in survival between dogs treated with surgical ligation and dogs treated with TCO. This study shows a previously unreported predisposition to PDA in certain breeds. Both surgical ligation and TCO are suitable techniques for PDA closure, although major complications were more common with surgical ligation. ACDO appears to be the method with the least complications and thus can be considered the safest method.

  12. Patients With Combined Membranous Nephropathy and Focal Segmental Glomerulosclerosis Have Comparable Clinical and Autoantibody Profiles With Primary Membranous Nephropathy: A Retrospective Observational Study.

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    Gu, Qiu-Hua; Cui, Zhao; Huang, Jing; Zhang, Yi-Miao; Qu, Zhen; Wang, Fang; Wang, Xin; Wang, Su-Xia; Liu, Gang; Zhao, Ming-Hui

    2016-05-01

    Patients with combined membranous nephropathy (MN) and focal segmental glomerulosclerosis (FSGS) have been reported with different clinical significance. Investigations on the possible mechanisms of the combined glomerular lesions are necessary but scarce. Twenty patients with both MN and FSGS lesions were enrolled in the study. Sixty-five patients with primary MN and 56 patients with primary FSGS were used as disease controls. Clinical data on renal biopsy and during follow-up were collected. Circulating anti-phospholipase A2 receptor (PLA2R) antibody, glomerular PLA2R expression, IgG4 deposition, and soluble urokinase receptor (suPAR) levels were detected. We found that patients with combined lesions presented with older age, less proteinuria, higher albumin, and better renal function on biopsy. These were comparable to the patients with primary MN, but differed from the patients with primary FSGS. Patients with combined lesions showed higher stages of MN, no cellular variant on FSGS classification, and more common (100.0%) tubulointerstitial injury than both primary MN and primary FSGS patients. In the patients with combined lesions, 80.0% had circulating anti-PLA2R antibody and 68.4% had IgG4 predominant deposition in glomeruli, which were comparable to primary MN. The patients with combined lesions had significantly lower urinary suPAR concentrations, than the primary FSGS patients (315.6 ± 151.0 vs 752.1 ± 633.9 pg/μmol; P = 0.002), but similar to the primary MN patients (267.9 ± 147.5 pg/μmol). We conclude that patients with combined MN and FSGS may share the same underlying pathogenesis with primary MN. The FSGS lesion might be secondary to primary MN.

  13. Clinical characteristics and favorable long-term outcomes for patients with idiopathic inflammatory myopathies: a retrospective single center study in China

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    Shu Xiao

    2011-11-01

    Full Text Available Abstract Background Little is known about the clinical features and true survival risk factors in Chinese Han population. We conducted the current study to investigate the clinical features, long-term outcome and true potential indicators associated with mortality of idiopathic inflammatory myopathies (IIM in China. Methods We restrospectvely investigated 188 patients diagnosed with IIM at our hospital from January 1986 to April 2009. The primary outcome was determined with mortality. The secondary outcomes for survival patients were organ damage and disease activity, health status, and disability, which were assessed with Myositis Damage Index, Myositis Disease Activity Assessment Visual Analogue Scales, Health Assessment Questionnaire Disability Index, and the Modified Rankin Scale, respectively. Potential prognostic factors for mortality were analyzed with the multivariate Cox regression model. Results Mean age at disease onset was 43.8 ± 15.8 years and male to female ratio was 1:2.1 in this cohort. The 1-, 5-, 10-, 15- and 20-year survival rates were 93.6%, 88.7%, 81%, 73.6% and 65.6%. The independent predicators for mortality were age at disease onset [hazard ratio (HR:1.05, 95% CI 1.02 - 1.08], presence of cancer (HR:3.68, 95%CI 1.39 - 9.74, and elevated IgA level at diagnosis (HR:2.80, 95% CI 1.16-6.74. At the end of the follow-up, 29 patients manifested drug withdrawal within an average 4.1 years (range 0.5-15.2 year, most patients (85.9% had no disease activity and 130 patients (83.4% had no disability. Conclusions The long-term outcomes of IIM patients in our cohort have improved dramatically. Those patients most likely to survive had a high chance of reaching stable disease status, and obtained long-term or possibly permanent remission to a large extent.

  14. Success and Survival Rates of Dental Implants Restored at an Undergraduate Dental Clinic: A 13-Year Retrospective Study with a Mean Follow-up of 5.8 Years.

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    Daneshvar, Shahrzad S; Matthews, Debora C; Michuad, Pierre-Luc; Ghiabi, Edmond

    2016-01-01

    The purpose of this study was to evaluate the clinical, radiographic, and patient-based outcomes of dental implants placed at an undergraduate student dental clinic. A retrospective study was performed to determine the success and survival rates of dental implants placed at the undergraduate dental clinic at Dalhousie University between January 1999 and January 2012. Only patients with a minimum of 1-year follow-up were included. Clinical and radiographic assessments determined implant success and survival rates. Questionnaires recorded patients' satisfaction with esthetics, comfort, and ease of hygiene. Of the 352 patients (n = 591 implants) who received implants over 13 years, 165 patients completed the clinical and radiographic examinations. By the end of the study period, demographic information and implant characteristics were collected for 111 (n = 217 implants; 47.5% in the maxilla, 52.6% in the mandible) of these patients. Of those assessed clinically, 36.4% were males and 63.6% females, with a mean age of 56.1 ± 14.15 years (range, 17 to 86 years) at the time of implant placement. The mean follow-up period was 5.8 years (range, 1 to 13 years). The overall implant success and survival rates were 88.0% and 97.2%, respectively. No observable bone loss was evident in 88.0% of the surviving implants. There were no implant fractures. Most patients (91.2%) were very satisfied with the implant restoration appearance, 88.0% were very comfortable with the implant, 92.6% were very satisfied with their ability to chew, and 84.8% reported easy hygiene maintenance at the implant sites. Implant success and survival in an undergraduate student clinic were comparable to those reported in the literature. It seems that inexperienced students were able to provide restorations that were very satisfying to the patients.

  15. Clinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders in UK general practice: a retrospective cohort study

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    Berger Ariel

    2012-03-01

    Full Text Available Abstract Background Clinical characteristics and patterns of healthcare utilization in patients with painful neuropathic disorders (PNDs who are under the care of general practitioners (GPs in the UK are not well understood. Methods Using a large electronic UK database, we identified all adults (age ≥ 18 years with any GP encounters between 1 January 2006 - 31 December 2006 at which a diagnosis of PND was noted ("PND patients". An age-and gender-matched comparison group also was constituted consisting of randomly selected patients with one or more GP encounters-but no mention of PNDs-during this period. Characteristics and patterns of healthcare utilization of patients in the two groups were then examined over the one-year study period. Results The study sample consisted of 31,688 patients with mention of PNDs and an equal number of matched comparators; mean age was 56 years, and 62% were women. The prevalence of various comorbidities was higher among patients in the PND group, including digestive disorders (31% vs. 17% for comparison group, circulatory disorders (29% vs. 22%, and depression (4% vs. 3% (all p p p Conclusions Patients with PNDs under the care of GPs in the UK have relatively high levels of use of healthcare services and pain-related pharmacotherapy.

  16. Inferior cerebellar hypoplasia resembling a Dandy-Walker-like malformation in purebred Eurasier dogs with familial non-progressive ataxia: a retrospective and prospective clinical cohort study.

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    Filipa Bernardino

    Full Text Available Cerebellar malformations can be inherited or caused by insults during cerebellar development. To date, only sporadic cases of cerebellar malformations have been reported in dogs, and the genetic background has remained obscure. Therefore, this study`s objective was to describe the clinical characteristics, imaging features and pedigree data of a familial cerebellar hypoplasia in purebred Eurasier dogs. A uniform cerebellar malformation characterized by consistent absence of the caudal portions of the cerebellar vermis and, to a lesser degree, the caudal portions of the cerebellar hemispheres in association with large retrocerebellar fluid accumulations was recognized in 14 closely related Eurasier dogs. Hydrocephalus was an additional feature in some dogs. All dogs displayed non-progressive ataxia, which had already been noted when the dogs were 5-6 weeks old. The severity of the ataxia varied between dogs, from mild truncal sway, subtle dysmetric gait, dysequilibrium and pelvic limb ataxia to severe cerebellar ataxia in puppies and episodic falling or rolling. Follow-up examinations in adult dogs showed improvement of the cerebellar ataxia and a still absent menace response. Epileptic seizures occurred in some dogs. The association of partial vermis agenesis with an enlarged fourth ventricle and an enlarged caudal (posterior fossa resembled a Dandy-Walker-like malformation in some dogs. Pedigree analyses were consistent with autosomal recessive inheritance.

  17. Inferior Cerebellar Hypoplasia Resembling a Dandy-Walker-Like Malformation in Purebred Eurasier Dogs with Familial Non-Progressive Ataxia: A Retrospective and Prospective Clinical Cohort Study

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    Bernardino, Filipa; Rentmeister, Kai; Schmidt, Martin J.; Bruehschwein, Andreas; Matiasek, Kaspar; Matiasek, Lara A.; Lauda, Alexander; Schoon, Heinz A.; Fischer, Andrea

    2015-01-01

    Cerebellar malformations can be inherited or caused by insults during cerebellar development. To date, only sporadic cases of cerebellar malformations have been reported in dogs, and the genetic background has remained obscure. Therefore, this study`s objective was to describe the clinical characteristics, imaging features and pedigree data of a familial cerebellar hypoplasia in purebred Eurasier dogs. A uniform cerebellar malformation characterized by consistent absence of the caudal portions of the cerebellar vermis and, to a lesser degree, the caudal portions of the cerebellar hemispheres in association with large retrocerebellar fluid accumulations was recognized in 14 closely related Eurasier dogs. Hydrocephalus was an additional feature in some dogs. All dogs displayed non-progressive ataxia, which had already been noted when the dogs were 5 – 6 weeks old. The severity of the ataxia varied between dogs, from mild truncal sway, subtle dysmetric gait, dysequilibrium and pelvic limb ataxia to severe cerebellar ataxia in puppies and episodic falling or rolling. Follow-up examinations in adult dogs showed improvement of the cerebellar ataxia and a still absent menace response. Epileptic seizures occurred in some dogs. The association of partial vermis agenesis with an enlarged fourth ventricle and an enlarged caudal (posterior) fossa resembled a Dandy-Walker-like malformation in some dogs. Pedigree analyses were consistent with autosomal recessive inheritance. PMID:25668516

  18. A RETROSPECTIVE STUDY OF BLUNT TRAUMA ABDOMEN

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    Kumawat

    2015-07-01

    Full Text Available BACKGROUND: Blunt abdominal trauma is one of the important components of poly - trauma. It requires suspicion, investigation and proper management in time, to avoid morbidity & mortality. AIM: The aim of this retrospective study spanning 5 years w.e.f. Jan, 2010 to December, 2014 in this tertiary care institute of Geetanjali Medical College & Hospital, Udaipur was to find out BTA patients in RTA, fall from height, and assault like injuries. We studied type of injuries, male - female ratio, age group, urban & rural population involvement & their operative & non - operative management. MATERIAL & METHOD S : The study is based on 273 cases of BTA; managed in this institute from admission, investigation, management & possible follow up. Observations are depicted in different tables. RESULT: Liver is most commonly involved organ followed by spleen, kidney & pancreas respectively. Initially solid organ injuries cases where treated by surgery, but than non - operative management are tried in haemostatically stable patients. Hollow visceral injuries were always managed by laparotomy & repair or resection as and when needed . Mortality occurred in 35 patients out 273 patients because of delay to reach hospital or septicemia, renal failure and shock due to multi organ failure. CONCLUSION: Close supervision with sophisticated infrastructure and quick action significantly reduces mortality.

  19. A retrospective study of spontaneous intracranial hemorrhage

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    Eka J. Wahjoepramono

    2016-02-01

    Full Text Available Spontaneous intracerebral hemorrhage (SICH is a serious disease despite progressing medical knowledge. SICH appears suddenly without warning, unlike ischemic strokes that are often preceded by a transient ischemic attack. Outcome is determined by the initial severity of the bleeding; mortality and morbidity of SICH are high. The aim of this study was to describe the characteristics of type, location, and outcome of SICH. A retrospective review was conducted on the records of 2042 cases admitted to a private hospital in Karawaci, Tangerang, between 1 January 1996 to 31 December 2008. Analysis was done on type, location, and the final outcome measures by the Glasgow Outcome Scale (GOS. The results of the study showed that the most prevalent type of SICH was hypertensive stroke, amounting to 1698 cases (83.1%, and the least commonly encountered type was dural fistula totaling  5 cases (0.3%. SICH due to hypertensive stroke frequently occurred in the basal ganglia (50.8% comprising the putamen, caudate nucleus and globus pallidus. On average, the outcome at the time of dismissal was good, where 105 cases (88.2% were GOS 4 and 5. SICH requires prompt and appropriate management. Therefore the signs and symptoms of intracranial hemorrhage should be promptly recognized and followed by appropriate ancillary examinations in order to promptly determine the management required, including possible surgical interventions.

  20. Acute burn during pregnancy: A retrospective study

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    Ezzatollah Rezaei

    2016-01-01

    Full Text Available Background & aim: The incidence of acute burn injuries in pregnant women is very low. Burn injuries during pregnancy are often associated with a high rate of fetal and maternal mortality and morbidity. In this study, we aimed to review the cases of acute burn during pregnancy and evaluate the outcome of these patients in Mashhad, Iran. Methods:This retrospective study was performed using the medical records of 48 pregnant women with thermal injuries over a 13-year period. Results: The results showed that 8 (16.7%, 27 (56.3%, and 13 (27.1% patients were in the first, second, and third trimesters of pregnancy. Moreover, 14 mothers (29.2% died, 24 (50.0% were discharged without any fetal problems, eight (16.7% had fetal death, 13 (27.1% had abortion, two (4.2% had normal vaginal delivery, and one (2.1% underwent normal caesarean section. Conclusion: The rate ofmaternal survival in the first and second trimesters was higher than the third one. In the third trimester, pregnancy termination is indicated only after fetal maturation.

  1. Investigation and clinical applications of muscle strength change in cerebrospinal fluid tap test in cases of idiopathic normal pressure hydrocephalus: A retrospective study.

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    Matsuoka, Tsuyoshi; Iida, Jun-Ichi; Kawahara, Makoto; Uchiyama, Yoshitomo

    2016-12-15

    The cerebrospinal fluid tap test (CSFTT) is widely used to diagnose idiopathic normal pressure hydrocephalus (iNPH) and predict the therapeutic effectiveness of shunting. However, the ability to walk cannot be quantified for patients who are unable to walk. Therefore, we examined whether the iNPH diagnostic aid is possible using dynamometry, even for patients who are unable to walk. In this study, 45 patients underwent grip strength assessment, quadriceps strength assessment, 10-m walk test, and 3-m Timed Up and Go test before and after CSFTT. Our investigation of physical functions indicated that the CSFTT-positive group demonstrated significant improvements in grip and bilateral quadriceps muscle strength. The results of the receiver operating characteristic analysis indicated that leg muscle strength measurement reliability was high and that the area under the curve was 0.754-0.811. Our investigation of the clinically effective cutoff point for the rate of change indicated that it was 13.6% for right quadriceps muscle strength and 15.3% for left quadriceps muscle strength. Comparing CSFTT results in cases of iNPH with the observed rate of change in muscle strength can aid in the diagnosis of iNPH.

  2. A retrospective metagenomics approach to studying Blastocystis.

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    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 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.

  3. Etiology, clinical course and outcome of healthcare-associated bloodstream infections in patients with hematological malignancies: a retrospective study of 350 patients in a Finnish tertiary care hospital.

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    Åttman, Emilia; Aittoniemi, Janne; Sinisalo, Marjatta; Vuento, Risto; Lyytikäinen, Outi; Kärki, Tommi; Syrjänen, Jaana; Huttunen, Reetta

    2015-01-01

    This retrospectively collected laboratory-based surveillance data includes 575 healthcare-associated bloodstream infections (BSIs) in 350 patients with hematological malignancy in Tampere University Hospital, Finland, during 1999-2001 and 2005-2010. The most common underlying diseases were acute myelogenous leukemia (n=283, 49%), followed by myeloma (n=87, 15%) and acute lymphocytic leukemia (n=76, 13%). The overall rate was 9.1 BSIs per 1000 patient-days. Gram-positive BSIs predominated and the most common pathogens were coagulase-negative staphylococci (23%), viridans streptococci (11%), enterococci (9%) and Escherichia coli (9%). Fungi caused 2% of BSIs. The 7-day and 28-day case fatalities were 5% and 10% and were highest in BSIs caused by P. aeruginosa (19% and 34%, respectively). The median age of patients with BSI has increased; it was 55.0 years during 1999-2001, compared to 59.0 years in 2005-2007 and 59.0 years in 2008-2010 (p<0.0001). Gram-positive bacteria predominated in this material. Case fatalities were low as compared to previous reports although the median age of patients increased.

  4. Antimicrobial resistance patterns, clinical features, and risk factors for septic shock and death of nosocomial E coli bacteremia in adult patients with hematological disease: A monocenter retrospective study in China.

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    Ma, Jie; Li, Ning; Liu, Yajie; Wang, Chong; Liu, Xiaoyan; Chen, Shengmei; Xie, Xinsheng; Gan, Silin; Wang, Meng; Cao, Weijie; Wang, Fang; Liu, Yanfan; Wan, Dingming; Sun, Ling; Sun, Hui

    2017-05-01

    The aim of this retrospective analysis was to evaluate the antimicrobial resistance, clinical features, and risk factors for septic shock and death of nosocomial E coli bacteremia in adult patients in a single hematological center in China. A retrospective case-control study of 157 adult hematological patients with 168 episodes of E coli bacteremia was initiated from April 2012 to July 2015. Antimicrobial susceptibility as well as antimicrobial co-resistance rates were analyzed. Clinical features and outcomes were also studied. In addition, risk factors for septic shock and death were investigated. Among the 553 positive blood isolates during the study period, the prevalence of E coli was 33.3% and ESBL production strains represented 61.9% of those examined. In all the E coli strains isolated, 85.6% were multidrug-resistance (MDR), 2.4% were extensive drug resistance (XDR), and 6.0% were resistant to carbapenems. More MDR phenotype was noted in ESBL-EC strains (98.6% vs 62.8%, Presistance rates to other antibiotics. Carbapenem resistant strains retained full sensitivity to tigecycline and 60% to amikacin. Piperacillin/tazobatam was the third sensitive drug to both ESBL-EC (77.1%) and non-ESBL-EC (86.0%). In our series, 81.6% episodes received appropriate initial antibiotic treatment and no significant decrease in it was found in bacteremia due to ESBL E coli and patients with neutropenia, septic shock. Septic shock was noted in 15.5% patients and the overall 30-day mortality rate was 21.7%. Multivariate analysis revealed that induction chemotherapy (OR 2.126; 95% CI 1.624-11.332; P = .003) and polymicrobial infection (OR 3.628; 95% CI 1.065-21.219; P = .041) were risk factors for septic shock, whereas male (OR 2.223; 95% CI 1.132-12.022; P resistant infectious patients.

  5. Odontogenic Infections: A 1-year Retrospective Study.

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    Mahmoodi, Benjamin; Weusmann, Jens; Azaripour, Adriano; Braun, Benedikt; Walter, Christian; Willershausen, Brita

    2015-04-01

    The purpose of this study was to analyze the prevalence, demographic patterns and management of odontogenic infections in patients undergoing treatment in an outpatient dental emergency service of a university hospital. In a retrospective study of the year 2012, all patients suffering from odontogenic infections were included. Demographic data, diagnosis and the conducted treatment were analyzed. Odontogenic infections were defined as pulpitis, apical and marginal periodontitis, abscesses and pericoronitis. A total of 2,058 out of 4,209 emergency patients suffered from odontogenic infections. The majority (45.0%) had an apical periodontitis, 20.8% abscesses, 17.3% a marginal periodontitis, 16.3% a pulpitis and 5.8% a pericoronitis. Mean age was 37.5 ± 17.0 years standard deviation (SD) (1.2-96.4). Most patients were 20 to 29 years (24.6%), followed by the age group of 30 to 39 year old patients (21.0%). Males were affected more frequently (55.5%) than females (45.5%). Most of the patients (64.5%) of the patients received a dental or surgical treatment. Antibiotics were prescribed in 31.7% of cases. Amoxicillin was the most common prescribed antibiotic (54.5%). Odontogenic infections represent one of the main reasons for consulting the emergency service. Due to the high number of cases and the severe complications, dentists have to be familiar with the surgical management of odontogenic infections as well as the appropriate use of antibiotics. Nearly half of all patients who sought, treatment in the emergency service had an odontogenic infectious disease. This should be considered for the organization and planning of the service.

  6. Implementation and effect of intensified case finding on diagnosis of tuberculosis in a large urban HIV clinic in Uganda: a retrospective cohort study.

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    Hermans Sabine

    2012-08-01

    Full Text Available Abstract Background Increased detection of tuberculosis (TB using intensified or active case finding (ICF is one of the cornerstones of the Stop TB Strategy, and contrasts with passive case finding (PCF which relies on self-reported symptoms. There is no clear guidance on implementation strategies. We implemented ICF in addition to ongoing PCF in our large urban HIV clinic in July 2010 using a twice-daily announcement screen method by a trained peer educator, asking waiting patients to self-refer to a trained peer supporter for screening of TB symptoms. We sought to determine the associated effect on TB case detection. Methods Suspects were investigated by sputum smear, chest X-ray and ultrasound, if indicated. Routinely collected clinical and laboratory data were merged with the ICF register and TB clinic data for patients attending the clinic in 2010. We compared the yield of TB cases (defined as the prevalence of newly diagnosed TB cases in the screened population, the type of TB diagnosed and the total cost per TB case identified (in United States Dollars [USD] for the period before and after ICF implementation. Results Of the 20,456 patients who visited the clinic in 2010, 614 were identified as TB suspects, 220 pre-ICF and 394 post-ICF (229 via PCF and 165 via ICF. The proportion diagnosed with TB dropped from 66% to 48% (60% in suspects identified through PCF and 31% through ICF. During the post-ICF period, TB suspects identified through ICF compared to PCF identification were more likely to be female, older, on ART and to have been enrolled in HIV care for a longer duration. The yield of combined PCF and ICF screening was 1.4% pre-ICF and 1.7% post-ICF with a cost per TB case identified of 12.29 USD and 21.80 USD, respectively. Conclusions Implementation of ICF in a large HIV clinic yielded more TB suspects and cases, but substantially increased costs and was unable to capture the majority of TB suspects who were referred for diagnosis

  7. Deep Neck Infections of Odontogenic Origin and Their Clinical Significance. A Retrospective Study from Hradec Králové, Czech Republic

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    Hana Doležalová

    2015-12-01

    Full Text Available Introduction: Cellulitis remains a very serious disease even today. Mortality, which varied between 10–40%, has been reduced owing to the standard securing of airway patency and use of an appropriate surgical treatment approach. Materials and methods: A total of 195 patients were hospitalised for cellulitis at the University Hospital in Hradec Králové during 2007–2011. The following parameters were evaluated: age, gender, dependence of incidence of the disease on the season of the year, frequency of attacks of the particular areas and their clinical characteristics, aetiology of the inflammation, types of patient complaints, prevalence of current systemic diseases, results of microbiological and selected laboratory analyses, socio-economic status of the patients, and duration of patient stay at the hospital. Statistical analysis was performed by using Pearson’s correlation coefficient, the statistical significance level was p < 0.05. Results: The mean age of the patients was 39.8 years. The group of 195 patients included 108 (55% males and 87 (45% females. The mean time between the first symptoms of the disease and admission to the Department was 5 days. From among the 195 patients, 116 (59.5% were working persons, 79 (40.5% were non-working (children, students, unemployed persons, women on maternity leave, retired people. The odontogenic origin of the disease was verified in 173 (88.7% patients. In total, 65 (33.3% patients had no coinciding complicating systemic disease, 22 (11.3% patients had diabetes mellitus. The most frequent symptom of cellulitis was painful swelling, found in 194 (99.5% patients, followed by jaw contracture, found in 153 (78.5% patients. Conclusion: The results are largely very similar to those of previous studies performed in other countries, except that we found no correlation between the prevalence of cellulitis and the socio-economic status, nor have we confirmed Klebsiella pneumoniae sp. as the cause of

  8. Unilateral sensorineural hearing loss: A retrospective study

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    Divyank Bansal

    2016-01-01

    Full Text Available Background: This retrospective study was carried out to know the characteristics of patients suffering from unilateral sensorineural hearing loss (USNHL (type and degree. Aims and Objectives: (1 To know the incidence of pure USNHL (other ear being normal in patients complaining of HL. (2 To establish the type and degree of USNHL in patients. Materials and Methods: This study was conducted over a period of more than 1 year to find out the pattern of pure USNHL (other ear being normal in the patients attending ear, nose, and throat outpatient department (OPD with a complaint of HL. Pure tone audiometry data of 1800 cases between August 2014 and December 2015 with HL were analyzed for this study. Demographic characteristics were compared with types and degrees of unilateral sensorineural hearing impairment. Results: A total of 1800 OPD patients who had a complaint of HL and had undergone pure tone audigram (PTA in a period of more than 1 year in the Department of Otorhinolaryngology and Head and Neck Surgery were studied. SNHL type was the highest with 802 cases (44.55%. Out of 802 cases of SNHL, 257 (32.05% were USNHL - out of which, only 155 patients (60.31% had pure USNHL with other ear being normal; this constituted the study group, i.e., 155 patients (8.6% out of 1800. Age of patients ranged from 9 years to 76 years (mean age - 41.5 years. Male:female ratio was 1.31:1. Both ears were almost equally involved. The highest numbers of USNHL patients were seen in the age group of 31-40 years (23.87%. Most cases presented with mild (34.2%, followed by profound (31.6% USNHL. Conclusion: Our study concluded that SNHL type is the most common type (44.55% of hearing impairment among patients complaining of HL. The incidence of pure USNHL (i.e. other ear being normal was 60.31% (155/257 cases of USNHL, 19.32% (155/802 cases of SNHL, and 8.6% (155/1800 cases of PTA performed on patients complaining of HL. Limited work has been published on incidence

  9. Recognition of actinic keratosis. A retrospective biopsy study of the clinical diagnostic accuracy by primary care physicians compared with dermatologists. Experience in Mexico

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    Andrés Tirado-Sánchez

    2011-10-01

    Full Text Available Background. Actinic keratoses (AK are dysplastic keratinocytic lesions confined to the epidermis. Currently, the standard screening method for detecting AK is performed by a health professional. Objectives. We seek to determine if were differences in diagnosis of AK by dermatologists (DL and primary care physicians (PCP in Mexico. Material and Methods. The clinical diagnoses of PCP and DL were correlated with histopathologic diagnoses. In total, 285 cases were analyzed. Results. DL diagnosed 90% (256/285 of the cases compared with 36% (102/285 of PCP (P= .001. Primary care physicians were the group with the lowest diagnostic accuracy rate. Conclusion: Primary care physician needs to acquire sufficient knowledge of basic dermatology as well as dermatopathology. The overall accuracy of the clinical diagnosis, mainly in hyperplastic AK, depends on the clinicopathologic correlation.

  10. A retrospective study of oral lichen planus in paediatric population

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    Kabita Chatterjee

    2012-01-01

    Full Text Available Aim: Well documented cases of oral lichen planus, a cell mediated immune condition is infrequently reported in paediatric population. This study was undertaken to obtain epidemiological data retrospectively and also to explore the possibility of any association that might exist among the clinical and histopathological features in paediatric patients suffering from oral lichen planus. Subjects and Methods: A retrospective study was carried out on 22 patients, younger than 18 years with clinical and histopathological diagnosis of oral lichen planus over a period of 14 years. The clinical characteristics and histopathological features were observed. The statistical analysis of the data was performed using Statistical Analysis Software (SAS, Version 9.1. Results: Analysis of data of 22 patients revealed that the average age of patient is 15.18 years with equal male and female predilection. The most common site is buccal mucosa (50% and most frequent clinical form is erosive (63.64%. Focusing on the histopathological findings, parakeratosis was found in 86.36% of the cases, acanthosis in 63.64% of cases, moderate basal cell degeneration was identified in 63.64% of cases and dense lymphocytic infiltration at juxtaepithelial connective tissue region was found in 59.09% of cases. Conclusions: Oral lichen planus in paediatric population is rare and appeared between 8 to 18 years of age. There is no significant gender predominance. The most common clinical form is erosive, manifesting mainly in buccal mucosa. Histopathological findings characteristic of oral lichen planus in paediatric patients include parakeratosis, acanthosis, liquefaction degeneration of basal cells and lymphocytic infiltration in the subepithelial layer.

  11. Clinical normative data for eating disorder examination questionnaire and eating disorder inventory for DSM-5 feeding and eating disorder classifications: a retrospective study of patients formerly diagnosed via DSM-IV.

    Science.gov (United States)

    Brewin, Nicola; Baggott, Jonathan; Dugard, Pat; Arcelus, Jon

    2014-07-01

    Normative data for measures of eating disorder (ED) psychopathology provide a fundamental description of a presentation and a means to establish clinically significant change following an intervention. Clinical norms for the ED population are lacking and out of date following the publication of Diagnostic and Statistical Manual of Mental Health Disorders (DSM) 5. This study aimed to show that scores from the Eating Disorder Examination Questionnaire (EDE-q) and the Eating Disorder Inventory (EDI) differ across ED diagnosis groups and provide norm data for DSM-5 ED diagnoses. Patients (n = 932) presenting to an out-patient service over 5 years were retrospectively re-diagnosed based on DSM-5 criteria. Statistical analysis showed a significant difference on most subscale scores of the EDE-q and the EDI across diagnosis. Means, standard deviations and percentile ranks are presented by diagnosis. The norms detailed contribute to improving the accuracy with which scores are interpreted when using DSM-5 and aid with the assessment of clinically significant change following treatment.

  12. Modified open-access scheduling for new patient evaluations at an academic chronic pain clinic increased patient access to care, but did not materially reduce their mean cancellation rate: A retrospective, observational study.

    Science.gov (United States)

    Sivanesan, Eellan; Lubarsky, David A; Ranasinghe, Chaturani T; Sarantopoulos, Constantine D; Epstein, Richard H

    2017-09-01

    To determine if open-access scheduling would reduce the cancellation rate for new patient evaluations in a chronic pain clinic by at least 50%. Retrospective, observational study using electronic health records. Chronic pain clinic of an academic anesthesia department. All patients scheduled for evaluation or follow-up appointments in the chronic pain clinic between April 1, 2014, and December 31, 2015. Open-access scheduling was instituted in April 2015 with appointments offered on a date of the patient's choosing ≥1 business day after calling, with no limit on the daily number of new patients. Mean cancellation rates for new patients were compared between the 12-month baseline period prior to and for 7months after the change, following an intervening 2-month washout period. The method of batch means (by month) and the 2-sided Student t-test were used; Popen-access scheduling was not implemented for this group. Access to care for new chronic pain patients improved with modified open-access scheduling. However, their mean cancellation rate only decreased from 35.7% to 31.5%, making this a marginally effective strategy to reduce cancellations. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Clinical Studies

    DEFF Research Database (Denmark)

    Pallesen, Ulla

    and repair? Have new materials improved longevity? Are there still clinical and material problems to be solved? And what has the highest impact on longevity of posterior resin restorations – the material, the dentist, the patient or the tooth? These matters will be discussed on the basis of the literature......Within the last 25 years composite resin materials have in many countries successively replaced amalgam as a restorative for posterior teeth. Resin materials and bonding systems are continuously being improved by the manufactures, adhesive procedures are now included in the curriculum of most...... universities and practicing dentists restore millions of teeth throughout the World with composite resin materials. Do we know enough about the clinical performance of these restorations over time? Numerous in vitro studies are being published on resin materials and adhesion, some of them attempting to imitate...

  14. Pelvic flexure enterotomy closure in the horse with a TA-90 stapling device: a retrospective clinical study of 84 cases (2001-2008).

    Science.gov (United States)

    Rosser, Julie; Brounts, Sabrina; Slone, Don; Lynch, Tim; Livesey, Michael; Hughes, Faith; Clark, Carol

    2012-06-01

    Our objective was to compare survival and complication rates of horses undergoing pelvic flexure enterotomy closure with a TA-90 stapler to those with hand-sewn closure. Medical records of horses undergoing pelvic flexure enterotomy between 2001 and 2008 were reviewed. History, clinical signs, surgical findings, surgical techniques, and post-operative complications were recorded. Long-term outcome was established by telephone questionnaire. Of 84 pelvic flexure enterotomies performed, 70 were stapled and 14 were hand-sewn. Seventy-seven horses survived to discharge (91.7%). There were no significant associations between survival and closure technique (P = 0.69). Follow-up was available for 54 horses; 50 survived long-term (93.0%). No statistical significance was identified between long-term survival and closure method (P = 0.39). Forty horses went on to athletic performance (80.0%). TA-90 stapled closure of pelvic flexure enterotomies is a safe technique resulting in survival and complication rates equivalent to those of hand-sewn closure.

  15. A long-term retrospective clinical study of short dental implant restoration%口腔短种植体长期修复效果的评估

    Institute of Scientific and Technical Information of China (English)

    吴茴; 李健慧; 邸萍; 邱立新; 林野; 罗佳

    2010-01-01

    目的 评估应用短种植体进行缺牙修复的长期效果,探讨其临床应用价值.方法 1998年8月至2004年8月共有43例患者于北京大学口腔医学院·口腔医院口腔种植中心植入短种植体77枚,回顾其临床资料及X线片,测量冠-种植体比(crown-implant ratio,C/I).选取其中负重已达到5年以上的15例患者29枚短种植体,测量种植体边缘骨高度,采用Zarb种植体成功标准及Wheeler存留标准评估短种植体5年成功率及存留率.结果 77枚短种植体的平均追踪时间为5.4年(36~99个月),其中固定修复74枚,C/I平均值为(1.08±0.21),活动修复3枚.负重已达5年以上的29枚短种植体中,种植术后即刻、二期术前、负重3年内、负重5年以上种植体近中边缘骨高度分别为(0.59±0.66)、(0.64±0.59)、(-0.05±1.11)、(-0.37±1.29)mm;远中边缘骨高度分别为(0.62±0.77)、(0.60±0.86)、(-0.26±1.12)、(-0.23±1. 59)mm.短种植体5年的存留率和成功率分别为97%和93%.结论 短种植体5年成功率与常规种植体无明显区别,可避免植骨手术、降低风险、缩短疗程、减轻患者的创伤及经济负担,具有良好的临床应用价值.%Objective To evaluate the long-term results of short implants and assess its clinical importance. Methods A total of 77 short implants were consecutively placed in 43 patients from August 1998 to August 2004. The clinical data was reviewed and the crown-implant ratio (C/I) was measured.Twenty-nine short implants in 15 patients were loaded for more than 5 years and the marginal bone height around implant measured. The implant success and survival ratio were evaluzted according to Zarb's successful criteria and Wheeler's survival criteria. Results The mean follow-up time was 5.4 years (36 ~99 months). Among these 77 short implants, 74 implants were fixed restoration, which mean C/I was ( 1.08 ±0. 21 ), 3 implants were removable restoration. Of 29 short implants which were loaded for

  16. Clinical evaluation of balloon occlusion of the lower abdominal aorta in patients with placenta previa and previous cesarean section: A retrospective study on 43 cases.

    Science.gov (United States)

    Chen, Manru; Xie, Lan

    2016-10-01

    This study investigated the efficacy of balloon occlusion of the lower abdominal aorta in cesarean section surgery for the patients with placenta previa and previous cesarean section. The patients who had placenta previa and underwent cesarean section (CS) were evaluated. The patients treated with CS to terminate the pregnancy were used as control group (23 cases); the patients treated with the preset abdominal aorta balloon before CS was taken as study group (20 cases). The investigated indicators included the intraoperative blood loss, blood loss within postoperative 24 h, the transfusion amount of red cell suspension (RCS), hospital stay, incidence rate of disseminated intravascular coagulation (DIC), the asphyxia, premature delivery and the mortality of the newborns. The two groups are comparable. The intraoperative blood loss, blood loss within postoperative 24 h, the transfusion amount of RCS and the percentage of uterus resection in the study group were significantly lower (P < 0.05) than that in the control group. The percentage of uterine cavity filling with ribbon gauze in the study group was higher than the control group (P < 0.05). The balloon occlusion of lower abdominal aorta seems effective in reducing postpartum hemorrhage and the blood transfusion and decreasing the risk of hysterectomy without harming the newborns. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Loss of Mitochondrial Tumor Suppressor Genes Expression Is Associated with Unfavorable Clinical Outcome in Head and Neck Squamous Cell Carcinoma: Data from Retrospective Study.

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    Ishrat Mahjabeen

    Full Text Available Mitochondrial genes play important roles in cellular energy metabolism, free radical generation, and apoptosis. Dysregulation of these genes have long been suspected to contribute to the generation of reactive oxygen species (ROS, increased proliferation and progression of cancer. A family of orthologues of yeast silent information regulator 3 (SIRT3, 4 (SIRT4 and mitochondrial tumor suppressor 1 (MTUS1 are important mitochondrial tumor suppressor genes which play an important role in the progression of multiple cancers. However, their role in the development of oxidative stress, enhanced proliferation and progression of head and neck squamous cell carcinoma (HNSCC has not yet been studied. In this study we aimed to test the association between reduced mitochondrial tumor suppressor genes' activities and enhancement in tissue oxidative stress and cell proliferation in HNSCC cases. The expression of mitochondrial tumor suppressor genes (SIRT3, SIRT4 and MTUS1, mitochondrial DNA repair gene (OGG1-2a and a proliferation marker (Ki-67 was studied in a study cohort of 120 HNSCC patients and controls with reverse transcriptase polymerase chain reaction (RT-PCR and real-time PCR (qPCR in order to determine the potential prognostic significance of these genes. A statistically significant downregulation of SIRT3 (p<0.001, SIRT4 (p<0.0001, MTUS1 (p<0.002 and OGG1 (p<0.0001 was observed in HNSCC compared to control samples. Ki-67 was also overexpressed (p<0.0001 in HNSCC versus control samples. Additionally, to explore gene-gene relationship, we observed a positive spearmen correlation between SIRT3 versus SIRT4 (r = 0.523***, p<0.0001, SIRT3 versus MTUS1 (r = 0.273***, p<0.001, SIRT3 versus OGG1-2a (r = 0.213*, p<0.03, SIRT4 versus OGG1 (r = 0.338***, p<0.0001 and MTUS1 versus OGG1-2a (r = 0.215*, p<0.03 in HNSCC cases. A negative spearman correlation was observed between OGG1 versus Ki-67 (r = -0.224**, p<0.01 and OGG1-2a versus Ki-67 (r = -0.224**, p<0

  18. Retrospective Study of Metastatic Melanoma and Renal Cell Carcinoma to the Brain with Multivariate Analysis of Prognostic Pre-Treatment Clinical Factors

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    Ethan A. Ferrel

    2016-03-01

    Full Text Available Patients with brain metastasis from renal cell carcinoma (RCC or melanoma have historically had very poor prognoses of less than one year. Stereotactic radiosurgery (SRS can be an effective treatment for patients with these tumors. This study analyzes the effect of pretreatment prognostic factors on overall survival (OS for RCC and melanoma patients with metastasis to the brain treated with SRS. A total of 122 patients with brain metastases from either RCC or melanoma were grouped by age at brain metastasis diagnosis, whether they received whole brain radiation therapy (WBRT in addition to SRS, or they underwent surgical resection, Karnofsky Performance Score (KPS, number of brain metastases, and primary tumor. Median survival times for melanoma patients and RCC patients were 8.20 ± 3.06 and 12.70 ± 2.63 months, respectively. Patients with >5 metastases had a significantly shorter median survival time (6.60 ± 2.45 months than the reference group (1 metastasis, 10.70 ± 13.40 months, p = 0.024. Patients with KPS ≤ 60 experienced significantly shorter survival than the reference group (KPS = 90–100, with median survival times of 5.80 ± 2.46 months (p < 0.001 and 45.20 ± 43.52 months, respectively. We found a median overall survival time of 12.7 and 8.2 months for RCC and melanoma, respectively. Our study determined that a higher number of brain metastases (>5 and lower KPS were statistically significant predictors of a lower OS prognosis.

  19. Primary hepatic lymphoma: a retrospective, multicenter Rare Cancer Network study

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    Gamze Ugurluer

    2016-10-01

    Full Text Available Primary hepatic lymphoma (PHL is a rare malignancy. We aimed to assess the clinical profile, outcome and prognostic factors in PHL through the Rare Cancer Network (RCN. A retrospective analysis of 41 patients was performed. Median age was 62 years (range, 23- 86 years with a male-to-female ratio of 1.9:1.0. Abdominal pain or discomfort was the most common presenting symptom. Regarding B-symptoms, 19.5% of patients had fever, 17.1% weight loss, and 9.8% night sweats. The most common radiological presentation was multiple lesions. Liver function tests were elevated in 56.1% of patients. The most common histopathological diagnosis was diffuse large B-cell lymphoma (65.9%. Most of the patients received Chop-like (cyclophosphamide, doxorubicin, vincristine, and prednisone regimens; 4 patients received radiotherapy (dose range, 30.6-40.0 Gy. Median survival was 163 months, and 5- and 10-year overall survival rates were 77 and 59%, respectively. The 5- and 10-year disease-free and lymphoma-specific survival rates were 69, 56, 87 and 70%, respectively. Multivariate analysis revealed that fever, weight loss, and normal hemoglobin level were the independent factors influencing the outcome. In this retrospective multicenter RCN study, patients with PHL had a relatively better prognosis than that reported elsewhere. Multicenter prospective studies are still warranted to establish treatment guidelines, outcome, and prognostic factors.

  20. Primary Hepatic Lymphoma: A Retrospective, Multicenter Rare Cancer Network Study

    Science.gov (United States)

    Ugurluer, Gamze; Miller, Robert C.; Li, Yexiong; Thariat, Juliette; Ghadjar, Pirus; Schick, Ulrike; Ozsahin, Mahmut

    2016-01-01

    Primary hepatic lymphoma (PHL) is a rare malignancy. We aimed to assess the clinical profile, outcome and prognostic factors in PHL through the Rare Cancer Network (RCN). A retrospective analysis of 41 patients was performed. Median age was 62 years (range, 23-86 years) with a male-to-female ratio of 1.9:1.0. Abdominal pain or discomfort was the most common presenting symptom. Regarding B-symptoms, 19.5% of patients had fever, 17.1% weight loss, and 9.8% night sweats. The most common radiological presentation was multiple lesions. Liver function tests were elevated in 56.1% of patients. The most common histopathological diagnosis was diffuse large B-cell lymphoma (65.9%). Most of the patients received Chop-like (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimens; 4 patients received radiotherapy (dose range, 30.6-40.0 Gy). Median survival was 163 months, and 5- and 10-year overall survival rates were 77 and 59%, respectively. The 5- and 10-year disease-free and lymphoma-specific survival rates were 69, 56, 87 and 70%, respectively. Multivariate analysis revealed that fever, weight loss, and normal hemoglobin level were the independent factors influencing the outcome. In this retrospective multicenter RCN study, patients with PHL had a relatively better prognosis than that reported elsewhere. Multicenter prospective studies are still warranted to establish treatment guidelines, outcome, and prognostic factors. PMID:27746888

  1. Psoriasis y síndrome metabólico: Estudio retrospectivo sobre 22 casos Psoriasis And Metabolic Syndrome: Retrospective Study About 22 Clinical Cases

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    E Carbo Amoroso

    2010-03-01

    Full Text Available La Psoriasis es una enfermedad crónica inmunomediada, que se caracteriza por lesiones eritematoescamosas, asociada en ocasiones con afectación articular. Existe una gran cantidad de evidencia que demuestra, un proceso inflamatorio sistémico subyacente patogénico. Un nuevo patrón de respuesta de linfocitos T se ha propuesto como es la Th17, acompañando a una respuesta Th1 y una posible disfunción de células T reguladoras. En los últimos años se la asociado a otros procesos inflamatorios crónicos como: la enfermedad de Crohn, EPOC, síndrome metabólico, arterioesclerosis y sus complicaciones cardiovasculares. El objetivo de nuestro trabajo fue evaluar la severidad de los pacientes con Psoriasis que concurren al consultorio de Dermatología, en el Hospital Cullen de la ciudad de Santa Fe, Argentina y determinar la prevalencia de aquellos con Síndrome metabólico. Para determinar la extensión / severidad de la enfermedad se utilizó el score de PASI y para el diagnóstico del Síndrome metabólico la definición de ATPIII. El 36% de los participantes se incluyeron dentro de la definición de la enfermedad, al cumplir con tres de los cinco criterios para su diagnóstico. A partir de los datos aportados sugerimos el screening de factores de riesgo cardiovasculares, en pacientes con Psoriasis.Psoriasis is a chronic, immune mediated disease, characterized by erythematous scamous lesions, often associated with articular involvement. A large body of evidence demonstrates an underlying systemic inflammatory process, which is pathogenic. A new pattern of response of Th17 lymphocytes has been proposed as the accompanying Th1 and a possible dysfunction of regulatory Tcells. In recent years, the association with other chronic inflammatory conditions such as Crohn's disease, COPD, metabolic syndrome, atherosclerosis and cardiovascular complications. The aim of our study was to assess the severity of psoriasis patients who fulfilled the office of

  2. [Preprosthetic orthodontic treatment--retrospective statistic study].

    Science.gov (United States)

    Ispas, Dana Catrinel; Eftene, Oana Alexandra; Temelcea, Anca; Pădure, Hariclea

    2011-01-01

    Orthodontic treatment as a help is the teeth movement made in order to facilitate the odontal,prosthetic and periodontal proceedures which are needed in the dentomaxilar and/or facial reabilitation. The aim of the study was to follow for 5 years which is the percentage of patients who asked for orthodontic treatment in the Orthodontic and Dentofacial Orthopedie Clinic from UMF 'Carol Davila'. We also followed the frequency related to the etiology of the loss of some teeth and also the relationship between the loss of the teeth and periodontal disease. In our country, the number of patients who ask for preprosthetic orthodontic treatment is lower comparing with Western and Northtern Europe, but the percentage is increasing due to the dentists calification. We can conclude by saying that the frequency of losing teeth by cavities is increased by age because all patients from the study group aged 35 and above lost their teeth from cavity etiology and the patients aged 18 and lower had genetic etiology in losing their teeth.

  3. Hyponatremic hypertensive syndrome - a retrospective cohort study

    Science.gov (United States)

    Mukherjee, Devdeep; Sinha, Rajiv; Akhtar, Md Shakil; Saha, Agni Sekhar

    2017-01-01

    AIM To ascertain the frequency of hyponatremic hypertensive syndrome (HHS) in a cohort of children with hypertensive emergency in a tertiary pediatric hospital. METHODS A retrospective review was undertaken among children with hypertensive emergency admitted in our tertiary children hospital between June 2014 and December 2015 with an aim to identify any children with HHS. Three children with HHS were identified during this period. RESULTS The 3 patients with HHS presented with hypertensive emergency. They were initially managed with Labetalol infusion and thereafter switched to oral anti-hypertensives (combination of Nifedipine sustained release, Hydralazine and Beta Blocker). All 3 were diagnosed to have unilateral renal artery stenosis. One child was lost to follow up, whereas the other 2 underwent renal angioplasty which was followed with normalization of blood pressure. CONCLUSION Despite activation of renin angiotensin axis secondary to renal artery stenosis, these groups of children have significant hyponatremia. Renal re-vascularisation produces excellent results in most of them. PMID:28101450

  4. A retrospective study of 377 biopsies with a provisional

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    Taxiarchis G. KONTOGIANNIS

    2014-08-01

    Full Text Available Residual cysts (RC are radicular cysts left behind after tooth extraction. Many jaw lesions of non-odontogenic inflammatory origin may mimic the residual cyst. Aim: Τo record and discuss the prevalence and the features of jaw lesions mimicking RC, from the specimen with a provisional diagnosis of RC submitted for pathologic examination. Materials & Methods: The biopsy request forms of all lesions submitted for pathologic examination with the clinical diagnosis of RC, during a 14-year period, and the respective final pathology reports, were retrospectively studied. Selected clinical features were recorded. Results: 377 cases were retrieved. In 42 of them (11.1% the pathologic diagnosis was of a non-inflammatory odontogenic lesion. The most commonly misdiagnosed lesion was the odontogenic keratocyst (45.26%, while one ameloblastoma and 2 malignancies (metastatic tumor and malignant spindle cell tumor were also found. Conclusions: A lesion clinically diagnosed as a RC stands 1 out of 10 possibilities to be a non-odontogenic inflammatory lesion including malignant neoplasms. Thus, all lesions with clinical and radiographic features consistent with a RC must be enucleated and examined.

  5. [Juvenile Pompe disease: retrospective clinical study].

    Science.gov (United States)

    Loureiro Neves, Filipa; Garcia, Paula Cristina; Madureira, Núria; Araújo, Henriqueta; Rodrigues, Fidjy; Estêvão, Maria Helena; Lacerda, Lúcia; Diogo Matos, Luísa Maria

    2013-01-01

    Introdução: A doença de Pompe ou glicogenose tipo II é uma doença autossómica recessiva por deficiência de maltase ácida. É uma entidade rara, com prevalência de 1/40.000 nas populações holandesa e afro-americana e 1/46000 na população australiana. Embora se distingam três formas de apresentação (infantil, juvenil e do adulto), observa-se um amplo espectro clínico. Em Portugal está disponível terapêutica enzimática de substituição desde 2006.Material e Métodos: Fez-se o estudo retrospetivo de quatro doentes (duas das quais irmãs), baseado na revisão dos processos clínicos.Resultados: Em todas, a doença manifestou-se no segundo ano de vida. O tempo até ao diagnóstico variou entre dois e onze anos. Aquando do diagnóstico, todas apresentavam miopatia com atraso de aquisições motoras e em duas havia hipertrofia miocárdica. A suspeita clínica surgiu por insuficiência respiratória em contexto infeccioso em duas doentes. Em todas havia elevação da creatina quinase e das aminotransferases. Todas evoluíram com insuficiência respiratória crónica por síndrome restritiva. O diagnóstico foi baseado na diminuição da atividade da maltase ácida em fibroblastos (0 a 1,5% do limite inferior do normal). Na biópsia muscular, realizada em três doentes, demonstrou-se acumulação lisossómica de glicogénio. Todas apresentavam a mutação c.1064T > C no exão 6 do gene GAA (glucosidase-alpha-acid), em homozigotia numa delas, associada às mutações c.1666A > G no exão 12 e c.2065G > A no exão 15 nas duas irmãs e à mutação c.380G > T no exão 2 na doente mais nova. Todas iniciaram terapia enzimática de substituiçãologo que disponível, com boa tolerância. A doente mais jovem faleceu pouco depois. As outras mantêm medidas de suporteventilatório e fisioterapia, deslocando-se a mais velha, em cadeira de rodas, mantendo a irmã marcha independente e necessitando a mais nova de andarilho.Conclusão: Os nossos casos incluem-se clinicamente na forma juvenil da doença de Pompe. A hipótese de doença de Pompe deve ser considerada em lactentes com miocardiopatia e nas miopatias progressivas, especialmente as das cinturas e dos músculos respiratórios em qualquer idade. A elevação da creatina quinase é um dado sensível, embora inespecífico. Dada a grande variabilidade dos achados genéticos, a demonstração da redução da atividade da maltase ácida continua a ser o pilar do diagnóstico.

  6. A retrospective study: osteoporosis and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    H. June Kuczynski

    1989-09-01

    Full Text Available The purpose of this stud y was to determine i f women who undergo hormone replacement therapy postmenopausally, will demonstrate less osteoporosis than women who do not undergo H R T. The osteoporosis subjects were 195 women who volunteered to participate in an NIHsponsored double-blind clinical trial entitled Safely and Efficacy of Fluoride Therapy in Osteoporosis. A convenience sample of 78 controls was obtained by inviting women seeking regular medical attention to join an epidemiological investigation of osteoporosis. The data were analyzed using Chisquare and Student’s t-ratio. The study concludes that future retrospective and prospective analyses appreciate the com plexity of the problem in terms of individual risk for osteoporosis.

  7. Dosimetric characterization of two radium sources for retrospective dosimetry studies

    Energy Technology Data Exchange (ETDEWEB)

    Candela-Juan, C., E-mail: ccanjuan@gmail.com [Radiation Oncology Department, La Fe University and Polytechnic Hospital, Valencia 46026, Spain and Department of Atomic, Molecular and Nuclear Physics, University of Valencia, Burjassot 46100 (Spain); Karlsson, M. [Division of Radiological Sciences, Department of Medical and Health Sciences, Linköping University, Linköping SE 581 85 (Sweden); Lundell, M. [Department of Medical Physics and Oncology, Karolinska University Hospital and Karolinska Institute, Stockholm SE 171 76 (Sweden); Ballester, F. [Department of Atomic, Molecular and Nuclear Physics, University of Valencia, Burjassot 46100 (Spain); Tedgren, Å. Carlsson [Division of Radiological Sciences, Department of Medical and Health Sciences, Linköping University, Linköping SE 581 85, Sweden and Swedish Radiation Safety Authority, Stockholm SE 171 16 (Sweden)

    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) radiation 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 estimated that

  8. Space Adaptation Back Pain: A Retrospective Study

    Science.gov (United States)

    Kerstman, Eric

    2009-01-01

    Astronaut back pain is frequently reported in the early phase of space flight as they adapt to microgravity. The epidemiology of space adaptation back pain (SABP) has not been well established. This presentation seeks to determine the exact incidence of SABP among astronauts, develop a case definition of SABP, delineate the nature and pattern of SABP, review available treatments and their effectiveness in relieving SABP; and identify any operational impact of SABP. A retrospective review of all available mission medical records of astronauts in the U.S. space program was performed. It was revealed that the incidence of SABP has been determined to be 53% among astronauts in the U.S. space program; most cases of SABP are mild, self-limited, or respond to available treatment; there are no currently accepted preventive measures for SABP; it is difficult to predict who will develop SABP; the precise mechanism and spinal structures responsible for SABP are uncertain; there was no documented evidence of direction operational mission impact related to SABP; and, that there was the potential for mission impact related to uncontrolled pain, sleep disturbance, or the adverse side effects pf anti-inflammatory medications

  9. The Role of Postmastectomy Radiation Therapy After Neoadjuvant Chemotherapy in Clinical Stage II-III Breast Cancer Patients With pN0: A Multicenter, Retrospective Study (KROG 12-05)

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    Shim, Su Jung [Department of Radiation Oncology, Eulji General Hospital, College of Medicine, Eulji University, Seoul (Korea, Republic of); Park, Won, E-mail: wonro.park@samsung.com [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Huh, Seung Jae; Choi, Doo Ho [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Shin, Kyung Hwan [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Lee, Nam Kwon [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Department of Radiation Oncology, Korea Medical Center, Korea University, School of Medicine, Seoul (Korea, Republic of); Suh, Chang-Ok; Keum, Ki Chang; Kim, Yong Bae [Department of Radiation Oncology, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Ahn, Seung Do; Kim, Su Ssan [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Ha, Sung W.; Chie, Eui Kyu; Kim, Kyubo [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Shin, Hyun Soo [Department of Radiation Oncology, Bundang CHA Hospital, School of Medicine, CHA University, Seongnam (Korea, Republic of); Kim, Jin Hee [Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Lee, Hyung-Sik [Department of Radiation Oncology, Dong-A University Hospital, Dong-A University School of Medicine, Busan (Korea, Republic of)

    2014-01-01

    Purpose: The purpose of this study was to investigate the role of postmastectomy radiation therapy (PMRT) after neoadjuvant chemotherapy (NAC) in clinical stage II-III breast cancer patients with pN0. Methods and Materials: We retrospectively identified 417 clinical stage II-III breast cancer patients who achieved an ypN0 at surgery after receiving NAC between 1998 and 2009. Of these, 151 patients underwent mastectomy after NAC. The effect of PMRT on disease-free survival (DFS), locoregional recurrence-free survival (LRRFS), and overall survival (OS) was evaluated by multivariate analysis including known prognostic factors using the Kaplan-Meier method and compared using the log–rank test and Cox proportional regression analysis. Results: Of the 151 patients who underwent mastectomy, 105 (69.5%) received PMRT and 46 patients (30.5%) did not. At a median follow-up of 59 months, 5 patients (3.3%) developed LRR (8 sites of recurrence) and 14 patients (9.3%) developed distant metastasis. The 5-year DFS, LRRFS, and OS rates were 91.2, 98.1, and 93.3% with PMRT and 83.0%, 92.3%, and 89.9% without PMRT, respectively (all P values not significant). By univariate analysis, only age (≤40 vs >40 years) was significantly associated with decreased DFS (P=.027). By multivariate analysis, age (≤40 vs >40 years) and pathologic T stage (0-is vs 1 vs 2-4) were significant prognostic factors affecting DFS (hazard ratio [HR] 0.353, 95% confidence interval [CI] 0.135-0.928, P=.035; HR 2.223, 95% CI 1.074-4.604, P=.031, respectively). PMRT showed no correlation with a difference in DFS, LRRFS, or OS by multivariate analysis. Conclusions: PMRT might not be necessary for pN0 patients after NAC, regardless of clinical stage. Prospective randomized clinical trial data are needed to assess whether PMRT can be safely omitted in pN0 patients after NAC and mastectomy for clinical stage II-III breast cancer.

  10. Retrospective study on structural neuroimaging in first-episode psychosis

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    Ricardo Coentre

    2016-05-01

    Full Text Available Background. No consensus between guidelines exists regarding neuroimaging in first-episode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT and magnetic resonance imaging (MRI in the initial medical work-up of patients presenting first-episode psychosis. Methods. The study subjects were 32 patients aged 18–48 years (mean age: 29.6 years, consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI were retrospectively studied. Diagnostic assessments were made using the Operational Criteria Checklist +. Neuroimaging images (CT and MRI and respective reports were analysed by an experienced consultant psychiatrist. Results. None of the patients had abnormalities in neuroimaging exams responsible for psychotic symptoms. Thirty-seven percent of patients had incidental brain findings not causally related to the psychosis (brain atrophy, arachnoid cyst, asymmetric lateral ventricles, dilated lateral ventricles, plagiocephaly and falx cerebri calcification. No further medical referral was needed for any of these patients. No significant differences regarding gender, age, diagnosis, duration of untreated psychosis, in-stay and cannabis use were found between patients who had neuroimaging abnormalities versus those without. Discussion. This study suggests that structural neuroimaging exams reveal scarce abnormalities in young patients with first-episode psychosis. Structural neuroimaging is especially useful in first-episode psychosis patients with neurological symptoms, atypical clinical picture and old age.

  11. A retrospective study of nine cases of Acanthamoeba keratitis

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    Tetsuya Mutoh

    2010-10-01

    Full Text Available Tetsuya Mutoh, Isao Ishikawa, Yukihiro Matsumoto, Makoto ChikudaDokkyo Medical University Koshigaya Hospital, Saitama, JapanPurpose: To evaluate the clinical features of Acanthamoeba keratitis in nine patients diagnosed at Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.Methods: In nine eyes of nine patients, Acanthamoeba keratitis was diagnosed by direct light microscopy of corneal scrapings stained by the Parker ink-potassium hydroxide method between September 2006 and September 2009. Their clinical features and course were studied retrospectively. Antifungal eye drops, systemic antifungal therapy, and surgical debridement of the corneal lesions were performed in all patients.Results: At presentation, the clinical stage was initial in six cases, transient in one case, and complete in two cases. The patients were all contact lens wearers who had washed their lens storage cases with tap water. After treatment, final visual acuity was improved in six cases, unchanged in one case, and worse in two cases. The patient with the worst final vision (hand motion had rheumatoid arthritis and was taking oral prednisolone, which led to corneal perforation and prevented adequate debridement from being done.Conclusion: Acanthamoeba keratitis is closely related to wearing contact lenses and washing the lens storage case with tap water. Although final visual acuity improved after treatment in most patients, insufficient surgical debridement resulted in a poor visual prognosis.Keywords: surgical debridement, Acanthamoeba keratitis, contact lens wearers

  12. Amebic Liver Abscess in Israeli Travelers: A Retrospective Study

    Science.gov (United States)

    Lachish, Tamar; Wieder-Finesod, Anat; Schwartz, Eli

    2016-01-01

    Amebic liver abscess (ALA) is endemic in developing countries. The epidemiology and clinical characteristics of the disease in developing countries are well described. Travelers from nonendemic countries can serve as a model for the natural history of ALA. Currently, the available literature on travelers is limited. This is a retrospective observational study on Israeli travelers diagnosed with ALA. Data regarding travel history, clinical presentation, imaging, and treatment were collected and analyzed. Among 6,867 ill returning Israeli travelers, amebiasis was diagnosed in 53 travelers (0.77%), of whom 14 were with ALA (0.2%). Twelve ALA cases (86%) had an exposure in the Indian subcontinent. The male to female ratio was 1:1, with no significant clinical differences between the sexes. The average lag period between exposure and onset of symptoms was 17.1 months. The lack of male predominance and the prolonged lag period may imply that behavioral factors are pivotal in the development of ALA. Larger case series of travelers are required. PMID:26928829

  13. Retrospective Study of Disease Incidence and Type of Pneumonia ...

    African Journals Online (AJOL)

    Retrospective Study of Disease Incidence and Type of Pneumonia in ... out on small ruminants submitted for necropsy in the Department of Veterinary Pathology, ... broncho-interstitial pneumonia with giant cells (40%) and collapsed lung (5%).

  14. Predicting the effectiveness of insulin pump therapy on glycemic control in clinical practice: a retrospective study of patients with type 1 diabetes from 10 outpatient diabetes clinics in Sweden over 5 years.

    Science.gov (United States)

    Clements, Mark; Matuleviciene, Viktorija; Attvall, Stig; Ekelund, Magnus; Pivodic, Aldina; Dahlqvist, Sofia; Fahlén, Martin; Haraldsson, Börje; Lind, Marcus

    2015-01-01

    Multicenter long-term studies of predictors for the effectiveness of continuous subcutaneous insulin infusion (CSII) in clinical practice are lacking. We hypothesized that there are substantially greater reductions in hemoglobin A1c (HbA1c) in patients with poor glycemic control and that other predictors may also exist. We used data from 10 outpatient diabetic clinics in Sweden and studied CSII treatment over 5 years. Patients with HbA1c values available ≤ 6 months before starting CSII and at 5 years were included (n = 272, 82% of CSII patients) along with 2,437 contemporaneous controls on multiple daily insulin injections (MDI). Baseline variables evaluated were age, sex, diabetes duration, insulin dose, body mass index (BMI), HbA1c at baseline, and outpatient clinical care unit. At 5 years, significantly greater reductions in HbA1c by CSII compared with MDI were found for patients with higher baseline HbA1c (P = 0.032) and lower baseline BMI (P = 0.013). For baseline HbA1c levels of 7.0%, 8.0%, and 9.0% and a BMI of 25 kg/m(2), the reduction in HbA1c level by CSII was 0.08% (difference not significant), 0.16% (95% confidence interval, 0.03-0.29%), and 0.25% (95% confidence interval, 0.11-0.39%), respectively. Corresponding analyses for the change in HbA1c level from start to 1 and 2 years revealed a significant interaction of insulin pump therapy only with baseline HbA1c levels (P pump therapy, but effects remain relatively modest even for patients with poor control. Factors predicting successful insulin pump use need further study.

  15. LAPAROSCOPIC GYNAEC SURGERIES – A RETROSPECTIVE STUDY

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    Hiremath

    2013-10-01

    Full Text Available ABSTRACT : BACKGROUND: There has been a rapid worldwide adoption of laparoscopic procedures across many surgical specialt ies, most notably in Gynaecology. Unfortunately, the increased adoption of laparoscopic surgery has also been accompanied by a corresponding rise in the rates and types of complications reported. AIMS : To audit the different types of laparoscopic surgerie s and their complications and comparison with other routes of surgery. METHODS & MATERIALS : We have retrospectively analysed 285 laparoscopic surgeries and 306 other routes of surgery which were done at our institute from July 2011 to April 2013.We admit t he patients 1 - 2 days prior to surgery and a complete medical work - up of the patient is done for elective laparoscopic surgery .We defer laparoscopy for malignant conditions, uterine size more than 20 weeks, cervix flushed to the vagina or with history of m ore than 2 pelvic surgeries. Sub - fertile women, after an initial workup, are subjected to diagnostic laparoscopy with chromopertubation. For laparoscopic cystectomies, patients with ultrasono graphy findings suggestive of benign tumours are selected. RESULT S : We have performed 285 laparoscopic procedures over this time period till date. Majority of these cases are Laparoscopic Assisted Vaginal Hysterectomies (LAVH [111 – 38.9%], followed by laparoscopic surgeries for various benign ovarian conditions ( BOC [62 – 21%] and Diagnostic Laparoscopies ( DL with or without laparoscopic ovarian drilling ( LOD [59 cases – 20.7%]. Out of 111 LAVH, 3 patients had bladder injury [2.7%] ; Out of 285 cases that underwent laparoscopic procedures, 5 [1.75%] required conversi on to laparotomy. Overall operative complications including major and minor, are significantly higher in the abdominal surgery group as compared to the laparoscopic group ( p value= 0.001 CONCLUSION : Laparoscopy is a safe route for conventional surgery, with lesser intraoperative, immediate post

  16. Revealing Latent Value of Clinically Acquired CTs of Traumatic Brain Injury Through Multi-Atlas Segmentation in a Retrospective Study of 1,003 with External Cross-Validation.

    Science.gov (United States)

    Plassard, Andrew J; Kelly, Patrick D; Asman, Andrew J; Kang, Hakmook; Patel, Mayur B; Landman, Bennett A

    2015-03-20

    Medical imaging plays a key role in guiding treatment of traumatic brain injury (TBI) and for diagnosing intracranial hemorrhage; most commonly rapid computed tomography (CT) imaging is performed. Outcomes for patients with TBI are variable and difficult to predict upon hospital admission. Quantitative outcome scales (e.g., the Marshall classification) have been proposed to grade TBI severity on CT, but such measures have had relatively low value in staging patients by prognosis. Herein, we examine a cohort of 1,003 subjects admitted for TBI and imaged clinically to identify potential prognostic metrics using a "big data" paradigm. For all patients, a brain scan was segmented with multi-atlas labeling, and intensity/volume/texture features were computed in a localized manner. In a 10-fold cross-validation approach, the explanatory value of the image-derived features is assessed for length of hospital stay (days), discharge disposition (five point scale from death to return home), and the Rancho Los Amigos functional outcome score (Rancho Score). Image-derived features increased the predictive R(2) to 0.38 (from 0.18) for length of stay, to 0.51 (from 0.4) for discharge disposition, and to 0.31 (from 0.16) for Rancho Score (over models consisting only of non-imaging admission metrics, but including positive/negative radiological CT findings). This study demonstrates that high volume retrospective analysis of clinical imaging data can reveal imaging signatures with prognostic value. These targets are suited for follow-up validation and represent targets for future feature selection efforts. Moreover, the increase in prognostic value would improve staging for intervention assessment and provide more reliable guidance for patients.

  17. A retrospective study of 102 patients with pemphigus

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    Mahmut Sami Metin

    2015-06-01

    Full Text Available Background and Design: Pemphigus is a severe and life-threatening chronic autoimmune mucocutaneous blistering disease. The aim of this study was to evaluate and analyze the course, prognostic factors and epidemiological, clinical and therapeutic features of pemphigus in patients followed between 2004 and 2013. Materials and Methods: We performed a 10-years retrospective study of patients diagnosed with pemphigus in Erzurum. The parameters evaluated include age, sex, diagnostic methods, duration of hospitalizations, distribution of lesions, duration and therapeutic doses. Results: The results showed that the estimated annual incidence rate was 1.31 cases per 100,000 person-years. The male to female ratio was 1.081. The mean age at onset of the disease was 48 years (range, 7–95 years. Thirty six patients had only skin lesions and sixty-six cases had both skin and oral mucosal lesions. The majority of the patients (58.8% with pemphigus were treated with middle or high-dose corticosteroids (40–160 mg/day. Conclusions: Pemphigus vulgaris is the most common clinical subtype in Erzurum and the mean age of the disease onset in the present study was found to be a decade earlier than in other parts of the world. The patients with both oral mucosa and skin involvement required higher corticosteroid doses and longer hospitalization time when compared to the patients with oral mucosa involvement alone.

  18. Impact of a half-day multidisciplinary symptom control and palliative care outpatient clinic in a comprehensive cancer center on recommendations, symptom intensity, and patient satisfaction: a retrospective descriptive study.

    Science.gov (United States)

    Strasser, Florian; Sweeney, Catherine; Willey, Jie; Benisch-Tolley, Susanne; Palmer, J Lynn; Bruera, Eduardo

    2004-06-01

    To characterize a new, one-stop multidisciplinary palliative care (MD) clinic which offers standardized multidisciplinary assessment, specific care recommendations, patient and family education, and on-site counseling, we retrospectively compared the assessments of 138 consecutive patients with advanced cancer referred to the MD clinic and 77 patients referred to a traditional pain and symptom management (PSM) clinic. The two groups were similar in tumor type, demographics, and symptom distress. The MD clinic team (physicians; nurses; pharmacists; physical, speech, and occupational therapists; social workers; chaplains; nutritionists; psychiatric nurse practitioner) delivered 1,066 non-physician recommendations (median 4 per patient, range 0-37). The PSM clinic team made no non-physician recommendations, but referred 14 patients to other medical specialists. In 80 (58%) MD-clinic patients with follow-up 9 days (median) after assessment, significant improvement was observed in pain, nausea, depression, anxiety, sleep, dyspnea, and well-being, but not in fatigue, anorexia, or drowsiness. In 83 patients interviewed after the MD clinic, satisfaction was rated as excellent (5 out of 5) in 86-97% of seven areas. Assessment at an MD clinic results in a high number of patient care recommendations, improved symptoms, and high levels of patient satisfaction.

  19. A retrospective review of trends and clinical characteristics of ...

    African Journals Online (AJOL)

    violent behaviour, impulsivity, depression, poor motivation, decreased ... Method: The clinical records of patients admitted to an acute psychiatric admission ward ... nursing notes were reviewed from 30 randomly selected patient folders for the ...

  20. 45,X/46,XY mosaicism: report on 14 patients from a Brazilian hospital. A retrospective study

    OpenAIRE

    Rafael Fabiano Machado Rosa; Willy Francisco Bartel D'Ecclesiis; Raquel Papandreus Dibbi; Rosana Cardoso Manique Rosa; Patrícia Trevisan; Carla Graziadio; Giorgio Adriano Paskulin; Paulo Ricardo Gazzola Zen

    2014-01-01

    CONTEXT AND OBJECTIVE: 45,X/46,XY mosaicism, or mixed gonadal dysgenesis, is considered to be a rare disorder of sex development. The aim of our study was to investigate the clinical and cytogenetic characteristics of patients with this mosaicism.DESIGN AND SETTING: A retrospective study in a referral hospital in southern Brazil.METHODS: Our sample consisted of patients diagnosed at the clinical genetics service of a referral hospital in southern Brazil, from 1975 to 2012. Clinical and cytoge...

  1. Non-traumatic ileal perforation: A retrospective study

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    Gurjit Singh

    2014-01-01

    Full Text Available Objective: To determine clinical features, operative findings and post-operative complications in patients operated for non-traumatic ileal perforation and to discuss the role of typhoid vaccination. Materials and Methods: A retrospective study was carried out from 2009-2010. Seven patients were admitted through casualty as cases of acute abdomen. Underlying conditions were typhoid ulcers (4 patients and non-specific etiology (3 patients. Diagnosis was made on clinical grounds, laboratory investigations, radiology and operative findings. Exploratory laporotomy was done. Different variables studied post-operatively were wound infection, residual abscess, recurrence and delayed post-operative complications. Results: Tenderness, distension and rigidity were found in maximum patients. Gases under diaphragm and air fluid levels were common radiological findings. However, widal test and blood culture for S. typhi was positive in four patients. Six patients had single perforation and one patient had two perforations, all being on antimesentric border of ileum. Maximum patients had peritoneal collection of less than 1000 ml. In five patients simple closure of perforation was done and in remaining two resection with end to side ileotransverse anatomosis was required. Wound infection and residual intraabdominal abscess were found in one patient each. Conclusion: Management criteria remain same in typhoid and non-specific perforations. Commonest cause of ileal perforation is typhoid fever in our country, so immunization against typhoid beyond 18 years of age is recommended.

  2. Correlation of Clinicohaematological Parameters in Paediatric Dengue: A Retrospective Study

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    Ramakrishna Pai Jakribettu

    2015-01-01

    Full Text Available Dengue is one of the arthropod-borne (arbo viral diseases transmitted by female mosquito Aedes aegypti. Dengue fever has a wide spectrum of clinical presentation ranging from flu-like illness to severe complicated stage of dengue hemorrhagic fever leading to mortality. This was a retrospective study conducted in a tertiary care hospital in Coastal Karnataka, South India, to know the correlation between the clinical presentation and haematological parameters in the paediatric cases presented with dengue symptoms. A total of 163 paediatric cases who presented fever and dengue-like illness were included in the study. Of which, 69 were confirmed dengue patients. Critical analysis showed that there was a significant difference in the haematological parameters like total leucocyte count, percent differential leucocyte count, and platelets count, in the erythrocyte sedimentation rate (P<0.05 to 0.0001. Additionally, when compared to nondengue patients, even the liver function and renal function parameters were significantly deranged (P<0.05 to 0.0001. Stratification based on NS1, IgG, and IgM showed significant alterations in the haematological, hepatic, and renal parameters. With respect to the treatment a small percentage of patients, that is, 8% (4 patients, required platelet transfusion as their counts went below 20,000/μL. Two patients succumbed to their illness while three required ICU stay.

  3. Thyroid dysfunction in type 2 diabetes mellitus: A retrospective study

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    Laloo Demitrost

    2012-01-01

    Full Text Available Introduction: Type 2 diabetes mellitus (DM is a growing problem in our country and we have observed that many patients are associated with thyroid dysfunction later in their life. However, the prevalence of thyroid dysfunction in these patients has not been investigated. Aims and Objectives: To find the prevalence of thyroid dysfunction in type 2 DM in Manipur, India. Materials and Methods: In this retrospective study, data of 202 Type 2 DM patients who attended the diabetic clinic of the Regional Institute of Medical Sciences, Imphal from January 2011 to July 2012, and whose thyroid stimulating hormone (TSH level was investigated were included. The inclusion criteria are known cases of type 2 DM. Exclusion criteria are patients with previous history of hypothyroidism and those on drugs affecting the thyroid profile. Results: Out the 202 type 2 DM patients for the study of which 61 are males and 141 are females, 139 (68.8% are euthyroid, 33 (16.3% have subclinical hypothyroidism (10 males and 23 females, 23 (11.4% have hypothyroidism (6 males and 17 females, 4 (2% have subclinical hyperthyroidism and 3 (1.5% are hyperthyroidism cases. Maximum cases were of hypothyroidism (subclinical and clinical seen in the age group of 45-64 years. Patients with BMI > 25 were at increased risk of having hypothyroidism (P < 0.016. Conclusion: Prevalence of hypothyroidism is quite high in type 2 DM patients above 45 years and more so if their BMI is over 25.

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

    Science.gov (United States)

    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.

  5. CLINICOPATHOLOGICAL STUDY OF LICHENOID REACTIONS: A RETROSPECTIVE ANALYSIS

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    Ravikant

    2015-04-01

    Full Text Available BACKGROUND: Lichenoid dermatose s refer to various, clinically different inflammatory dermatoses which share in common, various essential lichenoid histologic features. AIMS AND OBJECTIVE: In this study we have analysed the different clinicopathological aspects in lichenoid reactions, as prompt diagnosis of these lesions can greatly influence the morbidity associated with the disease. STUDY DESIGN: This was a 14 month retrospective analysis of cases presenting to the department of dermatology from June 2013 till July 2014. MATERIALS AND METHODS: All new patients diagnosed with lichenoid reaction clinically and histopathologically were included in the study. INCLUSION CRITERIA: All newly diagnosed cases of Lichenoid tissue reactions within the time period mentioned above . EXCLUSION CRITERI A: Patients whose adequate records were unavailable Statistical Analysis: The SPSS, version 13 software was used to statistically analyse the data. RESULTS: A total of 66 cases were diagnosed as lichenoid reactions, 51 were lichen planus and 15 had licheno id eruptions. Males (53% were more commonly affected than female s (47%, with lower limbs (69. 69% being the most common site of predilection. Oral lesions were seen among eleven patients. Histopathologically, the most consistent findings with lichenoid r eaction was the presence of a lymphocytic infiltrate followed by vacuolar degeneration of basal cell layer, hyperkeratosis, hypergranulosis, acanthosis, pigment incontinence and a band like infiltrate over the basal layer. CONCLUSION: In our study, Licheno id reactions were more common among adults from the 2 nd to 4 th decade and can show ed a male preponderance, with the most frequent archetype being lichen planus. Thus this study emphasises on the need of histological analysis in various clinically similar c ases of lichenoid dermatoses in order to arrive at a definitive diagnosis.

  6. Usefulness of multiplex PCR methods and respiratory viruses’ distribution in children below 15 years old according to age, seasons and clinical units in France: A 3 years retrospective study

    Science.gov (United States)

    Collin, Gilles; Ichou, Houria; Charpentier, Charlotte; Bendhafer, Samia; Dumitrescu, Madalina; Allal, Lahcene; Cojocaru, Bogdan; Desfrère, Luc; Descamps, Diane; Mandelbrot, Laurent; Houhou-Fidouh, Nadhira

    2017-01-01

    Background To date, only influenza and RSV testing are recommended for respiratory viruses’ detection in paediatric units. In this study, we described, according to seasons, ages and clinical units, the results obtained in children (<15 years old) by multiplex-PCR (mPCR) tests allowing a quick and wide range detection of all respiratory viruses. These results were also compared with RSV specific detection. Methods All nasopharyngeal mPCR and RSV tests requested by clinicians in our French teaching hospitals group between 2011 and 2014 were retrospectively included. All repeated samples for the same children in the same month were discarded. Results Of the 381 mPCR tests (344 children) performed, 51.4% were positive. Positivity and viral co-infection rates were higher in the 6–36 months old strata (81% and 25%, p<0.0001 and p = 0.04, respectively). Viral distribution showed strong variations across ages. During specific influenza epidemic periods, only 1/39 (2.5%) mPCR tests were positive for influenza and 19/39 (48.7%) for other viruses. During specific RSV epidemic periods, only 8/46 (17.4%) mPCR tests were positive for RSV and 14/46 (30.4%) for other viruses. 477/1529 (31.2%) of RSV immunochromatography-tests were positive. Among the negatives immunochromatography-test also explored by mPCR, 28/62 (31%) were positive for other respiratory viruses. Conclusion This study provides a wide description of respiratory viruses’ distribution among children in hospital settings using mPCR over 3 years. It emphasizes the number of undiagnosed respiratory viruses according to the current diagnosis practice in France and gives a better picture of respiratory viruses identified in hospital settings by mPCR all over the year in France. PMID:28235002

  7. Usefulness of multiplex PCR methods and respiratory viruses' distribution in children below 15 years old according to age, seasons and clinical units in France: A 3 years retrospective study.

    Science.gov (United States)

    Visseaux, Benoit; Collin, Gilles; Ichou, Houria; Charpentier, Charlotte; Bendhafer, Samia; Dumitrescu, Madalina; Allal, Lahcene; Cojocaru, Bogdan; Desfrère, Luc; Descamps, Diane; Mandelbrot, Laurent; Houhou-Fidouh, Nadhira

    2017-01-01

    To date, only influenza and RSV testing are recommended for respiratory viruses' detection in paediatric units. In this study, we described, according to seasons, ages and clinical units, the results obtained in children (<15 years old) by multiplex-PCR (mPCR) tests allowing a quick and wide range detection of all respiratory viruses. These results were also compared with RSV specific detection. All nasopharyngeal mPCR and RSV tests requested by clinicians in our French teaching hospitals group between 2011 and 2014 were retrospectively included. All repeated samples for the same children in the same month were discarded. Of the 381 mPCR tests (344 children) performed, 51.4% were positive. Positivity and viral co-infection rates were higher in the 6-36 months old strata (81% and 25%, p<0.0001 and p = 0.04, respectively). Viral distribution showed strong variations across ages. During specific influenza epidemic periods, only 1/39 (2.5%) mPCR tests were positive for influenza and 19/39 (48.7%) for other viruses. During specific RSV epidemic periods, only 8/46 (17.4%) mPCR tests were positive for RSV and 14/46 (30.4%) for other viruses. 477/1529 (31.2%) of RSV immunochromatography-tests were positive. Among the negatives immunochromatography-test also explored by mPCR, 28/62 (31%) were positive for other respiratory viruses. This study provides a wide description of respiratory viruses' distribution among children in hospital settings using mPCR over 3 years. It emphasizes the number of undiagnosed respiratory viruses according to the current diagnosis practice in France and gives a better picture of respiratory viruses identified in hospital settings by mPCR all over the year in France.

  8. Herpes Zoster in Healthy Children: A Retrospective Study

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    Birgül Tepe

    2016-06-01

    Full Text Available Objective: Herpes zoster is an acute dermatomal viral infection caused by the reactivation of varicella zoster virus. While it is commonly seen among elderly and immunocompromised individuals, it is rare in healthy children. The aim of this study was to evaluate the clinical features, treatment and complications of healthy children with herpes zoster. Methods: Thirty one patients aged between 0-16 years who were admitted to our clinic with the diagnosis of herpes zoster, between January 2014 and December 2014, were evaluated retrospectively for age, gender, month of admission, complaint, history of chickenpox infection or varicella vaccination, triggering factors, dermatomal involvement, complications and treatment. Results: Among 31 patients with diagnosis of herpes zoster, 19 were boys (61.3% and 12 were girls (38.7%. The mean of age was 9.12±4.4 years. Twenty patients had thoracic (64.5%, six had lumbar (19.4% and five had cervical involvements (16.2%. The most frequent symptoms were pruritus and pain, respectively. Six patients were administered topical treatment and 25 patients were treated with both systemic and topical treatments. Complication was not observed. Conclusion: Herpes zoster is also being encountered increasingly in healthy children nowadays. It is benign and generally no complications are observed. Incidence can vary because of geographic and socioeconomic differences like vaccination programs.

  9. Leprosy Reaction in Thai Population: A 20-Year Retrospective Study

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    Poonkiat Suchonwanit

    2015-01-01

    Full Text Available Background. Leprosy is a chronic infectious disease that presents with varying dermatological and neurological symptoms. The leprosy reactions occur over the chronic course of the disease and lead to extensive disability and morbidity. Objective. To analyze and identify the risk factors which contribute to leprosy reactions. Methods. In a retrospective study, we reviewed the medical records of leprosy patients registered at the leprosy clinic, Ramathibodi Hospital, Thailand, between March 1995 and April 2015. One hundred and eight patients were included; descriptive analysis was used for baseline characteristics and a binary logistic regression model was applied for identifying risk factors correlated with leprosy reactions. Results. Of the 108 cases analyzed, 51 were male and 57 were female. The mean age of presentation was 45 years. The borderline tuberculoid type was the most common clinical form. Leprosy reactions were documented in 61 cases (56.5%. The average time to reaction was 8.9 months. From multivariate analysis, risk factors for leprosy reactions were being female, positive bacillary index status, and MB treatment regimen. Conclusions. Leprosy reactions are common complications in leprosy patients. Being female, positive bacillary index status, and multibacillary treatment regimen are significantly associated with the reactions. Early detection in cases with risk factors followed by appropriate treatment could prevent the morbidity of leprosy patients.

  10. Ruminant neurological disease: a retrospective cohort study.

    Science.gov (United States)

    Giles, Lucy; Orr, Jayne; Viora, Lorenzo; Gutierrez-Quintana, Rodrigo; Logue, David; Guevar, Julien

    2017-09-05

    Between January 2006 and June 2016, 96 ruminants with neurological signs were donated to the Scottish Centre for Production Animal Health and Food Safety (SCPAHFS), University of Glasgow, by veterinarians in the field representing 5.4 per cent of all submissions. Forty-seven different neurological presenting signs were reported with 79 per cent of the donated patients presenting with abnormal gait. All cases presenting with abnormalities in more than 4 out of 10 neurological categories died or were euthanased on welfare grounds. Calves were significantly more likely to present with neurological disorders than adult cattle compared with the proportion of calves: cows in the Scottish cattle population and total case population donated to SCPAHFS. Lesions were most commonly localised to the spinal cord in sheep 47 per cent (16), the peripheral nervous system in cattle 45 per cent (28) and to the brain in the overall population 41 per cent (39). The most common aetiology of neurological pathologies observed was infectious or inflammatory 28 per cent (27). Definitive diagnoses could be reached in 84 per cent (81) of patients. When postmortem reports were available, they produced a diagnosis in 70 per cent (52) of cases and contradicted clinical diagnoses in 38 per cent (26) of cases. The most frequently diagnosed conditions in ruminants over the 10 years were spastic paresis, vertebral osteomyelitis and listeriosis. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. INVASIVE FUNGAL INFECTIONS OF HEAD AND NECK: A RETROSPECTIVE STUDY

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    Somu

    2015-08-01

    Full Text Available Invasive fungal infection of the head and neck is an emerging problem with diverse presentation. It has recently gained clinical importance as it causes considerable morbidity and mortality. It is more common in patients with diabetics, chronic renal disease, patients undergoing chemotherapy etc. Early recognition of this entity will enable treating surgeon to institute appropriate treatment. AIM OF THE STUDY: To review the microbiological and clinicopathological profile of patients diagn osed as invasive fungal infections of the head and neck in a tertiary referral hospital. METHODOLOGY: In this retrospective study we reviewed the clinical data ( M icrobiology, clinical manifestations, radiological investigation, diagnosis, therapy and histolopathology of 25 patients diagnosed and treated for invasive fungal infection of the head and neck in our unit in a tertiary care hospital. The period of study was July 2006 to July 2010 (4 years. All cases with a diagnosis of invasive fungal infection of the head and neck region, confirmed either by fungal smear, culture or histopathological examination were included in the study. RESULTS: In this study, Of the 25 patients, majority had invasive fungal rhinosinusitis (52%, mucormycosis (32% and zygomycotic necrotizing fasciitis (12%. One patient had invasive subcutaneous aspergillosis. Most of the patients presented in the fifth decade of life, 86% of these patients had uncontrolled diabetes. The commonest presentation in mucormycosis was head ache or facial pain (100% along with ptosis (88%. Fungal smear was positive in 81%, fungi were isolated in culture in 54% and histopathological study was positive for fungal hyphae in all these patients (100%. Though all these patients had florid fungal infection of the head and neck only one patient had clinical and radiological evidence of cervical lymphadenitis. CONCLUSION: A clinical suspicion of mucormycosis should be kept in mind in an immunocompromised patient

  12. Analysis of the clinical effects of transforaminal endoscopic discectomy on lumbar disk herniation combined with common peroneal nerve paralysis: a 2-year follow-up retrospective study on 32 patients

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    Wang YP

    2017-01-01

    Full Text Available Ya-peng Wang,* Wei Zhang, Jian Zhang, Ya-peng Sun,* Ji-long An, Wen-yuan Ding Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China *These authors contributed equally to this work Background: Very few studies have discussed transforaminal endoscopic discectomy (TED in the treatment of common peroneal nerve paralysis induced by lumbar disk herniation (LDH. This study aimed to evaluate the efficacy of TED in the treatment of LDH combined with common peroneal nerve paralysis.Materials and methods: The clinical and follow-up data of 32 patients with common peroneal nerve paralysis induced by LDH undergoing TED from March 2011 to April 2014 were retrospectively analyzed in this study. Follow-up was conducted immediately after the surgery, as well as 3, 12, and 24 months postoperatively. The parameters (including muscle strength recovery of the anterior tibial muscle, leg pain visual analog scale score, neurological function Japanese Orthopaedic Association [JOA] score, MacNab scores in the last follow-up, and the intraoperative and postoperative complications were recorded.Results: Three patients (9.4% had the anterior tibial muscle strength recovered to ≥ grade 4 immediately after the surgery. The anterior tibial muscle strength of patients recovered to basically stable form in the 6-month postoperative follow-up and that in the last follow-up were as follows: one case of grade 1, one case of grade 2, 28 cases of grade 4, and two cases of grade 5. The visual analog scale scores of leg pain were significantly reduced immediately after the surgery and also on 3, 12, and 24 months compared with preoperative period (all P<0.05. The postoperative JOA scores in the last follow-up were significantly higher than the preoperative JOA scores (P<0.05, and there were nine excellent cases (28.2%, 21 good cases (65.6%, one fair case (3.1% and one poor case (3.1% in the last follow-up, with

  13. 足阳明经筋型膝骨关节炎临床影像学研究%Retrospective Study on Clinical and Imaging Features of Foot-Yangming Meridian-muscle Syndrome of Knee Osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    陈宇; 杨林; 吴煊

    2016-01-01

    【目的】探讨足阳明经筋型膝骨关节炎(KOA)的临床影像学特征,进一步完善经筋理论的科学内涵。【方法】选取足阳明经筋型KOA病例31例(31个膝关节)为足阳明经筋型KOA组(研究组),健康体检者31例(31个健康膝关节)为空白对照组(空白组),进行基于髌股关系的临床影像学回顾性研究。【结果】2组Insall指数及髌骨指数比较,差异均无统计学意义(P>0.05);但2组髌股指数、髌股协调角与外侧髌骨角度比较,差异均有统计学意义(P <0.01)。【结论】髌股关系紊乱是足阳明经筋型KOA的主要病变特征之一。%Objective To investigate the clinical and imaging features of Foot-Yangming meridian-muscle syndrome of knee osteoarthritis(KOA) so as to promote the normalization and standardization of the meridian-muscle therapies. Methods A total of 31 KOA cases (involving 31 knees) of Foot-Yangming meridian-muscle syndrome were included into the study group , and 31 healthy volunteers (involving 31 knees) served as the control group. A retrospective research of patellofemoral relationship was carried out based on the clinical and imaging features. Results The differences of Insall index and patella index between the study group and control group were insignificant(P> 0 . 05), but the differences of patellofemoral index , patellofemoral congruence angle, and external patellar angle between the study group and control group were significant(P<0.01). Conclusion The patellofemoral relationship disorder is one of main lesions in Foot-Yangming meridian-muscle syndrome of KOA.

  14. 360 DEGREE SUBANNULAR TYMPANOPLASTY: A RETROSPECTIVE STUDY

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    Kuldeep

    2015-04-01

    Full Text Available OBJECTIVE OF THE STUDY: To study the efficacy of underlay tympanoplasty by elevating the annulus by 360 degrees. SUBJECTS AND METHODS : Two hundred patients with chronic otitis media , tubotympanic disease , inactive stage who underwent tympanoplasty by the above technique between the years 2009 to 2013 were selected for the study as and when they were admitted. All the patients were followed up for 6 months fol lowing surgery. Any complications like secondary infection , wound dehiscence , granulations , were looked for and treated appropriately. Status of the neotympanum was evaluated at the end of 3 months. Any anterior blunting , medialisation or lateralisation of the graft was noted. Any residual perforation was considered as failure. Hearing was evaluated in all patients with an intact neotympanum. RESULTS : Our study showed an overall success rate of 96% as far as graft uptake was concerned. Hearing improvement w as seen in 93% of our patients. 6 patients had complete air bone gap closure , 49 had AB gap of 10db or less , 131 had AB gap of 11 - 20db. 14 patients had no improvement in hearing. Overall hearing improvement was seen in 93% of our patients. CONCLUSION : In c onclusion 360 degree sub - annular tympanoplasty is a efficient technique of tympanoplasty with very good results.

  15. Dental implants in medically complex patients-a retrospective study.

    Science.gov (United States)

    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 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.

  16. E-GOVERNMENT DATABASES: A RETROSPECTIVE STUDY

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    RAJESH CHAUHAN

    2010-08-01

    Full Text Available The government is the biggest producer of information and efficient management of the vast amount of data available within the government departments is of utmost importance. Due to the advent of information and communication technology (ICT, the e-government applications are being implemented to improve government functioning by exploiting ICT potential. In order to meet government data needs, the databases need to be designed conforming to standard database design principles. This research paper attempts to study the structure of existing databases used in the government departments as e-government applications. The study reveals the extent of adherence to the most basic parameters while designing the database keeping in view the long term sustainability of e-government applications.

  17. Patient characteristics, menopause symptoms, and care provided at an interdisciplinary menopause clinic: retrospective chart review.

    Science.gov (United States)

    Sydora, Beate C; Yuksel, Nese; Veltri, Nicole L; Marillier, Justin; Sydora, Christoph P; Yaskina, Maryna; Battochio, Lori; Shandro, Tami M L; Ross, Sue

    2017-07-10

    The goal of this study was to describe the characteristics, menopause symptoms, and treatment progressions in women cared for at an interdisciplinary menopause clinic. We conducted a retrospective review of patient charts from women attending a multidisciplinary menopause clinic. Data collected from the charts included patient demographics, menopause symptoms, other concurrent medical conditions, and treatment recommendations. Data were entered into Research Electronic Data Capture database and analyzed descriptively. Generic symptom severity questionnaires were used to compare severity scores from initial to follow-up visits. Among the 198 women (mean age 52.1 y [±SD 6.3], 63.6% postmenopausal), the most common moderate/severe menopause symptoms were as follows: difficulty staying asleep or waking frequently (76.3%), tiredness (73.7%), and lack of interest in sex (60.1%). Women tended to have complex chronic medical conditions, with 54.5% suffering from four or more concurrent medical conditions. The majority of women (70.2%) were recommended various forms of hormone therapy. Women with a follow-up visit at 3 to 4 months reported a reduction in symptom severity. Our study addresses a gap in published information on patient characteristics and treatment in menopause-specific interdisciplinary clinics. The chart review highlights the variety of symptom experience and complexity of care faced in a menopausal clinic. Rigorous prospective studies including standardized data collection and follow-up are needed to help guide clinicians in managing complex menopause patients.

  18. Retrospective study of ameloblastoma: the possibility of conservative treatment.

    Science.gov (United States)

    Hasegawa, Takumi; Imai, Yusuke; Takeda, Daisuke; Yasuoka, Daisuke; Ri, Shinshou; Shigeta, Takashi; Minamikawa, Tsutomu; Shibuya, Yasuyuki; Komori, Takahide

    2013-11-09

    At our institutions, most cases of the solid or multicystic type were treated as conservatively as possible in order to avoid disadvantages of radical treatment. The aim of present study was to retrospectively analyze the ameloblastoma cases diagnosed at our two institutions, to classify them according to the criteria of the 2005 WHO classification, and to evaluate the possibility of using a conservative approach for the surgical treatment of ameloblastoma. Maxillary cases, unicystic cases, peripheral cases and resection-treated cases were excluded from this study. In 23 tumors of mandibular solid or multicystic ameloblastoma, a patient's age, gender, location, clinical signs, duration, radiographic appearance, preoperative diagnosis, ameloblastoma subtypes, treatment, and recurrence were investigated. The recurrence rate (48.7%) in this study was lower than the reported recurrence rate after conservative treatment for solid or multicystic ameloblastoma and was higher than the reported recurrence rate of ameloblastoma, inclusive of other types. However, all patients who were diagnosed with recurrences have maintained their quality of life and were satisfied for at least several years after the conservative treatment. In conclusion, we demonstrated one possibility that a conservative approach might be employed in the surgical treatment of ameloblastoma (even of the solid or multicystic type).

  19. Who are Sleeping in Sleep Laboratory? A Retrospective Study

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    Mine Ayşe Altun Emirza

    2012-03-01

    Full Text Available OBJECTIVE: Aim of this study is to compare the results of gold standard in diagnosing sleep disorders polysomnography (PSG with the physician’s preliminary diagnosis and complaints of patients in our data of sleep laboratory. METHODS: 656 patients who made PSG were included in the study. All of the patients age, gender, comorbid chronic disease, complaints, preliminary diagnosis and PSG diagnosis were evaluated retrospectively. RESULTS: In our study, the average age of patients was 56 and 43% women 57% were male. Complaints of patients were snoring, fatigue, stopped breath during sleep, insomnia, headache, daytime sleepiness, restless legs and abnormal behaviors during sleep. According to preliminary diagnoses and PSG diagnoses; Obstructive Sleep Apnea Syndrome (OSAS, narcolepsy, REM behavior disorder (RBD reduced (p 0.05. Sleep disorders in patients was accompanied by chronic diseases, hypertension (34.3%, diabetes (12.8%, Chronic Obstructive Pulmonary Disease (COPD (1.2%, epilepsy (1.8%, Parkinson's disease (3.5%, dementia (3.2%, depression (18.4%, cardiovascular disease (13.3% and cerebrovascular disease (4.9%. 9%. CONCLUSION: We are offering a good clinical history and physical examination with the correct interpretation of PSG for the differential diagnosis can be made true, accurate diagnoses and appropriate treatment modalities in our patients.

  20. Acetazolamide in vestibular migraine prophylaxis: a retrospective study.

    Science.gov (United States)

    Çelebisoy, Neşe; Gökçay, Figen; Karahan, Ceyda; Bilgen, Cem; Kirazlı, Tayfun; Karapolat, Hale; Köse, Timur

    2016-10-01

    The aim of this study is to check the efficacy of acetazolamide in the prophylaxis of vestibular migraine (VM). Treatment options in VM are mainly based on migraine guidelines. We tried to assess the efficacy of acetazolamide in these patients depending on clinical similarities with episodic ataxia type 2 and familial hemiplegic migraine responding to the drug. This is a retrospective cohort study. Among 50 patients with VM and prescribed acetazolamide 500 mg/day, 39 patients were studied as five had been lost on follow-up and six had stopped taking the drug due to side effects. Vertigo and headache frequency determined by number of attacks per month, and the severity determined by visual analog scales measured in centimeters from 0 to 10 were collected from the records. Initial reported figures for frequency and severity were compared with the results gathered after 3 months of treatment. The results were compared. Acetazolamide was effective in reducing both the frequency and severity of vertigo and headache attacks and this effect was more prominent for vertigo frequency and severity.

  1. Heterogeneous cytogenetic subgroups and outcomes in childhood acute megakaryoblastic leukemia : a retrospective international study

    NARCIS (Netherlands)

    Inaba, Hiroto; Zhou, Yinmei; Abla, Oussama; Adachi, Souichi; Auvrignon, Anne; Beverloo, H. Berna; de Bont, Eveline; Chang, Tai-Tsung; Creutzig, Ursula; Dworzak, Michael; Elitzur, Sarah; Fynn, Alcira; Forestier, Erik; Hasle, Henrik; Liang, Der-Cherng; Lee, Vincent; Locatelli, Franco; Masetti, Riccardo; De Moerloose, Barbara; Reinhardt, Dirk; Rodriguez, Laura; Van Roy, Nadine; Shen, Shuhong; Taga, Takashi; Tomizawa, Daisuke; Yeoh, Allen E. J.; Zimmermann, Martin; Raimondi, Susana C.

    2015-01-01

    Comprehensive clinical studies of patients with acute megakaryoblastic leukemia (AMKL) are lacking. We performed an international retrospective study on 490 patients (age 50 chromosomes (n=44, 11.8%). Chromosome gain occurred in 195 of 372 (52.4%) patients: +21 (n = 106, 28.5%), +19 (n = 93, 25.0%),

  2. Frequency of hypertension in chronic Chagas' disease: retrospective clinical study Freqüência da hipertensão arterial na doença de Chagas crônica: estudo clínico retrospectivo

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    Cristina Brandt Friedrich Martin Gurgel

    2003-12-01

    Full Text Available OBJECTIVE: To assess the frequency of hypertension in chagasic patients, as well as its clinical behavior and cardiologic findings. METHODS: We carried out a retrospective study with 225 patients with chronic Chagas' disease and hypertension (104 males, mean age of 55.1 ± 11.8. These patients were being followed up in the outpatient care clinics from 1984 to 2000. The study assessed the clinical, electrocardiographic, and radiological viewpoints. RESULTS: Of the 225 hypertensive patients (prevalence = 33.3%, 78 (34.7% had mild hypertension, 108 (48% had moderate hypertension, and 39 (17.3% had severe hypertension. The association of left anterosuperior divisional block and right bundle-branch block occurred in 39 cases (17.3%, and enlargement of the cardiac area on radiological examination occurred in 93 (44.9% of the 207 cases studied. The undetermined form of Chagas' disease was the most prevalent, 30.2% of the cases, followed by the form associated with conduction disorders in 27.1%, and the isolated form of conduction disorders in 21.3%. CONCLUSION: Chagasic patients had a frequency of hypertension similar to that of the general population, and the clinical profile of the hypertensive chagasic patients seemed not to differ a lot from that of the chagasic patients.OBJETIVO: Verificar a freqüência da hipertensão arterial sistêmica em chagásicos e seu comportamento clínico e os achados cardiológicos. MÉTODOS: Estudo retrospectivo em 225 portadores de doença chagásica crônica e hipertensão arterial sistêmica (104 homens, idade média de 55,1±11,8 anos, acompanhados em ambulatório entre os anos de 1984 e 2000, avaliado do ponto de vista clínico, eletrocardiográfico e radiológico. RESULTADOS: Nos 225 hipertensos (prevalência = 33,3% a hipertensão arterial sistêmica leve ocorreu em 78 casos (34,7%, a moderada em 108 (48% e a grave em 39 (17,3%. A associação do bloqueio divisional ântero-superior do ramo esquerdo do feixe de

  3. RETROSPECTIVE AND PROSPECTIVE STUDY OF SNAKE BITE CELLULITIS

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    Kalanand Choudhary

    2017-02-01

    Full Text Available BACKGROUND This study is planned to assess the incidence and clinical manifestation of cellulitis and other surgical complication in snakebite patients in order to find out the nature and burden of the disease. MATERIALS AND METHODS This is a five-year retrospective and prospective study conducted in the Department of Surgery, Chhattisgarh Institute of Medical Sciences, Bilaspur and Chhattisgarh. Out of total 284 patients admitted with snakebite, 164 (58.7% patients suffered cellulitis and other surgical complications, which was managed and analysed. The categorical data was expressed as rates, ratio and percentage. RESULTS Out of 164 (58.7% patients who developed cellulitis and other changes, 75.2% were males and mean age of the study population was 34.3±14.7 years. Majority of patients had snakebite on lower limb (75.2%. The most common symptom complex was pain + swelling 70.3% at the site of the bite. 25 (15.2% patients underwent wound debridement and 7 (4.26% patients required skin grafting. 2 (1.2% patients suffered from compartment syndrome and required fasciotomy, wound debridement and skin grafting. CONCLUSION The present study shows high incidence of cellulitis and other surgical conditions in patients with snakebite and most common clinical feature was pain + swelling (cellulitis. So, in any case of snakebite, proper precautionary measures should be taken to prevent them. If cellulitis and other surgical condition has already developed, then it should be treated promptly in order to prevent the loss of limb or life.

  4. Complications of exodontia: A retrospective study

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    Gokul Parameswar Venkateshwar

    2011-01-01

    Full Text Available Purpose: The purpose of this study was to analyze the incidence of various complications following routine exodontia performed using fixed protocols. Materials and Methods: A total of 22,330 extractions carried out in 14,975 patients, aged between 14 and 82 years, who reported to the Department of Oral and Maxillofacial Surgery at Padmashree Dr. D. Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, were evaluated for various complications. Results: The most common complications encountered were tooth fracture, trismus, fracture of cortical plates and dry socket. Wound dehiscence, postoperative pain and hemorrhage were encountered less frequently. Luxation of adjacent teeth, fracture of maxillary tuberosity, and displacement of tooth into adjacent tissue spaces were rare complications. Conclusion: The practice of exodontia inevitably results in complications from time to time. It is imperative for the clinician to recognize impending complications and manage them accordingly.

  5. Clinical efficacy of β-lactam/β-lactamase inhibitor combinations for the treatment of bloodstream infection due to extended-spectrum β-lactamase-producing Enterobacteriaceae in haematological patients with neutropaenia: a study protocol for a retrospective observational study (BICAR)

    Science.gov (United States)

    Gudiol, C; Royo-Cebrecos, C; Tebe, C; Abdala, E; Akova, M; Álvarez, R; Maestro-de la Calle, G; Cano, A; Cervera, C; Clemente, W T; Martín-Dávila, P; Freifeld, A; Gómez, L; Gottlieb, T; Gurguí, M; Herrera, F; Manzur, A; Maschmeyer, G; Meije, Y; Montejo, M; Peghin, M; Rodríguez-Baño, J; Ruiz-Camps, I; Sukiennik, T C; Carratalà, J

    2017-01-01

    Introduction Bloodstream infection (BSI) due to extended-spectrum β-lactamase-producing Gram-negative bacilli (ESBL-GNB) is increasing at an alarming pace worldwide. Although β-lactam/β-lactamase inhibitor (BLBLI) combinations have been suggested as an alternative to carbapenems for the treatment of BSI due to these resistant organisms in the general population, their usefulness for the treatment of BSI due to ESBL-GNB in haematological patients with neutropaenia is yet to be elucidated. The aim of the BICAR study is to compare the efficacy of BLBLI combinations with that of carbapenems for the treatment of BSI due to an ESBL-GNB in this population. Methods and analysis A multinational, multicentre, observational retrospective study. Episodes of BSI due to ESBL-GNB occurring in haematological patients and haematopoietic stem cell transplant recipients with neutropaenia from 1 January 2006 to 31 March 2015 will be analysed. The primary end point will be case-fatality rate within 30 days of onset of BSI. The secondary end points will be 7-day and 14-day case-fatality rates, microbiological failure, colonisation/infection by resistant bacteria, superinfection, intensive care unit admission and development of adverse events. Sample size The number of expected episodes of BSI due to ESBL-GNB in the participant centres will be 260 with a ratio of control to experimental participants of 2. Ethics and dissemination The protocol of the study was approved at the first site by the Research Ethics Committee (REC) of Hospital Universitari de Bellvitge. Approval will be also sought from all relevant RECs. Any formal presentation or publication of data from this study will be considered as a joint publication by the participating investigators and will follow the recommendations of the International Committee of Medical Journal Editors (ICMJE). The study has been endorsed by the European Study Group for Bloodstream Infection and Sepsis (ESGBIS) and the European Study Group

  6. Retrospective Descriptive Study of Cerebral Palsy in Nepal

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    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…

  7. A retrospective transversal study of enlargement and college dropout

    OpenAIRE

    Cabrera, Lidia; Bethencourt Benítez, José Tomás; González Afonso, Miriam; Pedro ÁLVAREZ PÉREZ

    2006-01-01

    At present leaving and prolonging studies constitutes a serious problem at the university level. This report pre-sents the results of a retrospective transversal study which purpose was to identify risk factors related with dropout. The methodology design used can be for help

  8. Retrospective study of prognostic factors in pediatric invasive pneumococcal disease

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    Peng, Chun-Chih; Chang, Hung-Yang; Huang, Daniel Tsung-Ning; Chang, Lung; Lei, Wei-Te

    2017-01-01

    Streptococcus pneumoniae remains the leading causative pathogen in pediatric pneumonia and bacteremia throughout the world. The invasive pneumococcal disease (IPD) is known as isolation of S. pneumoniae from a normally sterile site (e.g., blood, cerebrospinal fluid, synovial fluid, pericardial fluid, pleural fluid, or peritoneal fluid). The aim of this study is to survey the clinical manifestations and laboratory results of IPD and identify the prognostic factors of mortality. From January 2001 to December 2006, a retrospective review of chart was performed in a teaching hospital in Taipei. The hospitalized pediatric patients with the diagnosis of pneumonia, arthritis, infectious endocarditis, meningitis or sepsis were recruited. Among them, 50 patients were pneumococcal infections proved by positive culture results or antigen tests. Clinical manifestations, laboratory data and hospitalization courses were analyzed. The median age was 3.5-year-old and there were 30 male patients (60%). Eight patients (16%) had underlying disease such as leukemia or congenital heart disease. Hemolytic uremic syndrome (HUS) was observed in ten patients and extracorporeal membrane oxygenation (ECMO) was performed in three patients. Leukocytosis, elevated C-reactive protein and AST level were noted in most of the patients. The overall mortality rate was 10%. We found that leukopenia, thrombocytopenia and high CRP level were significant predictors for mortality. In conclusion, S. pneumoniae remains an important health threat worldwide and IPD is life-threatening with high mortality rate. We found leukopenia, thrombocytopenia, and high CRP levels to be associated with mortality in pediatric IPD, and these factors are worthy of special attention at admission. Although we failed to identify a statistically significant prognostic factor in multivariate analysis due to relatively small sample size, we suggest an aggressive antibiotic treatment in patients with these factors at admission

  9. Co-morbidity in bipolar disorder: A retrospective study

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    Ravindra Neelakanthappa Munoli

    2014-01-01

    Full Text Available Background: Bipolar disorder is a relatively common, long-term, and disabling psychiatric illness that is associated with high levels of functional impairment, morbidity, mortality, and an increased risk of suicide. Psychiatric co-morbidity in bipolar disorder ranges from 57.3% to 74.3%, whereas medical co-morbidity varies from 2.7-70%. Indian scenario in this aspect is not clear. Materials and Methods: The objective was to ascertain the prevalence of physical and psychiatric co-morbidities in patients attending a tertiary care center over a period of 1 year and its relationship with socio-demographic and clinical variables. One hundred and twenty-five case record files were included in the review. OPCRIT software was used for re-establishing the diagnosis of bipolar disorder, which yielded 120 cases. A semi-structured pro-forma, specifically designed for the study, was used to collect the socio-demographic and clinical details. Results: Co-morbid psychiatric disorders were found in 52 (43.3% of the sample, whereas co-morbid physical illness was present in 77 (64.2% patients. The most common psychiatric disorder associated was substance use disorder (27.5%, whereas co-morbid cardiovascular disorder was the most frequent physical diagnosis in the sample (20%. Discussion: The prevalence of co-morbid psychiatric disorders in bipolar patients was lower than that reported in western literature. It could be related to retrospective nature of study or reflect true lower prevalence rates. Also, certain disorders such as eating disorders were absent in our sample, and migraine diagnosis was very infrequent.

  10. Bronchial Artery Embolization for Massive Hemoptysis: a Retrospective Study

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    Ali Fani

    2013-05-01

    Full Text Available   Introduction: To assess the efficacy and safety of bronchial artery embolization in the treatment of massive hemoptysis.   Materials and Methods: A retrospective study on 46 patients (26 males and 20 females who were referred to the Razavi Hospital from April 2009 to May 2012 with massive hemoptysis and had bronchial artery embolization procedures. General characteristics of the patients including age, gender, etiology, and thorax computed tomograms, findings of bronchial angiographic, results of the embolization, complications related to bronchial artery embolization and clinical outcome during follow-up were reviewed. Results: The etiology included previous pulmonary tuberculosis in 20 cases, previous tuberculosis with bronchiectasis in 16 cases, bronchiectasis in 6 cases, and active pulmonary tuberculosis in one case. No identifiable causes could be detected in three patients. Moreover, massive hemoptysis was successfully and immediately controlled following the embolization procedure in all patients. One patient developed recurrent hemoptysis during one month following the procedure and was treated by re-embolization. No major procedure–related complication such as bronchial infarction was identified However none of the patientsexperienced neurological complications. Conclusion: Bronchial artery embolization is a safe and effective means of controlling massive hemoptysis and should be regarded as the first-line treatment for this condition.

  11. Foreign body penetrations of hand and wrist: a retrospective study.

    Science.gov (United States)

    Hocaoğlu, Emre; Kuvat, Samet Vasfi; Özalp, Burhan; Akhmedov, Anvar; Doğan, Yunus; Kozanoğlu, Erol; Mete, Fethi Sarper; Erer, Metin

    2013-01-01

    Despite significant practical knowledge and experience on foreign body penetration injuries to the hand and/or wrist, deficient management and complications can still be encountered, and ignorance of its causative and eventual social aspects unfortunately is a substantial fact. This study aims to cover the clinical and social properties and the management of these kinds of injuries. A retrospective analysis of 86 patients requiring evaluation and treatment in a Hand Surgery Division of a university hospital was performed. The median age was 32 (min: 4, max: 63). Industrial workers constituted the largest occupational group (n=22, 25.6%). Twenty-three (26.7%) of the cases were elective admissions. Thirteen (15.1%) patients had various comorbidities, and five (5.8%) had psychiatric diagnoses at the time of the injury. The index finger was the most frequent site of injury (n=29, 33.7%). General anesthesia was not necessary for the management of 94.2% of the cases. In 26 (30%) of the patients, neural, tendinous or osseous damage was observed. Twenty-four (30%) patients were included in a postoperative hand physiotherapy program. The practically well-known general features of the issue and those aspects that may still be overlooked currently are reevaluated herein, in light of our observational data.

  12. Oral Piercing and Oral Diseases: A Short Time Retrospective Study

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    Francesco Inchingolo, Marco Tatullo, Fabio M. Abenavoli, Massimo Marrelli, Alessio D. Inchingolo, Antonio Palladino, Angelo M. Inchingolo, Gianna Dipalma

    2011-01-01

    Full Text Available Body piercing indicates the puncturing of a part of the body in which jewelry may be worn. In recent years, oral piercing is increasingly popular especially among young people. Body piercing has to be considered as a surgical procedure to all intents and purposes and, as such, has to be performed only by qualified personnel able to assure high standards of professionalism in facilities subject to sanitary inspections.The aim of the present work is to verify what risks patients may be exposed to and what complications may occur after a healthcare professional performs oral piercing.Our retrospective study includes 108 patients (74 males and 34 females aged between 14 and 39 years, who had oral piercing done 12±4 months earlier. All the patients underwent clinical examination to reveal the possible presence of late complications. After piercing, none of the 108 patients developed widespread complications.Although all patients said they had followed the piercers' instructions, 96% of them reported postoperative local complications such as bleeding within 12 hours of piercing (90%, perilesional edema for 3±2 days after piercing surgery (80%, and persistent mucosal atrophy (70%.

  13. Children with Warts: A Retrospective Study in an Outpatient Setting.

    Science.gov (United States)

    Kuwabara, Anne M; Rainer, Barbara M; Basdag, Hatice; Cohen, Bernard A

    2015-01-01

    The purpose is to investigate the demographics and course of common warts in children in an outpatient setting. A retrospective medical chart review and telephone survey study were completed on an outpatient cohort of children (0-17 yrs) with a clinical diagnosis of warts at a single-center, university-based pediatric dermatology practice. The main outcome measures included management, time to resolution, and associated factors of warts in children. Of the 254 patients we contacted, 214 agreed to participate in the survey. The most commonly involved sites were the hands and the head and neck area. Most children received some form of therapy, but it is unclear that any form of treatment altered the course. However, children with a medical history of childhood infections or more than one anatomic site had significantly greater risk of having a longer time to resolution. Warts resolved in 65% of children by 2 years and in 80% within 4 years, regardless of treatment. With the exception of a history of childhood infections and having more than one anatomic site, time to resolution was not altered by wart or patient characteristics. Thus counseling without aggressive destructive treatment is a reasonable approach to managing warts in most children. Our findings will provide guidance in the process of shared decision making with parents and children. © 2015 Wiley Periodicals, Inc.

  14. Stafne bone cavity: a retrospective study of 11 cases.

    Science.gov (United States)

    Quesada-Gómez, Carmen; Valmaseda-Castellón, Eduard; Berini-Aytés, Leonardo; Gay-Escoda, Cosme

    2006-05-01

    To describe the clinical and radiological characteristics of patients with Stafne bone cavity. A retrospective, observational study of 11 cases of Stafne bone cavity. After finding an imagine compatible with Stafne bone cavity in the Orthopantomograph(r) of 11 patients, a sialography of the mandibular gland was made in 3 cases, computerized tomography (CT) in 6 cases, and in 4 cases surgical intervention to confirm the diagnosis. The average age was 51.5 years, predominantly males. The entity was diagnosed incidentally during a routine radiology in all cases. The sialography revealed glandular tissue within the defect, and the CT demonstrated the conservation of the lingual cortical and the peripheral origin of the lesion. Glandular tissue was found within the lesions of two of the patients who underwent surgery, and in the other two the cavity was empty. No progressive changes were found in any of the 11 cases. Stafne bone cavity was an incidental finding, presenting no evolutionary changes, and as such conservatory therapy based on periodic controls was indicated. Currently, complementary techniques such as CT are sufficient to establish a certain diagnosis.

  15. CLINICAL AND BIOCHEMICAL DATA OF ADULT THALASSEMIA MAJOR PATIENTS (TM WITH MULTIPLE ENDOCRINE COMPLICATIONS (MEC VERSUS TM PATIENTS WITH NORMAL ENDOCRINE FUNCTIONS: A RETROSPECTIVE LONG-TERM STUDY (40 YEARS IN A TERTIARY CARE CENTER IN ITALY

    Directory of Open Access Journals (Sweden)

    Vincenzo De Sanctis

    2016-04-01

    Full Text Available Abstract. Introduction: It is well known that the older generation of adult TM patients has a higher incidence of morbidities and co-morbidities. At present, little information is available on adult TM patients with multiple endocrine complications (MEC. The main objectives of this longitudinal retrospective survey were: 1 to establish the incidence and progression of MEC (3 or more in TM patients; 2 to compare the clinical, laboratory and imaging data to a sex and age-matched group of TM patients without MEC; 3 to assess the influence of iron overload represented by serum ferritin (peak and mean annual value at the last endocrine observation. Patients and Methods: The study was started in January 1974 and was completed by the same physician at the end of December 2015. The registry database of the regularly followed TM patients from diagnosis included 145 adults (> 18 years. All TM patients were of Italian ethnic origin. Eleven out of 145 patients (7.5 % developed MEC. Twenty-four other patients (12 females and 12 males had a normal endocrine function (16.5 % and served as controls. Results: In our survey, four important, relevant aspects emerged in the MEC group. These included the late age at the start of chelation therapy with desferrioxamine mesylate (DFO; the higher serum ferritin peak (8521.8 ± 5958.9 vs 3575.2± 1801.4 ng/ml ; the higher percentage of splenectomized (81.8 % vs. 28.5% patients and poor compliance registered mainly during the peripubertal and pubertal age (72.7 % vs.16.6 % in TM patients developing MEC versus those without endocrine complications. Furthermore, a negative correlation was observed in all TM patients between LIC and final height (r: -0.424; p= 0.031. Conclusions: Our study supports the view that simultaneous involvement of more than one endocrine gland is not uncommon (7.5 %. It mainly occurred in TM patients who started chelation therapy with DFO late in life and who had irregular/poor compliance to

  16. Treatment of convulsive status epilepticus in the UMCG: A retrospective, observational study

    NARCIS (Netherlands)

    Vlaskamp, D.R.M.; Brouwer, O.F.; Callenbach, P.M.C.

    2013-01-01

    Objectives: Little is known about clinical practice with respect to the application of guidelines in the treatment of Convulsive Status Epilepticus (CSE). This retrospective, observational study evaluated treatment of episodes of CSE in children at the University Medical Centre Groningen (UMCG). Mat

  17. Continuous neurophatic orofacial pain: A retrospective study of 23 cases.

    Science.gov (United States)

    Sotorra-Figuerola, Dídac; Sánchez-Torres, Alba; Valmaseda-Castellón, Eduard; Gay-Escoda, Cosme

    2016-04-01

    To determine the clinical characteristics of Continuous Neuropathic Orofacial Pain in patients that suffer Persistent Idiopathic Facial Pain (PIFP), Painful Post-Traumatic Trigeminal Neuropathy (PPTTN) or Burning Mouth Syndrome (BMS) and to describe their treatment. A retrospective observational study was made, reviewing the clinical history of the patients diagnosed with Continuous Neuropathic Orofacial Pain between 2004 and 2011 at the Orofacial Pain Unit of the Master of Oral Surgery and Implantology of the University of Barcelona and at the Orofacial Pain Unit of the Teknon Medical Center of Barcelona. The average age of the patients with Continuous Neuropathic Orofacial Pain was 54.5, with a clear female predominance (86.9%, n=20). Of all patients, 60.9% (n=14) were suffering a PIFP, 21.7% (n=5) had a BMS and 17.4% (n=4) were presenting a PPTTN. The pain quality described by the patients with Continuous Neuropathic Orofacial Pain was oppressive (43.47%, n=10), widely represented by patients with PIFP, and burning (39.13%, n=9) being the only quality that described patients with BMS. The treatment carried out with the patients was only pharmacologic. The most used drugs for the treatment of PIFP and PPTTN were clonazepam (50%, n=9) and amitriptyline (44.44%, n=8). However, a 55.5% (n=10) of the patients with PIFP or PPTTN required the association of two or more drugs for a correct pain control. All the patients with BMS responded satisfactorily to clonazepam. Continuous Neuropathic Orofacial Pain is a little known condition among the general population, physicians and dentists. This favors a late diagnosis and inaccurate treatments which entail unnecessary suffering. It is important to inform both the general population and health professionals concerning this painful condition. Continuous neuropathic orofacial pain, persistent idiopathic facial pain, painful post-traumatic trigeminal neuropathy, burning mouth syndrome, atypical odontalgia.

  18. Clinical characteristics of adnexal masses in Korean children and adolescents: retrospective analysis of 409 cases.

    Science.gov (United States)

    Ryoo, UiNam; Lee, Dong-Yun; Bae, Duk-Soo; Yoon, Byung-Koo; Choi, DooSeok

    2010-01-01

    To analyze the clinical characteristics of young Korean female children and adolescents who underwent surgery because of adnexal masses during the last 14 years. Retrospective cohort study (Canadian Task Force classification II-2). University hospital. Three hundred ninety-six young female patients aged 20 years or younger who underwent surgery because of adnexal masses between January 1995 and March 2009. None. For over 14 years, 396 young patients underwent 409 operations because of adnexal masses (13 patients underwent 2 separate operations). Abdominal pain (n = 184 [45.0%]) was the most common initial symptom and was more frequent in group 1 (Korean females with adnexal masses will provide insight into the evaluation and surgical management of children and adolescents. Copyright 2010 AAGL. Published by Elsevier Inc. All rights reserved.

  19. 伴全身多系统创伤颌面伤患者的综合救治%A retrospective study of clinical comprehensive management of maxillofacial trauma patients associated with multiple systemic injuries

    Institute of Scientific and Technical Information of China (English)

    谭颖微; 周中华; 张建设; 赵文峰; 蔡俊; 唐震; 李焰; 陈增力

    2012-01-01

    PURPOSE: To study the definitive surgical timing and indications in clinical comprehensive management of oral and maxillofacial trauma patients associated with multiple systemic injuries. METHODS: A total of 4869 patients with oral and maxillofacial trauma treated over a 20-year period in four general hospitals were retrospectively reviewed. The clinical conditions of associated multiple systemic injuries with oral and maxillofacial trauma and the specific definitive surgical timing were analyzed. RESULTS: 3364 patients had facial fractures, 1505 patients had soft tissue injuries. 1524 (31.3%) patients had injuries in other parts of the body, among which 570 (37.4%) were cranio-cerebral injuries, 545(35.8%) were orthopedic injuries, 170(11.2%) were thoracic injuries, 151(9.9%) were ophthalmic injuries, 54 (3.3%) were spinal injuries and 34 (2.2%) were abdominal injuries. There were 422 (74%) patients associated cranio-cerebral injuries in whom maxillofacial fractures surgery within 4 weeks after trauma, 115(76.2%) patients had associated ophthalmic injuries in whom maxillofacial fractures surgery was performed within the first 7 days after trauma. The maxillofacial definitive surgical treatment in some other associated patients including orthopedic, thoracic, abdominal and spinal injuries was delayed in different times. CONCLUSION: Clinical comprehensive management in maxillofacial trauma patients associated with multiple systemic injuries needs cooperation within multiple specialties and departments. A large number of oral and maxillofacial trauma patients with multiple systemic injuries are amenable to definitive maxillofacial surgery in early lime after trauma, or surgical management of other injuries of the body, if the conditions of respiratory and circulatory system were stable.%目的:研究伴发身体其他部位创伤的颌面伤患者综合救治中专科确定性手术时机和适应证.方法:回顾性统计4所大型综合医院口腔科病房近20

  20. Effectiveness and safety of 1 vs 4 h blood pressure profile with clinical and laboratory assessment for the exclusion of gestational hypertension and pre-eclampsia: a retrospective study in a university affiliated maternity hospital.

    Science.gov (United States)

    McCarthy, Elizabeth Anne; Carins, Thomas A; Hannigan, Yolanda; Bardien, Nadia; Shub, Alexis; Walker, Susan P

    2015-11-18

    We asked whether 60 compared with 240 min observation is sufficiently informative and safe for pregnancy day assessment (PDAC) of suspected pre-eclampsia (PE). A retrospective study of 209 pregnant women (475 PDAC assessments, 6 months) with routinely collected blood pressure (BP), symptom and laboratory information. We proposed a 60 min screening algorithm comprising: absence of symptoms, normal laboratory parameters and ≤1high-BP reading (systolic blood pressure, SBP 140 mm Hg or higher or diastolic blood pressure, DBP 90 mm Hg or higher). We also evaluated two less inclusive screening algorithms. We determined short-term outcomes (within 4 h): severe hypertension, proteinuric hypertension and pregnancy-induced hypertension, as well as long-term outcome: PE-related diagnoses up to the early puerperium. We assessed performance of alternate screening algorithms performance using 2×2 tables. 1 in 3 women met all screen negative criteria at 1 h. Their risk of hypertension requiring treatment in the next 3 h was 1.8% and of failing to diagnose proteinuric hypertensive PE at 4 h was 5.1%. If BP triggers were 5 mm Hg lower, 1 in 6 women would be screen-negative of whom 1.1% subsequently develops treatment-requiring hypertension and 4.5% demonstrate short-term proteinuric hypertension. We present sensitivity, specificity, negative and positive likelihood ratios for alternate screening algorithms. We endorse further research into the safest screening test where women are considered for discharge after 60 min. Safety, patient and staff satisfaction should be assessed prospectively. Any screening test should be used in conjunction with good clinical care to minimise maternal and perinatal hazards of PE. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Nine year longitudinal retrospective study of Taekwondo injuries

    OpenAIRE

    Kazemi, Mohsen; Chudolinski, Artur; Turgeon, Matt; Simon, Aaron; Ho, Eric; Coombe, Lianne

    2009-01-01

    This retrospective longitudinal study aims to describe reported Taekwondo injuries and to examine associations between competitor experience level, age and gender, and the type, location, and mechanism of injury sustained. Additionally, we examined whether recent rule changes concerning increased point value of head shots in adult Taekwondo competition had affected injury incidence.

  2. Oral cancer: a retrospective study of 100 Danish cases

    DEFF Research Database (Denmark)

    Pinholt, E M; Rindum, J; Pindborg, J J

    1997-01-01

    One hundred Danes with oral cancer who were collected consecutively from 1986 to 1991 were evaluated retrospectively. The study included subjective and objective observations in 56% men and in 44% women. M:F ratio was 1.2:1. Fifty percent of the patients were non-smokers. Nine percent were women ...

  3. Effectiveness and safety of 1 vs 4 h blood pressure profile with clinical and laboratory assessment for the exclusion of gestational hypertension and pre-eclampsia: a retrospective study in a university affiliated maternity hospital

    OpenAIRE

    McCarthy, Elizabeth Anne; Carins, Thomas A; Hannigan, Yolanda; Bardien, Nadia; Shub, Alexis; Susan P Walker

    2015-01-01

    Objective We asked whether 60 compared with 240 min observation is sufficiently informative and safe for pregnancy day assessment (PDAC) of suspected pre-eclampsia (PE). Design A retrospective study of 209 pregnant women (475 PDAC assessments, 6 months) with routinely collected blood pressure (BP), symptom and laboratory information. We proposed a 60 min screening algorithm comprising: absence of symptoms, normal laboratory parameters and ≤1high-BP reading (systolic blood pressure, SBP 140 mm...

  4. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study

    Science.gov (United States)

    Pinto, José Antonio; Ribeiro, Davi Knoll; Cavallini, Andre Freitas da Silva; Duarte, Caue; Freitas, Gabriel Santos

    2016-01-01

    Introduction Obstructive sleep apnea (OSA) is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA) and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women) with a mean age of 50.05 years (range 19–75 years). The prevalence of comorbidities were hypertension (39%), obesity (34%), depression (19%), gastroesophageal reflux disease (GERD) (18%), diabetes mellitus (15%), hypercholesterolemia (10%), asthma (4%), and no comorbidities (33%). Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI) values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations. PMID:27096019

  5. Outcome of gastrostomy in parkinsonism: A retrospective study.

    Science.gov (United States)

    Marois, Clémence; Amador, Maria Del Mar; Payan, Christine; Lacomblez, Lucette; Bonnet, Anne-Marie; Degos, Bertrand; Corvol, Jean-Christophe; Vidailhet, Marie; Le Forestier, Nadine; Mesnage, Valérie; Grabli, David

    2017-06-23

    To investigate the indications and the outcomes of gastrostomy tube insertion in patients with parkinsonian syndromes. Consecutive patients with Parkinson's disease or atypical parkinsonism, seen in two French tertiary referral movement disorders centers, that received gastrostomy tube insertion (GTI) for feeding between 2008 and 2014 were included in this retrospective study. Data regarding clinical status, indications and outcomes were retrieved from medical files. The main outcome measure was survival duration following gastrostomy insertion according to Kaplan-Meier estimate. Cox analysis was also performed to identify factors associated with survival. Finally, we described short term and long term adverse effects occurring during the follow-up period. We identified 33 patients with Parkinsonism that received GTI during the study period. One patient was excluded from the analysis because of missing data. Among 32 patients, 7 (22%) had Parkinson's disease and 25 (78%) had atypical parkinsonism. The median survival following the procedure was 186 days (CI 95% [62-309]). In Cox model analysis, total dependency was the only factor negatively associated with survival (HR 0.1; 95% CI [0.02-0.4], p = 0.001). Pneumonia was the most frequent adverse event. In this sample of patients with parkinsonian syndromes, survival after GTI was short particularly in totally dependent subjects. Aspiration pneumonia was not prevented by GTI. A larger prospective study is warranted to assess the potential benefits of gastrostomy, in order to identify the most appropriate indications and timing for the procedure. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study

    Directory of Open Access Journals (Sweden)

    Pinto, José Antonio

    2016-03-01

    Full Text Available Introduction Obstructive sleep apnea (OSA is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women with a mean age of 50.05 years (range 19–75 years. The prevalence of comorbidities were hypertension (39%, obesity (34%, depression (19%, gastroesophageal reflux disease (GERD (18%, diabetes mellitus (15%, hypercholesterolemia (10%, asthma (4%, and no comorbidities (33%. Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations.

  7. Pemphigoid gestationis: a retrospective study in southwest Iran.

    Directory of Open Access Journals (Sweden)

    Sima Rassai

    2013-06-01

    Full Text Available Pemphigoid gestationis (PG is a rare autoimmune bullous dermatosis of pregnancy usually presents in the second or third trimester. It is characterized by pruritic, urticarial plaques with the development of tense vesicles and bullae within the lesions. Pathogenesis of PG is not fully established, however, most patients develop circulating autoantibodies targeting the bullous pemphigoid (BP 180 antigen. The aim of this work is to draw a profile of the epidemiology, clinical aspects, treatment and evolution of the disease by studying hospital series. We retrospectively investigated the 13 patients who were diagnosed with PG based on hospital data at the Referral Center of Southwest Iran located in Ahvaz city between March 2002 and March 2011. The age of onset was 21 to 40 years (mean age: 27.5 years. The onset of the disease occurred in the second trimester of pregnancy in 6 patients and in the third trimester of pregnancy in 4 patients. One patient had a flare up of disease during the first trimester and two out of cases in puerperium period. In all cases, pruritus was the first symptom, followed by an erythematous vesiculobullous eruption.  The diagnosis of PG was confirmed by skin biopsy. Ten out of the patients treated with oral corticosteroids (0.5-1 mg/kg/day, one of the patients underwent oral corticosteroids plus topical glucocorticoid and the last patient treated with topical glucocorticoid. PG remains a rare dermatosis of pregnancy. Our series had two particularities compared to other studies: high frequency in primigravida and the frequent involvement of the face. Additionally our study demonstrated that improvement could occur faster and provide acceptable management if the treatment of the patients would be implemented sooner.

  8. Bipartite Medial Cuneiform: Case Report and Retrospective Review of 1000 Magnetic Resonance (MR Imaging Studies

    Directory of Open Access Journals (Sweden)

    Geraldine H. Chang

    2014-01-01

    Full Text Available Objective. To present a unique case report of a Lisfranc fracture in a patient with a bipartite medial cuneiform and to evaluate the prevalence of the bipartite medial cuneiform in a retrospective review of 1000 magnetic resonance (MR imaging studies of the foot. Materials and Methods. Case report followed by a retrospective review of 1000 MR imaging studies of the foot for the presence or absence of a bipartite medial cuneiform. Results. The incidence of the bipartite medial cuneiform is 0.1%. Conclusion. A bipartite medial cuneiform is a rare finding but one with both clinical and surgical implications.

  9. Surgery for posttraumatic syringomyelia: a retrospective study of seven patients

    Institute of Scientific and Technical Information of China (English)

    CAO Fei; YANG Xiao-feng; LIU Wei-guo; LI Gu; ZHENG Xue-sheng; WEN Liang

    2007-01-01

    Objective: To analyze retrospectively the clinical symptoms, signs, radiological findings and results of treatment of posttraumatic syringomyelia.Methods: The data of 7 patients with posttraumatic syringomyelia confirmed by computerized tomography(CT) and magnetic resonance imaging (MRI) in our hospital between 1999 and 2004 were reviewed retrospectively. The patients underwent decompressive laminectomy or syringo-subarachnoid (S-S) shunting with microsurgery. Long-term follow-up was available (range:13-65 months).Results: The major clinical manifestations of posttraumatic syringomyelia usually included the onset of increasing signs and the development of new symptoms after an apparently stable period. The clinical symptoms included pain, sensory disturbance, weakness, and problems in autonomic nerves. Syrinx existed merely at the cervical level in 4 cases and extended downward to the thoracic levels in the other 3 cases. One case underwent decompressive laminectomy, 6 cases were treated by S-S shunting. During the early postoperative period, all the patients showed an improvement of symptoms of syrinx without major complication or death. The decreased size or collapse of the syrinx was demonstrated by postoperative MRI.Conclusions: Posttraumatic syringomyelia is a disabling sequela of spinal cord injury, developing months to years after spinal injury. MRI is the standard diagnostic technique for syringomyelia. The patients with posttraumatic syringomyelia combined with progressive neurological deterioration should be treated with operations. S-S shunting procedure is effective in some patients with posttraumatic syringomyelia. Decompressive procedure may be an alternative primary surgical treatment for patients with kyphosis and cord compression.

  10. Neuroelectrophysiological indexes and clinical characteristics of patients with peroneal muscular atrophy: Retrospective analysis of 24 cases

    Institute of Scientific and Technical Information of China (English)

    Changchun Su; Qinbao Qin

    2006-01-01

    BACKGROUND: Peroneal muscular atrophy (PMA) is characterized by insidious onset, gradually progressive course of disease, very mild disability degree and easily subjecting to missed diagnosis and misdiagnosis.Nerve conductive velocity is helpful in the diagnosis of atypical cases.OBJECTIVE: To retrospectively analyze the characteristics of clinical manifestation, electromyogram (EMG),motor and sensory nerve conduction velocity of patients with PMA.DESIGN: Retrospective case analysis.SETTING: Department of Neurology, Guangzhou First People's Hospital.PARTICIPANTS: Twenty-four patients with PMA, including 16 males and 8 females, aged 5-68 years old,admitted to Guangzhou First People's Hospital between March 1996 and January 2006 were recruited.Informed consents were obtained from all the patients.METHODS: All the patients subjected to EMG and detection of nerve conduction velocity at distal end of four extremities with a Keypoint evoked potential/ EMG instrument (Denmark). Sensory and motor conduction velocity, EMG changes of upper and lower extremities were observed, and relationship of neuroelectrophysiological characteristics and clinical symptoms was analyzed.MAIN OUTCOME MEASURES: Changes in sensory and motor conduction velocity, EMG and clinical manifestations of 24 patients.RESULTS: ① All the patients suffered from insidious onset and gradually progressive course of PMA.Muscular atrophy of lower extremity was found in 14 patients, and that of upper extremity in 5 patients. ② Routine nerve conduction study showed that sensory and motor conduction velocity were stepped down,especially in 16 patients with type Ⅰ PMA (demyelinating pattern, nerve conduction velocity below normal level 50%). Motor nerve conduction velocity of median nerve, ulnar nerve, common peroneal nerve and tibial nerve averaged 34.8 m/s, 37.2 m/s, 16.5 m/s and 17.4 m/s, respectively; Sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve averaged 27.9%, 24.6 m

  11. Cabergoline for Cushing's disease: a large retrospective multicenter study.

    Science.gov (United States)

    Ferriere, A; Cortet, C; Chanson, P; Delemer, B; Caron, P; Chabre, O; Reznik, Y; Bertherat, J; Rohmer, V; Briet, C; Raingeard, I; Castinetti, F; Beckers, A; Vroonen, L; Maiter, D; Cephise-Velayoudom, F L; Nunes, M L; Haissaguerre, M; Tabarin, A

    2017-03-01

    The efficacy of cabergoline in Cushing's disease (CD) is controversial. The aim of this study was to assess the efficacy and tolerability of cabergoline in a large contemporary cohort of patients with CD. We conducted a retrospective multicenter study from thirteen French and Belgian university hospitals. Sixty-two patients with CD received cabergoline monotherapy or add-on therapy. Symptom score, biological markers of hypercortisolism and adverse effects were recorded. Twenty-one (40%) of 53 patients who received cabergoline monotherapy had normal urinary free cortisol (UFC) values within 12 months (complete responders), and five of these patients developed corticotropic insufficiency. The fall in UFC was associated with significant reductions in midnight cortisol and plasma ACTH, and with clinical improvement. Compared to other patients, complete responders had similar median baseline UFC (2.0 vs 2.5xULN) and plasma prolactin concentrations but received lower doses of cabergoline (1.5 vs 3.5 mg/week, P 12 months), cabergoline was withdrawn in 28% of complete responders because of treatment escape or intolerance. Overall, sustained control of hypercortisolism was obtained in 23% of patients for 32.5 months (19-105). Nine patients on steroidogenesis inhibitors received cabergoline add-on therapy for 19 months (1-240). Hypercortisolism was controlled in 56% of these patients during the first year of treatment with cabergoline at 1.0 mg/week (0.5-3.5). About 20-25% of CD patients are good responders to cabergoline therapy allowing long-term control of hypercortisolism at relatively low dosages and with acceptable tolerability. No single parameter, including the baseline UFC and prolactin levels, predicted the response to cabergoline. © 2017 European Society of Endocrinology.

  12. Scrub typhus meningitis in South India--a retrospective study.

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    Stalin Viswanathan

    Full Text Available BACKGROUND: Scrub typhus is prevalent in India although definite statistics are not available. There has been only one study on scrub typhus meningitis 20 years ago. Most reports of meningitis/meningoencephalitis in scrub typhus are case reports. METHODS: A retrospective study done in Pondicherry to extract cases of scrub typhus admitted to hospital between February 2011 and January 2012. Diagnosis was by a combination of any one of the following in a patient with an acute febrile illness--a positive scrub IgM ELISA, Weil-Felix test, and an eschar. Lumbar puncture was performed in patients with headache, nuchal rigidity, altered sensorium or cranial nerve deficits. RESULTS: Sixty five cases of scrub typhus were found, and 17 (17/65 had meningitis. There were 33 males and 32 females. Thirteen had an eschar. Median cerebrospinal fluid (CSF cell count, lymphocyte percentage, CSF protein, CSF glucose/blood glucose, CSF ADA were 54 cells/µL, 98%, 88 mg/dL, 0.622 and 3.5 U/mL respectively. Computed tomography was normal in patients with altered sensorium and cranial nerve deficits. Patients with meningitis had lesser respiratory symptoms and signs and higher urea levels. All patients had received doxycycline except one who additionally received chloramphenicol. CONCLUSION: Meningitis in scrub typhus is mild with quick and complete recovery. Clinical features and CSF findings can mimic tuberculous meningitis, except for ADA levels. In the Indian context where both scrub typhus and tuberculosis are endemic, ADA and scrub IgM may be helpful in identifying patients with scrub meningitis and in avoiding prolonged empirical antituberculous therapy in cases of lymphocytic meningitis.

  13. Otomycosis: a retrospective study Otomicoses: um estudo retrospectivo

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    Zélia Braz Vieira da Silva Pontes

    2009-06-01

    Full Text Available Otomycosis is a fungal infection of the external ear canal with only a few studies about its real frequence in Brazil. AIM: to evaluate otomycosis frequence and characteristics in patients with clinical suspicion of external otitis. STUDY DESIGN: Retrospective study with transversal cohort (2000-2006. MATERIALS AND METHODS:103 patients were assigned to mycological diagnosis (direct microscopic examination and culture. RESULTS: Otomycosis was diagnosed in 19.4% of the patients. Patient age varied from 2 to 66 years (an average of 23.5 years of age, and 60% of otomycosis cases were seen in women between 2 to 20 years of age. Chronic otitis, previous antibiotic therapy and the lack of cerumen were predisposing factors; itching, otalgia, otorrhea and hypoacusis were the symptoms reported by the patients. The most frequently isolated species were C. albicans (30%, C. parapsilosis (20%, A. niger (20%, A. flavus (10%, A. fumigatus (5%, C. tropicalis (5%, Trichosporon asahii (5% and Scedosporium apiospermum (5%. CONCLUSIONS: Otomycosis is endemic in João Pessoa-PB. Clinical exam and mycological studies are important for diagnostic purposes because otomycosis symptoms are not specific.Otomicose é uma infecção fúngica do conduto auditivo externo com poucos estudos sobre sua real frequência no Brasil. OBJETIVO: Avaliar a frequência e características das otomicoses em pacientes com suspeita clínica de otite externa. DESENHO DO ESTUDO: Estudo retrospectivo com corte transversal (2000-2006. MATERIAL E MÉTODOS: 103 pacientes foram atendidos para diagnóstico micológico (exame microscópico direto e cultivo. RESULTADOS: Otomicoses foram diagnosticadas em 19,4% dos pacientes. A idade desses pacientes variou de 2 a 66 anos (média de 23,5 anos e 60% das otomicoses foram observadas em mulheres entre 2 a 20 anos de idade. Otite crônica, antibioticoterapia prévia e ausência de cerume foram os fatores predisponentes e prurido otológico, otalgia

  14. Congenital Zika syndrome with arthrogryposis: retrospective case series study

    Science.gov (United States)

    Filho, Epitacio Leite Rolim; Lins, Otavio Gomes; Aragão, Maria de Fátima Viana Vasco; Brainer-Lima, Alessandra Mertens; Cruz, Danielle Di Cavalcanti Sousa; Rocha, Maria Angela Wanderley; Sobral da Silva, Paula Fabiana; Carvalho, Maria Durce Costa Gomes; do Amaral, Fernando José; Gomes, Joelma Arruda; Ribeiro de Medeiros, Igor Colaço; Ventura, Camila V; Ramos, Regina Coeli

    2016-01-01

    Objective To describe the clinical, radiological, and electromyographic features in a series of children with joint contractures (arthrogryposis) associated with congenital infection presumably caused by Zika virus. Design Retrospective case series study. Setting Association for Assistance of Disabled Children, Pernambuco state, Brazil. Participants Seven children with arthrogryposis and a diagnosis of congenital infection presumably caused by Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Main clinical, radiological, and electromyographic findings, and likely correlation between clinical and primary neurological abnormalities. Results The brain images of all seven children were characteristic of congenital infection and arthrogryposis. Two children tested positive for IgM to Zika virus in the cerebrospinal fluid. Arthrogryposis was present in the arms and legs of six children (86%) and the legs of one child (14%). Hip radiographs showed bilateral dislocation in seven children, subluxation of the knee associated with genu valgus in three children (43%), which was bilateral in two (29%). All the children underwent high definition ultrasonography of the joints, and there was no evidence of abnormalities. Moderate signs of remodeling of the motor units and a reduced recruitment pattern were found on needle electromyography (monopolar). Five of the children underwent brain computed tomography (CT) and magnetic resonance imaging (MRI) and the remaining two CT only. All presented malformations of cortical development, calcifications predominantly in the cortex and subcortical white matter (especially in the junction between the cortex and white matter), reduction in brain volume, ventriculomegaly, and hypoplasia of the brainstem and cerebellum. MRI of the spine in four children showed apparent thinning of the cord and reduced ventral roots. Conclusions Congenital Zika syndrome should be added to the differential diagnosis of congenital

  15. Retrospective evaluation of the clinical management of patients with periodontal abscesses attending a teaching hospital

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    Modupeoluwa Omotunde Soroye

    2016-01-01

    Full Text Available Aim: This study aimed to examine the clinical management of patients who attended a Nigerian teaching hospital with periodontal abscesses. Setting and Design: This is a retrospective study among patients who attended the Periodontics Clinic of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, between January 2008 and December 2015. Patients and Methods: Information about the diagnosis was obtained from the departmental log book, and case notes were retrieved from record department. Data collection elicited information on age, sex, tribe, frequency of tooth brushing, dental attendance, medical history, clinical features, involved tooth/teeth, and treatment received. Statistical Analysis Used: Epi info version 3.5.1 was used for statistical analysis. Results: Patients aged between 15 and 87 years, with a mean age of 35.53 ± 19.30 years. Majority of patients were males, had minor ethnic extractions, had some form of education, first dental clinic attendees, indulged in once-daily toothbrushing, fully dentate, and had fair/poor oral hygiene. A total of 8.8% and 31.6% of the participants smoked cigarettes and consumed alcohol, respectively. A fifth of the participants had systemic diseases such as hypertension, diabetes mellitus, and peptic ulcer disease. Majority of the participants (91.2% had severe pain. About two-fifths had periodontal abscess around the incisors and the molars. The upper right quadrant was mostly involved (31.6%. Two-fifth of the patients had extraction done. Conclusion: Data from this study revealed periodontal abscess as a severely painful condition in naÏve dental patients, successfully treated mainly through extraction of the implicated tooth/teeth. This implies that oral health awareness and regular dental attendance may prevent its occurrence.

  16. Retrospective Study of a Series of Choanal Atresia Patients

    Science.gov (United States)

    Manica, Denise; Schweiger, Cláudia; Netto, Cátia C Saleh; Kuhl, Gabriel

    2013-01-01

    Introduction Although it has been more than 250 years since the first description of choanal atresia (CA), there are still doubts about this abnormality. The differences between unilateral and bilateral forms are seldom discussed. Objectives Aggregate data from patients diagnosed with CA, grouping patients with unilateral and bilateral forms. Methods Retrospective study. Results Eighteen patients were included: 12 (66.6%) presented bilateral atresia, of which 77.8% were mixed bony-membranous type and 22.2% were pure bony type. From the 12 patients with bilateral atresia, 10 presented related malformations, 3 of whom had CHARGE syndrome (coloboma, heart defects, choanal atresia, retardation of growth and development, genitourinary problems, ear abnormalities). From the remaining 6 patients with unilateral atresia, only 2 showed malformations, 1 renal and 1 cardiac. All patients with unilateral atresia needed only 1 surgical procedure, and patients with the bilateral form needed a median of 2.85 interventions (p = 0.003). The median age of surgical procedure in the unilateral group was 6 years, ranging from 6 months to 18 years, and in the bilateral group was 25 days, ranging from 6 days to 6 years (p = 0.003). The median interval between diagnosis and surgery was 9 months in the unilateral group, ranging from 1 month to 18 years, and in the bilateral group was 1 day, ranging from 1 day to 2 months (p = 0.001). Discussion and Conclusions Success rates with the endoscopic approach vary from 62 to 100%. Nonetheless, most of these reports present results without considering the number of compromised sides. In our opinion, unilateral and bilateral cases involve distinct patients (taking into account the related malformations), have diverging clinical presentations, and show discrepant restenosis rates and therefore could be considered in different groups of analysis. PMID:25992054

  17. Comparison of clinical characteristics of bipolar and depressive disorders in Korean clinical sample of youth: a retrospective chart review.

    Science.gov (United States)

    Shon, Seung-Hyun; Joo, Yeonho; Park, Jangho; Youngstrom, Eric A; Kim, Hyo-Won

    2014-05-01

    The purpose of this study was to compare the clinical characteristics of bipolar disorder I, II (BD I and II) and not otherwise specified (BD NOS) to those of major depressive disorder (MDD) in a clinical sample of Korean children and adolescents. This study was a cross-sectional review of longitudinal observational data. Two psychiatrists retrospectively reviewed the medical records of 198 children and adolescents (age 6-18) that were diagnosed as having bipolar or depressive disorders from March 2010 to February 2012 at Department of Psychiatry of Asan Medical Center, Seoul, Korea. Every subject's diagnoses were reviewed and confirmed. BD I, II and MDD were assessed according to the Diagnostic and Statistical Manual-IV criteria. BD NOS was defined based on the criteria for the Course and Outcome of Bipolar Youth study. Comparisons were made in demographic information, clinical characteristics, family history, and psychiatric comorbidities at baseline and during observation. Among 198 subjects, 20 (10.1 %) subjects were diagnosed as having BD I, 10 (5.1 %) as BD II, 25 (12.6 %) as BD NOS and 143 (73.7 %) as MDD. BD depression was associated with mood change while taking an antidepressant, familial bipolarity, aggressive behaviors, and atypical features. Comorbid obsessive-compulsive disorder tended to be higher in BD NOS than in MDD. Presence of psychosocial stressors was more common in MDD than in BD depression. In children and adolescents, bipolar depression is distinct from unipolar depression in family history, comorbidity, and clinical characteristics.

  18. Adverse effect profile of trichlormethiazide: a retrospective observational study

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    Nishida Yayoi

    2011-05-01

    Full Text Available Abstract Background Trichlormethiazide, a thiazide diuretic, was introduced in 1960 and remains one of the most frequently used diuretics for treating hypertension in Japan. While numerous clinical trials have indicated important side effects of thiazides, e.g., adverse effects on electrolytes and uric acid, very few data exist on serum electrolyte levels in patients with trichlormethiazide treatment. We performed a retrospective cohort study to assess the adverse effects of trichlormethiazide, focusing on serum electrolyte and uric acid levels. Methods We used data from the Clinical Data Warehouse of Nihon University School of Medicine obtained between Nov 1, 2004 and July 31, 2010, to identify cohorts of new trichlormethiazide users (n = 99 for 1 mg, n = 61 for 2 mg daily dosage and an equal number of non-users (control. We used propensity-score matching to adjust for differences between users and control for each dosage, and compared serum chemical data including serum sodium, potassium, uric acid, creatinine and urea nitrogen. The mean exposure of trichlormethiazide of 1 mg and 2 mg users was 58 days and 64 days, respectively. Results The mean age was 66 years, and 55% of trichlormethiazide users of the 1 mg dose were female. In trichlormethiazide users of the 2 mg dose, the mean age was 68 years, and 43% of users were female. There were no statistically significant differences in all covariates (age, sex, comorbid diseases, past drugs, and current antihypertensive drugs between trichlormethiazide users and controls for both doses. In trichlormethiazide users of the 2 mg dose, the reduction of serum potassium level and the elevation of serum uric acid level were significant compared with control, whereas changes of mean serum sodium, creatinine and urea nitrogen levels were not significant. In trichlormethiazide users of the 1 mg dose, all tests showed no statistically significant change from baseline to during the exposure period in

  19. A study on mental disorders: 5-year retrospective study

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    Thalappillil Mathew Celine

    2014-01-01

    Full Text Available Background: "Mental disorder" is the most common used term in the modern life and the main reason behind this may be the mechanical way of life or stress and strain among youth. Aim: To find the pattern of mental disorders of hospitalized patients in a medical college hospital from 1 st April 2005 to 31 st March 2010. Settings and Design: A retrospective study conducted among the patients admitted with mental disorders in a medical college hospital from 1 st April 2005 to 31 st March 2010. Materials and Methods: Data collected from the registers maintained in the medical records department. Statistical Analysis: Z test is used for the comparison of proportions. Results: A total of 7908 mental disorder cases reported in the medical college hospital, 5564 (70.36% were males and 2344 (29.64% were females. Most cases occurred in the age group of 30-44 years. Mental disorder was more among females than males in 0-29 years and ≥ 60 years, but in 30-59 years males were more. In each year, mental disorders were reported more in males than females. Of the cases, most of them were mood disorders. Mental and behavioral disorders due to psychoactive substance use were more among males but schizophrenia, delusional disorders, mood disorders, stress-related disorders, mental retardation, and so on were more among females. Conclusion: Mood disorder was the most occurred mental disorder and the next leading mental disorder was mental and behavioral disorders due to psychoactive substance use. Counseling can be helpful for preventing most of the mental disorders. Improve the mental health care facilities will be the solution for controlling the mental disorders.

  20. 'Schizoid' personality and antisocial conduct: a retrospective case not study.

    Science.gov (United States)

    Wolff, S; Cull, A

    1986-08-01

    A retrospective case not analysis for 30 boys diagnosed as having a 'schizoid' personality disorder (Asperger's syndrome) in childhood, and for 30 matched clinic attenders (with systematic follow-up data for 19 matched pairs), showed the incidence of antisocial conduct to be the same in the two groups. However, the 'schizoid' boys stole less often and had fewer alcohol problems. In this group antisocial conduct was less related to family disruption and social disadvantage, and more to an unusual fantasy life. Clinical descriptions of a series of 'schizoid' boys and girls with conspicuous antisocial conduct follow. They suggest that characteristic patterns of antisocial conduct in such children are persistent expressions of hostility and, especially in girls, pathological lying, for which environmental circumstances provide no explanation.

  1. The clinical characteristics of hemorrhagic stroke during pregnancy:a retrospective study%妊娠期出血性脑血管病的临床特征和治疗对策

    Institute of Scientific and Technical Information of China (English)

    梁竹巍; 高婉丽; 曹勇; 李燕蓉; 王歆莉

    2015-01-01

    Objective We studied the clinical characteristics of perinatal cerebral haemorrhage,the clinical features of different treatment methods,and patients with different causes,and to investigate the treatment approaches to perinatal cerebral haemorrhage.Methods The clinical data of 76 patients with perinatal cerebral haemorrhage were retrospectively analysed.These patients were treated at Beijing Tiantan Hospital,Capital Medical University between January 1997 and December 2012.They were divided into surgery and conservative treatment groups.Results Paticnts with perinatal cerebral haemorrhage were relatively young.Of the 76 total patients,60 were ≤25 years old,including 6 patients who were 19 years old,which suggests that patients with perinatal cerebral haemorrhage were younger than the general cerebral haemorrhage population.The mortality rate was 32% among this young population,.the causes of cerebral haemorrhage included 30 cases of arteriovenous malformation (AVM),16 cases of preeclampsia,8 cases of aneurysm (AN),8 cases of moyamoya disease (MMD),4 cases of cavernous haemangioma,4 cases of venous sinus thrombosis,and 6 case of unknown reasons.The average Glasgow coma score (GCS) of patients on admission was 11.8 ±4.5,GCS 15-11 included 54 cases,GCS 6-10 included 16 cases,GCS 0-5 included 16 cases.The onset of cerebral haemorrhage caused occurred at an earlier gestational age (27.8 ± 9.1 weeks),primarily during mid-pregnancy;this result might be related to an intolerance of cerebrovascular diseases caused by the changes of blood volume and cerebral blood flow that occur during the second trimester,including arteriovenous malformation,aneurysm and cavernous haemangiomas.Of 76 total cases of perinatal cerebral haemorrhage,24 resulted in maternal death,4 resulted in intrauterine death,and 28 resulted in neonatal death.The clinical characteristics and maternal and perinatal prognoses of the surgery group did not significantly differ from the conservative group

  2. Retrospective study on clinical characteristics of 643 patients with suspected dengue in Guangzhou%广州市区疑似登革热643例临床特征分析

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    王慧敏; 詹伟祥; 陈培松; 姜傥

    2015-01-01

    Objective This study is to analyze the clinical features and laboratory parameters of suspected dengue patients in our hospital during a dengue outbreak in Guangzhou at fall 2014, which is useful for the prevention and management of dengue and disease diagnosis. Methods Data of patients with suspected dengue was collected from September 2014 to November in our hospital. Clinical and laboratory data were retrospectively analyzed to describe the clinical characteristics of this outbreak and the diagnostic value of laboratory parameters. Results Totally 643 suspected cases were selected, including 466 cases confirmed with dengue fever. In these cases, the positive rates of the 0~12 year age group, 13~50 year age group and 51~year age group were 42.0%, 74.4%and 80.8%, respectively. The primary symptom of suspected patients was fever. In dengue patients with fever alone symptom were 69.7%, while fever combined with respiratory infections, merged rash and gastrointestinal symptoms were 19.5%, 6.7%and 2.1%, respectively. The rates of leucopenia, thrombocytopenia, and elevated hematocrit ratio in dengue patients were 73.2%, 33.3%and 3.1%, respectively, and were higher than those of the negative groups. WBC, HCT and PLT had a high positive predictive value (>80%) in evaluating diagnostic efficiency of laboratory parameter for dengue. In 51~years old group, WBC and PLT were significantly decreased more than those of the other two groups. Conclusion This outbreak of dengue in Guangzhou has typical clinical symptoms. WBC and PLT have diagnostic value in screening the disease. In the older age group, the positive rate was significantly higher than those of other age groups and the decrease of WBC and PLT were more obvious, indicating that we should strengthen the prevention and management of this age group.%目的:分析2014年秋季广州市区登革热爆发性流行期间疑似病例的临床特点和实验室检查指标,为该疾病的诊断和防

  3. Studying time to pregnancy by use of a retrospective design

    DEFF Research Database (Denmark)

    Joffe, Michael; Key, Jane; Best, Nicky

    2005-01-01

    Biologic fertility can be measured using time to pregnancy (TTP). Retrospective designs, although lacking detailed timed information about behavior and exposure, are useful since they have a well-defined target population, often have good response rates, and are simpler and less expensive...... at the beginning of unprotected intercourse. More complete inference is possible if the study design covers the whole population, not just those who achieve a pregnancy....

  4. Infectious sacroiliitis: a retrospective, multicentre study of 39 adults

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    Hermet Marion

    2012-11-01

    Full Text Available Abstract Background Non-brucellar and non-tuberculous infectious sacroiliitis (ISI is a rare disease, with misleading clinical signs that delay diagnosis. Most observations are based on isolated case reports or small case series. Our aim was to describe the clinical, bacteriological, and radiological characteristics of ISI, as well as the evolution of these arthritis cases under treatment. Methods This retrospective study included all ISI cases diagnosed between 1995 and 2011 in eight French rheumatology departments. ISI was diagnosed if sacroiliitis was confirmed bacteriologically or, in the absence of pathogenic agents, if clinical, biological, and radiological data was compatible with this diagnosis and evolution was favourable under antibiotic therapy. Results Overall, 39 cases of ISI were identified in adults, comprising 23 women and 16 men, with a mean age at diagnosis of 39.7 ± 18.1 years. The left sacroiliac joint (SI was affected in 59% of cases, with five cases occurring during the post-partum period. Lumbogluteal pain was the most common symptom (36/39. Manipulations of the SI joint were performed in seven patients and were always painful. Mean score for pain using the visual analogue score was 7.3/10 at admission, while 16 patients were febrile at diagnosis. No risk factor was found for 30.7% of patients. A diagnosis of ISI was only suspected in five cases at admission. The mean time to diagnosis was long, being 43.3 ± 69.1 days on average. Mean C-reactive protein was 149.7 ± 115.3 mg/l, and leukocytosis (leukocytes ≥ 10 G/l was uncommon (n = 15 (mean level of leukocytes 10.4 ± 3.5 G/l. Radiographs (n = 33 were abnormal in 20 cases, revealing lesions of SI, while an abdominopelvic computed tomography (CT scan (n = 27 was abnormal in 21 cases, suggesting arthritis of the SI joints in 13 cases (48.1% and a psoas abscess in eight. Bone scans (n = 14 showed hyperfixation of the SI in 13 cases

  5. OSL studies of local bricks for retrospective dosimetric application

    Science.gov (United States)

    Singh, A. K.; Menon, S. N.; Kadam, S. Y.; Koul, D. K.; Datta, D.

    2016-09-01

    Luminescence properties of quartz extracted from bricks has been reported worldwide for its use in dose estimation in case of nuclear or radiological accident. Accordingly, in this study the feasibility of utilizing the optically stimulated luminescence (OSL) emission of quartz extracted from red bricks collected from three different locations in and around Mumbai, India for retrospective dosimetry was explored. Thermoluminescence and OSL characterization of the samples were carried out. The growth curve, thermal stability and equivalent dose plateau of the OSL signal suggested the signals to be well behaving. Subsequently, the dose recovery tests carried for different administered doses, using single aliquot regenerative protocol, demonstrated the feasibility of the OSL emissions of these samples for dose evaluation in retrospective dosimetry.

  6. Retrospective Demographic Analysis of Patients Seeking Care at a Free University Chiropractic Clinic

    Science.gov (United States)

    Stevens, Gerald; Campeanu, Michael; Sorrento, Andrew T.; Ryu, Jiwoon; Burke, Jeanmarie

    2016-01-01

    Objective The purpose of this study was to describe the demographics, presenting complaints, and health history of new patients seeking treatment at a free chiropractic clinic within a university health center. Methods A retrospective analysis of patient files from 2008 to 2009 was performed for a free student chiropractic clinic in the Buffalo, NY, area. Demographics, presenting complaints, and health history of new patients seeking treatment were recorded. Results There were 343 new chiropractic patient files. Most patients were between the ages of 18 and 30 years (n = 304, 88%) with an almost equal distribution of men (n = 163, 48%) and women (n = 180, 52%). The patients were mostly single (n = 300, 87%). Patients self-reported that their case histories excluded a current medical diagnosis (n = 261, 76%), previous history of disease (n = 216, 63%), allergies (n = 240, 70%), previous surgical procedures (n = 279, 81%), and medication use (n = 250, 73%). The frequencies of spinal complaints were as follows: lumbar spine, n = 176 (51%); cervical spine, n = 78 (23%); and thoracic spine, n = 44 (13%). Maintenance care, headaches, and spine-related upper and lower extremities complaints accounted for the other 13% of patients treated. Half were chronic (n = 172, 50%), and a third were acute (n=108, 31%). Patients averaged 6 chiropractic visits, with 88% having 11 visits or less. Conclusion This study found that new patients seeking care at a free student chiropractic clinic within a university health center in the Buffalo area mainly consisted of young single adults, with chronic lumbar spine complaints with few comorbidities. PMID:27069428

  7. 持续性炎症-免疫抑制-分解代谢综合征63例临床分析%A retrospective clinical study of sixty-three cases with persistent inflammation immunosuppression and catabolism syndrome

    Institute of Scientific and Technical Information of China (English)

    丁仁彧; 邱佳男; 刘宝燕; 李晓霞; 孙旖旎; 梁英健; 肇冬梅; 朱然; 章志丹

    2016-01-01

    目的 通过分析入住ICU的持续性炎症-免疫抑制-分解代谢综合征(PICS)患者的临床特点及预后,提高对PICS的认识,以进一步明确PICS的临床意义.方法 回顾性分析2014年1月1日至12月31日入住中国医科大学附属第一医院重症医学科≥10 d、年龄≥18岁的126例患者的临床资料,包括性别、年龄、入ICU的急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)和序贯器官功能衰竭评分(SOFA)、入ICU诊断、实验室指标、ICU获得性感染、临床转归等.结果 126例患者中63例发生PICS,63例为非PICS患者,PICS发生率为50.0%.PICS组和非PICS组患者性别、年龄、基础疾病、入ICU时APACHEⅡ、SOFA、患者来源差异均无统计学意义(P>0.05);两组患者内、外科疾病占比差异无统计学意义(P>0.05);PICS组患者发生消化道穿孔比例较非PICS组高(P =0.042).PICS组继发ICU获得性感染比例高于非PICS组[63.5% (40/63)比23.8%(15/63);P<0.001];PICS组念珠菌占致病菌比例较非PICS组高[22.4% (11/49)比2/17;P=0.003].与非PICS组比,PICS组住ICU时间明显延长[(31.6 ±28.8)d比(20.4±11.3)d;P=0.0046],ICU病死率明显升高[28.6% (18/63)比6.3% (4/63);P=0.001].结论 PICS在ICU患者中常见,PICS患者继发感染的风险高,住ICU时间长,ICU病死率高.%Objective To study the clinical characteristics and prognosis of patients with persistent inflammation immunosuppression and catabolism syndrome (PICS) in ICU.Methods A total of 126 patients admitted to ICU (ICU stay of more than 10 days,age ≥ 18 years) between January 2014 to December 2014 were retrospectively studied.Data were collected from electronic medical records including demographics,underlying disease,Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score,Sequential Organ Failure Assessment (SOFA) score,laboratory parameters,ICU acquired infections and clinical outcome.Results The overall incidence of PICS in ICU patients (ICU

  8. Criminal poisoning of commuters in Bangladesh: prospective and retrospective study.

    Science.gov (United States)

    Majumder, M Mahbub Alam; Basher, Ariful; Faiz, M Abul; Kuch, Ulrich; Pogoda, Werner; Kauert, Gerold F; Toennes, Stefan W

    2008-08-25

    Travel-related poisoning is an emerging social and public health emergency in Bangladesh but its cause and significance have not been determined. To investigate this syndrome we performed a prospective clinical study and retrospective analysis of hospital records in a general medicine unit of a public tertiary care teaching hospital in Dhaka, Bangladesh, using toxicological analysis by fluorescence polarization immunoassay (FPIA) and liquid chromatography coupled to time-of-flight mass spectrometry (LC-TOF MS). The participants of the prospective study were 130 consecutive patients aged 16-80 years who were admitted with central nervous system depression (Glasgow Coma Score 3-14) after using public transportation, in the absence of other abnormalities, from January through June 2004, and a convenience sample of 15 such patients admitted during 3 days in May 2006. In 2004-2006, travel-related poisoning increased from 6.1 to 9.5% of all admissions (210-309 of 3266-3843 per year), representing 46.6-55.7% of all admitted poisoning cases. Incidents were associated with bus (76%), taxi, train, and air travel, or local markets; 98% of patients remembered buying or accepting food or drinks before losing consciousness. Direct financial damage (missing property) was diverse and frequently existential. Among 94 urine samples analyzed by FPIA, 74% tested positive for benzodiazepines. Among 15 urine samples analyzed by LC-TOF MS, lorazepam was detected in all; five also contained diazepam or metabolites; nitrazepam was present in three. FPIA results obtained for these 15 samples were below the recommended cut-off in eight (53%; lorazepam only). Our findings show that the massive medicosocial emergency of travel-related poisoning in Bangladesh is the result of drug-facilitated organized crime and that benzodiazepine drugs are used to commit these crimes, suggesting modifications to the local emergency management of the victims of this type of poisoning. They also highlight the

  9. A retrospective study of clinical and immunologic features of 67 cases of patients with scrub typhus%67例恙虫病患者临床表现及免疫学特点分析

    Institute of Scientific and Technical Information of China (English)

    周宜庆; 徐菱遥; 孔练花; 王茜; 韩亚萍; 李军; 金柯

    2015-01-01

    目的 分析67例恙虫病患者的临床特点及免疫学特征.方法 回顾性分析2010年1月至2013年12月在南京医科大学第一附属医院住院治疗的67例恙虫病患者的流行病学资料、临床体征表现、实验室及影像学检查结果,治疗情况.结果 67例恙虫病患者发病以秋冬型为主,10、11月高发.临床体征:临床上以发热(100.0%,67/67)、焦痂或溃疡(91.0%,61/67)、斑丘疹(52.2%,35/67)及外周淋巴结肿大(46.3%,31/67)为主要表现.血液指标:①血常规检查:80.6%(54/67)的患者白细胞(WBC)数量正常[(4~10)×109/L]或低于正常值,其中62.7%(42/67)的患者淋巴细胞(Lym)百分比>40%;34.3% (23/67)的患者血小板(PLT)计数<100×109/L,最低值为14×109/L.②外周血淋巴细胞亚群检查:共有17名患者进行此项检查.其中82.4%(14/17)的患者CD3+T细胞比例正常,82.4%(14/17)例CD4+T细胞比例降低,94.1%(16/17)的患者CD8+T细胞比例升高,88.2(15/17)的患者B淋巴细胞比例降低.③炎症指标检查:95.2%(59/62)的患者C反应蛋白(CRP)升高,93.8%(45/48)的患者铁蛋白升高,89.1%(49/55)的患者红细胞沉降率(ESR)加快.④肝功能检查:77.6%(52/67)的患者丙氨酸氨基转移酶(ALT)水平升高,80.6%(54/67)的患者天门冬氨酸氨基转移酶(AST)水平升高.⑤腺苷脱氨酶(ADA)检查:94.6%(35/37)的患者ADA升高.⑥抗核抗体(ANA)检查:31.0%(13/42)的患者ANA水平升高.⑦EB病毒检查:15.6%(7/45)的患者EB病毒DNA(+).77.6%(38/49)的患者胸部影像学异常.2例临床诊断为伴有结核菌感染,治疗以喹诺酮类或大环内酯类抗生素抗感染治疗为主,67例患者均痊愈.结论 67例患者秋冬型恙虫病临床表现典型,且存在免疫紊乱现象.%Objective To study the clinical and immunologic features of 67 cases of patients with scrub typhus.Methods Epidemiological data,clinical manifestations,laboratory and image examination results and

  10. Clinical Factors Associated with Long-Term Complete Remission versus Poor Response to Chemotherapy in HIV-Infected Children and Adolescents with Kaposi Sarcoma Receiving Bleomycin and Vincristine: A Retrospective Observational Study.

    Science.gov (United States)

    El-Mallawany, Nader Kim; Kamiyango, William; Slone, Jeremy S; Villiera, Jimmy; Kovarik, Carrie L; Cox, Carrie M; Dittmer, Dirk P; Ahmed, Saeed; Schutze, Gordon E; Scheurer, Michael E; Kazembe, Peter N; Mehta, Parth S

    2016-01-01

    Kaposi sarcoma (KS) is the most common HIV-associated malignancy in children and adolescents in Africa. Pediatric KS is distinct from adult disease. We evaluated the clinical characteristics associated with long-term outcomes. We performed a retrospective observational analysis of 70 HIV-infected children and adolescents with KS less than 18 years of age diagnosed between 8/2010 and 6/2013 in Lilongwe, Malawi. Local first-line treatment included bleomycin and vincristine plus nevirapine-based highly active anti-retroviral therapy (HAART). Median age was 8.6 years (range 1.7-17.9); there were 35 females (50%). Most common sites of presentation were: lymph node (74%), skin (59%), subcutaneous nodules (33%), oral (27%), woody edema (24%), and visceral (16%). Eighteen (26%) presented with lymphadenopathy only. Severe CD4 suppression occurred in 28%. At time of KS diagnosis, 49% were already on HAART. Overall, 28% presented with a platelet count < 100 x 109/L and 37% with hemoglobin < 8 g/dL. The 2-year event-free (EFS) and overall survival (OS) were 46% and 58% respectively (median follow-up 29 months, range 15-50). Multivariable analysis of risk of death and failure to achieve EFS demonstrated that visceral disease (odds ratios [OR] 19.08 and 11.61, 95% CI 2.22-163.90 and 1.60-83.95 respectively) and presenting with more than 20 skin/oral lesions (OR 9.57 and 22.90, 95% CI 1.01-90.99 and 1.00-524.13 respectively) were independent risk factors for both. Woody edema was associated with failure to achieve EFS (OR 7.80, 95% CI 1.84-33.08) but not death. Univariable analysis revealed that lymph node involvement was favorable for EFS (OR 0.28, 95% CI 0.08-0.99), while T1 TIS staging criteria, presence of cytopenias, and severe immune suppression were not associated with increased mortality. Long-term complete remission is achievable in pediatric KS, however outcomes vary according to clinical presentation. Based on clinical heterogeneity, treatment according to risk

  11. The clinical diagnosis and treatment about 22 cases of limbic encephalitis were retrospectively analyzed.

    Science.gov (United States)

    Zang, Weiping; Zhang, Zhijun; Feng, Laihui; Zhang, Ailing

    2016-03-01

    To summarize and analyze the clinical characteristics and treatment of limbic encephalitis, in order to provide the basis for clinical work. We retrospectively analyzed the clinical characteristics, magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) and self immune antibody results of 22 patients with limbic encephalitis in Zheng zhou people's Hospital from March 2013 to May 2014. 22 cases of patients with psychiatric disturbance, such as hallucinations being typical clinical manifestations: Memory decline in 18 cases: Seizures in 13 patients: Altered level of consciousness in 10 cases; Movement disorders in 7 cases and 9 cases with febrile.14 cases have relieved after treating with antiviral and immunosuppressive therapy, 5 cases left memory decline, 2 patients left overwhelmingly excited, 1 cases of seizures. The clinical symptoms of patients with limbic encephalitis are complicated changeable and unspecific. so earlier diagnosis and treatment are very important for the prognosis of patients.

  12. Prevalence and Risk Factors for Delirium in Acute Stroke Patients. A Retrospective 5-Years Clinical Series.

    Science.gov (United States)

    Alvarez-Perez, Francisco José; Paiva, Fatima

    2017-03-01

    Delirium is characterized by disturbances of attention and cognition that cause functional decline and complications. The predisposing factors of delirium are age, male gender, systemic or metabolic disorders, dementia, and stroke. This study aims to evaluate the prevalence of delirium and to identify risk factors. This is a retrospective study that includes patients admitted over 5 years with acute stroke. Patients with transient ischemic attack or venous thrombosis were excluded. Delirium was defined according the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Demographical characteristics, clinical-radiological profile, dependence on discharge (modified Rankin Scale score of ≥3 and Barthel Index delirium. A total of 1161 patients were admitted (910 ischemic and 162 hemorrhagic). During hospitalization, 118 patients presented with delirium (10.2%) and 93 died (8%). On discharge, 517 patients were dependent (44.5%). Delirium was significantly associated with age, male gender, cortical infarcts in anterior circulation, higher leukocyte count, cholesterol and fibrinogen levels, lower albumin, atrial fibrillation, previous diagnosis of Alzheimer's disease, and hemorrhagic stroke. Logistic regression results showed that only previous Alzheimer's disease was related to delirium (odds ratio 21.68 [95% confidence interval 1.190-395.026, P = .038]). Dependence on discharge was associated with delirium. Ten percent of the patients presented with delirium associated with older age, Alzheimer's disease, and cortical anterior stroke. Patients with delirium had a higher risk of functional dependence on discharge. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. Impact of pharmacist integration in a pediatric primary care clinic on vaccination errors: a retrospective review.

    Science.gov (United States)

    Haas-Gehres, Anna; Sebastian, Sonya; Lamberjack, Kristen

    2014-01-01

    To measure the impact of ambulatory clinical pharmacist integration in a pediatric primary care clinic on vaccination error rates and to evaluate missed opportunities. A retrospective, quasi-experimental review of electronic medical records of visit encounters during a 3-month period compared vaccine error rates and missed opportunities between two pediatric residency primary care clinics. The intervention clinic has a full-time ambulatory clinical pharmacist integrated into the health care team. Pharmacy services were not provided at the comparison clinic. A vaccine error was defined as follows: doses administered before minimum recommended age, doses administered before minimum recommended spacing from a previous dose, doses administered unnecessarily, live virus vaccination administered too close to a previous live vaccine, and doses invalid for combinations of these reasons. 900 encounters were randomly selected and reviewed. The error rate was found to be 0.28% in the intervention clinic and 2.7% in the comparison clinic. The difference in error rates was found to be significant (P = 0.0021). The number of encounters with greater than or equal to one missed opportunity was significantly higher in the comparison clinic compared with the intervention clinic (29.3% vs. 10.2%; P clinic with a pharmacist had reductions in vaccination errors as well as missed opportunities. Pharmacists play a key role in the pediatric primary care team to improve the appropriate use of vaccines.

  14. Children's vomiting following posterior fossa surgery: A retrospective study

    Directory of Open Access Journals (Sweden)

    Dundon Belinda

    2009-07-01

    Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

  15. Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years

    Directory of Open Access Journals (Sweden)

    Fei Qi

    2015-01-01

    Full Text Available Background: Healthcare-associated pneumonia (HCAP is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis. Methods: Retrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities, dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU, mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk. Results: Among 612 patients (mean age of 70.7 years, 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%. Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP. Conclusion: Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality.

  16. Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years

    Institute of Scientific and Technical Information of China (English)

    Fei Qi; Guo-Xin Zhang; Dan-Yang She; Zhi-Xin Liang; Ren-Tao Wang; Zhen Yang; Liang-An Chen

    2015-01-01

    Background:Healthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality,and there is no clear evidence that this is due to inappropriate antibiotic therapy.This study was to elucidate the clinical features,pathogens,therapy,and outcomes of HCAP,and to clarify the risk factors for drug-resistant pathogens and prognosis.Methods:Retrospective observational study among hospitalized patients with HCAP over 10 years.The primary outcome was 30-day all-cause hospital mortality after admission.Demographics (age,gender,clinical features,and comorbidities),dates of admission,discharge and/or death,hospitalization costs,microbiological results,chest imaging studies,and CURB-65 were analyzed.Antibiotics,admission to Intensive Care Unit (ICU),mechanical ventilation,and pneumonia prognosis were recorded.Patients were dichotomized based on CURB-65 (low-vs.high-risk).Results:Among 612 patients (mean age of 70.7 years),88.4% had at least one comorbidity.Commonly detected pathogens were Acinetobacter baumannii,Pseudomonas aeruginosa,and coagulase-negative staphylococci.Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%).Mean age,length of stay,hospitalization expenses,ICU admission,mechanical ventilation use,malignancies,and detection rate for P.aeruginosa,and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group.CURB-65 ≥3,malignancies,and mechanical ventilation were associated with an increased mortality.Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAR.Conclusion:Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach.CURB-65 ≥3,malignancies,and mechanical ventilation may result in an increased mortality.

  17. Retrospective study on the 7.5-year survival of resin-bonded dental prostheses in single missing second premolar cases

    Directory of Open Access Journals (Sweden)

    Ayça Deniz Izgi

    2016-01-01

    Conclusions: Within the limitations of this retrospective clinical study, it seems that the design and cementation regimen used for the RBFDPs presented can guarantee clinical success in the restoration of single missing second premolar teeth.

  18. Clinical performance of enamel-dentine bonded all-ceramic restorations: retrospective evaluation in a postgraduate clinic.

    Science.gov (United States)

    Printzell, Lisa; Haseid, Carl Fredrik; Ekfeldt, Anders; Hjortsjö, Carl

    2016-01-01

    The aim of this retrospective study was to evaluate the clinical survival and success of five dif- ferent types of adhesive bonded all-ceramic restorations, in a postgraduate clinic. All ceramic enamel-dentin adhesive bonded restorations, either partial (n=94) or full coverage (n=145), were assessed by clinical examination using a modified Californian Dental Association (CDA) system for quality evaluation of dental care and a questionnaire assessing patient satis- faction (VAS) of 29 subjects with 239 restorations. The same 3-step adhesive bonding system in combination with dual-cured resin composite cement was used for all restorations Rubber dam was used for moisture control.The ceramics were evaluated with respect to patient satisfaction, esthetics, technical and biological complications. The reasons for treatment were mineralisation disorders (n=82), trauma (n=40), esthetic (n=57) and pathological tooth wear (n=60). Observation period for the restorations was up to 71 month (mean 33). All restorations were in place at the examinations (l00% survival rate). Number offractures and infractions were 28 and 20 respectively giving a 69% success rate. No significant difference was observed between full coverage and partial coverage restorations. Most of the fractures were small chippings of the veneering porcelain. From a biological point of view subgingival location of the restoration margin showed a significant correlation with bleeding on probing.The esthetic outcome seemed to depend on the ability of the selected veneering material to mask a severe tooth discoloration.The patients reported a high degree of satisfaction with both the esthetics and the function of their restorations. In conclusion all-ceramic enamel-dentin-bonded restorations demonstrated good short-term survival rate.The success rate was found to be lower. Both technical and biological complica- tions were present but mainly without any need of correction.The patients were in general very satisfied

  19. Retrospective study of efficacy and toxicity on patients older than 70 years within a randomized clinical trial of two cisplatin-based combinations in patients with small-cell lung cancer.

    Science.gov (United States)

    Safont, María José; Artal-Cortes, Angel; Sirera, Rafael; Gómez-Codina, José; González-Larriba, José Luis; Barneto, Isidoro; Carrato, Alfredo; Isla, Dolores; Rosell, Rafael; Camps, Carlos

    2009-01-01

    A retrospective analysis based on the Spanish Lung Cancer Group (SLCG) clinical trial of high-dose epirubicin/cisplatin in patients with small-cell lung cancer (SCLC) was performed. Patients younger than 70 years vs. older than 70 years old were analyzed to evaluate the influence of age on response to treatment, toxicity, time to progression (TTP) and overall survival (OS) of the chemotherapy schedule. Three hundred and thirty eight patients 70 years, were analyzed. Objective responses were similar in both groups. In patients less than 70 years higher TTP (36 weeks vs. 32 weeks) and OS (47 weeks vs. 42 weeks) were seen, attributable to the improved results observed in the subgroup of patients with limited disease (LD). No significant differences were observed when toxicity profile of both groups was compared, except for a higher rate of febrile neutropenia observed in the elderly group with extensive disease (4.6% vs. 8.8%, p=0.01). In the subgroup of patients with LD, elderly patients received less total cisplatin dose (401 vs. 508 mg/m(2), p=0.01) although less treatment delays were reported (10 days vs. 15 days, p=0.05). Age was likely to be a negative prognostic factor for OS of elderly patients with LD. It also seemed to be related to a greater dose reduction, which may explain that toxic episodes and delays occurred more frequently in the younger patients receiving the full scheduled dose. However, the definitive reason to explain this could not be established due to the characteristics of our analysis.

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

    Science.gov (United States)

    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.

  1. Establishing a multicenter longitudinal clinical cohort Study in ...

    African Journals Online (AJOL)

    ... clinical cohort Study in Ethiopia: Advanced Clinical Monitoring of Antiretroviral Treatment Project. ... Ethiopian Journal of Health Sciences ... Using similar recruitment procedures, a total of 120 children were enrolled in each of retrospective ...

  2. CT-diagnosed emphysema and prognosis of chronic airflow obstruction: a retrospective study

    OpenAIRE

    Kurashima, Kazuyoshi; Fukuda, Chiaki; Nakamoto, Keitaro; Takaku, Yotaro; Hijikata, Naoya; Hoshi, Toshiko; Kanauchi, Tetsu; Ueda, Miyuki; Takayanagi, Noboru; Sugita, Yutaka; Araki, Ryuichiro

    2013-01-01

    Objective CT-diagnosed emphysema is associated with poor prognosis in chronic obstructive pulmonary disease (COPD). Its clinical impacts on prognoses of asthma with chronic airflow obstruction (CAO) are not well known. We sought to compare mortalities and prognostic factors in COPD and asthma with CAO by the presence or absence of CT-diagnosed emphysema. Design Retrospective cohort study. Setting Referral centre hospital for respiratory disease. Participants 1272 patients aged over 40 years w...

  3. Retrospective study of cattle poisonings in California: recognition, diagnosis, and treatment

    OpenAIRE

    Puschner B; Varga A

    2012-01-01

    Anita Varga,1 Birgit Puschner21William R Pritchard Veterinary Medical Teaching Hospital, Large Animal Clinic, School of Veterinary Medicine, University of California, Davis, CA, USA; 2Department of Molecular Biosciences and the California Animal Health and Food Safety Laboratory System, School of Veterinary Medicine, University of California, Davis, CA, USAAbstract: In this retrospective study all suspect bovine intoxications submitted to the California Animal Health and Food Safety Laborator...

  4. Pemphigus Vulgaris and Infections: A Retrospective Study on 155 Patients

    Directory of Open Access Journals (Sweden)

    Nafiseh Esmaili

    2013-01-01

    Full Text Available Background. Autoimmune process and immunosuppressive therapy of pemphigus vulgaris would predispose the patients to infections. Aim. We aimed to study the prevalence of infection and pathogenic agents in pemphigus vulgaris patients admitted to dermatology service. Material and methods. This retrospective study was conducted on 155 pemphigus vulgaris patients (68 males, 87 females admitted to dermatology service between 2009 and 2011. In this study, the diagnosis of pemphigus vulgaris was confirmed by light microscopic and direct immunofluorescence findings. Data were collected through a questionnaire. Results. Of 155 pemphigus vulgaris patients, 33 had infection at admission and 9 acquired nosocomial infection. In addition, 37 cases of oral candidiasis and 15 cases of localized herpes simplex were recorded. Totally, 94 cases of infection were recorded. The occurrence of infection was significantly related to the severity of disease, number of hospital admissions, and presence of diabetes mellitus. The most common pathogenic germs isolated from cultures were Staphylococcus aureus and Escherichia coli. Conclusion. Severity of pemphigus vulgaris and diabetes were directly related with tendency to infections. Staphylococcus aureus and Escherichia coli were the most common pathogenic agents. Due to limitations of retrospective study, a prospective study is recommended.

  5. Retrospective clinical comparison of idiopathic versus symptomatic epilepsy in 240 dogs with seizures.

    Science.gov (United States)

    Pákozdy, Akos; Leschnik, Michael; Tichy, Alexander G; Thalhammer, Johann G

    2008-12-01

    In the present study, 240 cases of dogs with seizures were analysed retrospectively. The aim was to examine the underlying aetiology and to compare primary or idiopathic epilepsy (IE) with symptomatic epilepsy (SE) concerning signalment, history, ictal pattern, clinical and neurological findings. The diagnosis of symptomatic epilepsy was based on confirmed pathological changes in haematology, serum biochemistry, cerebrospinal fluid (CSF) analysis and morphological changes of the brain by CT/MRI or histopathological examination. Seizure aetiologies were classified as idiopathic epilepsy (IE, n = 115) and symptomatic epilepsy (SE, n = 125). Symptomatic epilepsy was mainly caused by intracranial neoplasia (39) and encephalitis (23). The following variables showed significant difference between the IE and SE group: age, body weight, presence of partial seizures, cluster seizures, status epilepticus, ictal vocalisation and neurological deficits. In 48% of the cases, seizures were found to be due to IE, while 16% were due to intracranial neoplasia and 10% to encephalitis. Status epilepticus, cluster seizures, partial seizures, vocalisation during seizure and impaired neurological status were more readily seen with symptomatic epilepsy. If the first seizure occurred between one and five years of age or the seizures occurred during resting condition, the diagnosis was more likely IE than SE.

  6. A retrospective study of surgically excised phaeochromocytomas in Newfoundland, Canada

    Directory of Open Access Journals (Sweden)

    Joanna Holland

    2014-01-01

    Full Text Available Objective: A retrospective study detailing the circumstances surrounding diagnosis and treatment of pheochromocytomas with the associated genetic disorders. Materials and Methods: All patients with surgically excised pheochromocytomas in the Health Sciences Center, St. John′s, Newfoundland, Canada between January 2001 and December 2010 were retrospectively analyzed to determine associated familial syndromes, age, tumor size, symptomatology, and percentage of paragangliomas and bilateral pheochromocytomas. Pathology specimen reports, adrenalectomy lists and Meditech (electronic medical record diagnostic codes provided a comprehensive database for this study. Results: Twenty-four patients were studied; familial disorder patients comprised 42% (10/24. Average age at diagnosis was 57 among the sporadic and 34 in familial disorder groups (P = 0.006. Average tumor size was 4.5 cm in the sporadic group and 3 cm in the familial disorder group (P = 0.19. All atypical cases including bilateral or extra-adrenal tumors and malignancy occurred in familial disorder patients. Conclusions: The proportion of familial disorder patients (42% was higher in this study than would be expected, likely a result of the relatively high incidence of hereditary autosomal dominant disorders within Newfoundland. Among familial disorder patients, the average younger age at diagnosis and the smaller tumor size suggest syndromic pheochromocytomas may develop earlier, however they are more likely to be diagnosed sooner due to biochemical surveillance testing in known genetic disorder patients. We also demonstrate a relatively high incidence of surgically resected pheochromocytomas of 4.679/million/year in Newfoundland.

  7. A retrospective study of surgically excised phaeochromocytomas in Newfoundland, Canada.

    Science.gov (United States)

    Holland, Joanna; Chandurkar, Vikram

    2014-07-01

    A retrospective study detailing the circumstances surrounding diagnosis and treatment of pheochromocytomas with the associated genetic disorders. All patients with surgically excised pheochromocytomas in the Health Sciences Center, St. John's, Newfoundland, Canada between January 2001 and December 2010 were retrospectively analyzed to determine associated familial syndromes, age, tumor size, symptomatology, and percentage of paragangliomas and bilateral pheochromocytomas. Pathology specimen reports, adrenalectomy lists and Meditech (electronic medical record) diagnostic codes provided a comprehensive database for this study. Twenty-four patients were studied; familial disorder patients comprised 42% (10/24). Average age at diagnosis was 57 among the sporadic and 34 in familial disorder groups (P = 0.006). Average tumor size was 4.5 cm in the sporadic group and 3 cm in the familial disorder group (P = 0.19). All atypical cases including bilateral or extra-adrenal tumors and malignancy occurred in familial disorder patients. The proportion of familial disorder patients (42%) was higher in this study than would be expected, likely a result of the relatively high incidence of hereditary autosomal dominant disorders within Newfoundland. Among familial disorder patients, the average younger age at diagnosis and the smaller tumor size suggest syndromic pheochromocytomas may develop earlier, however they are more likely to be diagnosed sooner due to biochemical surveillance testing in known genetic disorder patients. We also demonstrate a relatively high incidence of surgically resected pheochromocytomas of 4.679/million/year in Newfoundland.

  8. Retrospective and clinical evaluation of retrievable, tooth-implant supported zirconia-ceramic restorations.

    Science.gov (United States)

    Mundt, Torsten; Heinemann, Friedhelm; Schankath, Christof; Schwahn, Christian; Biffar, Reiner

    2013-09-01

    Permanent cementations of zirconia-ceramic restorations may conflict with the rationale for retrievability of implant-supported restorations. The aim of this study was to test the hypothesis that retrievable, tooth-implant supported FDPs made of veneered zirconia ceramic cores are a viable treatment alternative. Restorations of patients in private practice and dental clinic were evaluated by reviewing patient records retrospectively and performing a final clinical examination. Permanently cemented copings protected the tooth abutments. The zirconia-ceramic restorations were semi-permanently cemented to the copings and the implant abutments using acrylic-urethane cement. In addition to Kaplan-Meier analyses for complications, the effect of age, gender, signs of bruxism, jaw and number of units on complications was estimated using Cox regression analyses (significance p ceramic restorations (3-12 units) ranged from 12.7-47.9 months. Core fractures of two posterior prostheses in patients with signs of bruxism yielded a 40-month survival rate of 93.5%. There were 10 cohesive chippings within the veneering porcelain for seven patients (six patients with signs of bruxism), which resulted in 40-month chipping rates of 5.6% among non-bruxers and 100% among patients with signs of bruxism. The hazard ratio for signs of bruxism was 20 (95% confidence interval: 2.1-188.3, p = 0.009). Retrievable, tooth-implant supported restorations made of zirconia-ceramics should be used with caution because of some core fractures and a considerable number of minor veneer fractures. The fracture risk was very high among patients with signs of bruxism. Due to the low number of occasions for intentional retrievals, a recommendation to use semi-permanently cemented, all-ceramic FDPs would still be premature.

  9. Classification and clinical features of headache disorders in Pakistan: a retrospective review of clinical data.

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    Muhammed Murtaza

    Full Text Available BACKGROUND: Morbidity associated with primary headache disorders is a major public health problem with an overall prevalence of 46%. Tension-type headache and migraine are the two most prevalent causes. However, headache has not been sufficiently studied as a cause of morbidity in the developing world. Literature on prevalence and classification of these disorders in South Asia is scarce. The aim of this study is to describe the classification and clinical features of headache patients who seek medical advice in Pakistan. METHODS AND RESULTS: Medical records of 255 consecutive patients who presented to a headache clinic at a tertiary care hospital were reviewed. Demographic details, onset and lifetime duration of illness, pattern of headache, associated features and family history were recorded. International Classification of Headache Disorders version 2 was applied. 66% of all patients were women and 81% of them were between 16 and 49 years of age. Migraine was the most common disorder (206 patients followed by tension-type headache (58 patients, medication-overuse headache (6 patients and cluster headache (4 patients. Chronic daily headache was seen in 99 patients. Patients with tension-type headache suffered from more frequent episodes of headache than patients with migraine (p<0.001. Duration of each headache episode was higher in women with menstrually related migraine (p = 0.015. Median age at presentation and at onset was lower in patients with migraine who reported a first-degree family history of the disease (p = 0.003 and p<0.001 respectively. CONCLUSIONS/SIGNIFICANCE: Patients who seek medical advice for headache in Pakistan are usually in their most productive ages. Migraine and tension-type headache are the most common clinical presentations of headache. Onset of migraine is earlier in patients with first-degree family history. Menstrually related migraine affects women with headache episodes of longer duration than other patients

  10. Posaconazole for primary antifungal prophylaxis in patients with acute myeloid leukaemia or myelodysplastic syndrome during remission induction chemotherapy: a single-centre retrospective study in Korea and clinical considerations.

    Science.gov (United States)

    Cho, Sung-Yeon; Lee, Dong-Gun; Choi, Su-Mi; Choi, Jae-Ki; Lee, Hyo-Jin; Kim, Si-Hyun; Park, Sun Hee; Choi, Jung-Hyun; Yoo, Jin-Hong; Kim, Yoo-Jin; Kim, Hee-Je; Min, Woo-Sung

    2015-09-01

    Posaconazole was introduced as the primary antifungal prophylaxis (PAP) in acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS) patients during remission induction chemotherapy. Data on breakthrough invasive fungal infections (IFIs) from various centres are essential, as there are several considerations in treating IFIs in the posaconazole era. The aim of this study was to evaluate the effectiveness of posaconazole PAP and identify characteristics of IFIs at a single centre in Korea. We retrospectively reviewed consecutive patients with AML/MDS undergoing remission induction chemotherapy between December 2010 and November 2013. Of the 424 patients, 140 received posaconazole and 284 received fluconazole prophylaxis. The incidence of breakthrough proven/probable IFIs (15.5% vs. 2.9%, P posaconazole group compared to the fluconazole group. In the posaconazole PAP group, two cases of breakthrough mucormycosis were noted among 13 proven/probable/possible IFI cases (15.4%). Overall and IFI-related mortality was 12.1% and 1.9% respectively. Fungus-free survival was significantly higher in the posaconazole group (74.7% vs. 87.1%, P = 0.028). Breakthrough IFIs and EAFT decreased significantly after posaconazole PAP. The benefit in fungus-free survival was noted with posaconazole PAP. Clinicians should be vigilant to identify non-Aspergillus IFIs with active diagnostic effort.

  11. Clinical Assessment of Affective Instability: Comparing EMA Indices, Questionnaire Reports, and Retrospective Recall

    Science.gov (United States)

    Solhan, Marika B.; Trull, Timothy J.; Jahng, Seungmin; Wood, Phillip K.

    2009-01-01

    Traditional self-report measures of psychopathology may be influenced by a variety of recall biases. Ecological momentary assessment (EMA) reduces these biases by assessing individuals' experiences as they occur in their natural environments. This study examines the discrepancy between trait questionnaire, retrospective report, and EMA measures of…

  12. [Brucella orchitis: A retrospective study of 69 cases].

    Science.gov (United States)

    Wang, Wen-qing; Guo, Zheng-yin

    2016-01-01

    To investigate the epidemiological characteristics, clinical manifestations, diagnosis, and treatment of Brucella orchitis, so as to provide reliable evidence for the prevention and treatment of the disease. We conducted retrospective statistical analyses on the medical records of 48 outpatients and 21 inpatients with Brucella orchitis. Brucella orchitis was diagnosed in 6.67% of the male patients with brucellosis (69/1 034). The disease exhibited typical epidemiological features, with a higher incidence rate among those in frequent contact with sheep and elderly people, in the period from April to July, and in the areas with sheep husbandry. All the Brucella orchitis patients had such local symptoms as testicular pain and swelling, more frequently involving both testes, and other most common symptoms included fever, chills, sweating, and painful joints. Based on IIEF-5, 45 of the patients suffered from severe erectile dysfunction, with their reproductive function temporarily affected in the course of the disease. Misdiagnosis easily occurred in the early stage of the disease. Therapeutic options mainly included doxycycline hydrochloride and rifampicin, administered orally or intravenously, which could effect a cure, though relapse might occur in some cases. Bru- cella orchitis has distinct epidemiological characteristics, with clinical manifestations of testicular pain and swelling. Though a transient disease, it affects the reproductive function of the patient before cured. It can be treated by combined oral and intravenous medication, with painkillers or ice bags for testicular pain and swelling.

  13. A Retrospective Study of Congenital Cardiac Abnormality Associated with Scoliosis

    Science.gov (United States)

    Ucpunar, Hanifi; Sevencan, Ahmet; Balioglu, Mehmet Bulent; Albayrak, Akif; Polat, Veli

    2016-01-01

    Study Design Retrospective study. Purpose To identify the incidence of congenital cardiac abnormalities in patients who had scoliosis and underwent surgical treatment for scoliosis. Overview of Literature Congenital and idiopathic scoliosis (IS) are associated with cardiac abnormalities. We sought to establish and compare the incidence of congenital cardiac abnormalities in patients with idiopathic and congenital scoliosis (CS) who underwent surgical treatment for scoliosis. Methods Ninety consecutive scoliosis patients, who underwent surgical correction of scoliosis, were classified as CS (55 patients, 28 female [51%]) and IS (35 patients, 21 female [60%]). The complete data of the patients, including medical records, plain radiograph and transthoracic echocardiography were retrospectively assessed. Results We found that mitral valve prolapse was the most common cardiac abnormality in both patients with IS (nine patients, 26%) and CS (13 patients, 24%). Other congenital cardiac abnormalities were atrial septal aneurysm (23% of IS patients, 18% of CS patients), pulmonary insufficiency (20% of IS patients, 4% of CS patients), aortic insufficiency (17% of IS patients), atrial septal defect (11% of IS patients, 13% of CS patients), patent foramen ovale (15% of CS patients), dextrocardia (4% of CS patients), bicuspid aortic valve (3% of IS patients), aortic stenosis (2% of CS patients), ventricular septal defect (2% of CS patients), and cardiomyopathy (2% of CS patients). Conclusions We determined the increased incidence of congenital cardiac abnormalities among patients with congenital and IS. Mitral valve prolapse appeared to be the most prevalent congenital cardiac abnormality in both groups. PMID:27114761

  14. 恒牙撕脱性损伤临床特征的回顾性分析%A retrospective study about the clinical characteristics of avulsion of permanent teeth

    Institute of Scientific and Technical Information of China (English)

    王伟; 黄超; 刘艳丽; 赵寅华; 张旻; 陈永进

    2016-01-01

    目的:分析恒牙撕脱性损伤的分布特征。方法:对131名患者共179个撕脱性损伤患牙进行临床特征回顾性研究,包括年龄、性别、病因、牙保存方法、牙离体时间及是否伴有软硬组织伤等,并对观察半年以上且伴有牙槽骨骨折的撕脱性患牙愈后进行统计分析。结果:主要病因为摔伤(59%),好发于上颌中切牙(78%)。仅3%的人能够在30 min内就医;45%伴发软组织损伤;34%伴发牙槽骨骨折,其中10%牙槽骨骨折在初诊中被漏诊;撕脱性损伤伴牙槽骨骨折牙根吸收率略高于无牙槽骨骨折(P>0.05)。结论:多数患者由于就诊延误再植牙属于延迟再植;牙撕脱性损伤多伴发软硬组织的损伤,但撕脱性损伤患牙是否伴有牙槽骨损伤与其远期根吸收无明显关联。%AIM:To analyze the clinical characteristics of avulsion of permanent teeth.METHODS:A ret-rospective analysis was performed on the dental records of 131 patients with avolsion of 179 permanent teeth.The clinical data of avulsed teeth were collected,and the follow-up period was more than 6 months.The factors were analyzed in re-lation to postoperative outcomes.RESULTS:Wound in fall was the major reason for tooth avulsion (59%),and the maxillary incisors were the mainly avulsed permanent teeth(78%)Tooth avulsion was accompanied with injuries of the alveolar bone in 10% cases,with soft tissue injuries in 45% cases.Only 3% the avulsed teeth were replanted within 30 min at Emergency Department.10%alveolar bone fracture was not diagnosed at the first visit.Tooth avulsion accom-panied with and without injuries of alveolar bone on showed no stastitic significance in root resorption(P>0.05).CON-CLUSION:Most tooth replantation was delayed due to delayed clinical visit.Alveolar bone fracture may not be correla-ted with root resorption in avulsed permanent teeth.

  15. A retrospective clinicopathological study on oral lichen planus and malignant transformation: Analysis of 518 cases

    OpenAIRE

    Shen, Zheng Yu; LIU Wei; Zhu, Lai Kuan; Feng, Jin Qiu; Tang, Guo Yao; Zhou, Zeng Tong

    2012-01-01

    Objective: To investigate the epidemiological and clinical characteristics of a relatively large cohort of patients with oral lichen planus (OLP) from eastern China. Study design: A total of 518 patients with histologically confirmed OLP in a long-term follow-up period (6 months-21.5 years) were retrospectively reviewed in our clinic. Results: Of the 518 patients, 353 females and 165 males were identified. The average age at diagnosis was 46.3 years (range 9-81 years) with the buccal mucosa b...

  16. Oral lichen planus: A retrospective study of 633 patients from Bucharest, Romania

    Science.gov (United States)

    Parlatescu, Ioanina; Gheorghe, Carmen; Tovaru, Mihaela; Costache, Mariana; Sardella, Andrea

    2013-01-01

    Objective: In this retrospective study, patients’ medical records were reviewed to investigate the profiles of 633 OLP cases in a group of Romania. Material and Methods: In this retrospective study, the following clinical data were obtained from the medical charts of patients: gender, age, clinical presentation of OLP, site affected, presence of symptoms, extraoral manifestations of lichen planus, presence of systemic diseases, and history of medications. Results: Most (78.67%) OLP patients were female and the mean age at presentation was 52 years. The white type of the disease (reticular/papular/plaque lesions) was the main form encountered in this sample (48.97%). Among patients with available hepatitis C virus test results, 9.6% were serum-positive. OLP was associated with gallbladder disease (i.e. cholecystitis, cholelithiasis) in 19% of patients. Six patients (0.95%) developed squamous cell carcinoma at a site with confirmed OLP lesions. Conclusions: To the best of our knowledge, no similar study has been conducted in a Romanian population. The present investigation revealed the predominance of OLP among middle-aged white women and the prevalence of bilateral involvement of the buccal mucosa with reticular white lesions. Anti-HCV circulating antibodies were more common in patients with OLP than in the general population and, notably, OLP was associated with gallbladder disease (cholecystitis, cholelithiasis) in 19% of patients. Key words:Oral lichen planus, oral mucosal diseases, retrospective study. PMID:23229244

  17. [Fatal child abuse in Japan and Germany. Comparative retrospective study].

    Science.gov (United States)

    Ohtsuji, M; Ohshima, T; Kondo, T; Godoy, M R; Oehmichen, M

    1998-01-01

    In this study a record for comparative international epidemiological studies on autopsy cases of child abuse is introduced. The form was proved in a retrospective comparative survey of cases of fatal child abuse at the Department of Legal Medicine in Kanazawa (Japan) and Institute of Legal Medicine of Lübeck (Germany). A total of 33 cases were included. The following data were evaluated: age and gender of victims and assailants, relationship between victims and assailants, causes and methods of abuse, chief autopsy findings, and causes of death. The results were leading into two directions between Kanazawa and Lübeck: (1) In the years of 1981-1996 in Kanazawa 23 cases of fatal child abuse were autopsied while during the same period in Lübeck only 10 cases were registered. (2) While sexual abuse was not registered in Kanazawa, it was recorded twice in Lübeck.

  18. [Brucellosis: retrospective evaluation of the clinical, laboratory and epidemiological features of 151 cases].

    Science.gov (United States)

    Demiroğlu, Y Ziya; Turunç, Tuba; Alişkan, Hikmet; Colakoğlu, Sule; Arslan, Hande

    2007-10-01

    The aim of this study was to retrospectively evaluate the clinical and laboratory characteristics, complications and treatment oucomes of 151 brucellosis cases (age range: 15-79 years; 89 female), who were followed in our clinic between the period of January 2003-July 2005. Of them, 66.2% were diagnosed as acute, 23.8% as subacute and 9.9% as chronic brucellosis. Risk factors were detected as consumption of unpasteurized milk and diary products (80%), stock-breeding (14%) and risky profession such as veterinary, laboratory technician and butcher (3.3%). Most common complaints were arthralgia (87.4%), malaise (86%), fever (79.5%), sweating (78%), and waist pain (71%). In view of laboratory findings, increased erytrocyte sedimentation rate was detected in 61.6%, C-reactive protein positivity in 60%, lymphomonocytosis in 44.4% and anemia in 51.7% of them. Blood cultures were performed from 125 of the patients, and 64 (51.2%) of them yielded Brucella spp. The other specimens in which bacterial growth were detected in one of each, were bone marrow, sternoclavicular joint, psoas abscess, urine and pleural fluid. Standard tube agglutination (STA) test was found negative in 1.3% of patients who were culture positive, while it was positive at 1/160 titer in 20.5%, at 1/320 in 14%, at 1/640 in 14.6% and > or = 1/1280 in 49.7 percent. The most common complication was found as musculo-skeletal system involvement (30 spondylodiscitis, 15 sacroileitis, five peripheric arthritis, one tendinitis) with a rate of 33.7 percent. Other complications were nervous system involvement in 6% (two acute and seven chronic meningitis), genitourinary involvement in 5.3% (five epididymo-orchitis, two prostatitis, one with Brucella positive urine culture), peritonitis in 0.6% and skin involvement in 0.6 percent. Seven different therapy protocols were applied to the patients according to complications and case specialty, however doxycycline+rifampicin combination during six weeks was the most

  19. Eleven-Year Retrospective Survival Study of 275 Veneered Lithium Disilicate Single Crowns.

    Science.gov (United States)

    Simeone, Piero; Gracis, Stefano

    2015-01-01

    The aim of the present clinical retrospective study was to evaluate the long-term survival and clinical performance of veneered lithium disilicate single restorations in anterior and posterior areas after up to 11 years. Following a rigid protocol, 275 lithium disilicate single crowns (35 IPS Empress II and 240 e.max Press) were cemented over 11 years, in 106 patients, using an adhesive technique; of these 106 were anterior (38.5%) and 169 posterior (61.5%) teeth. Teeth receiving endodontic therapy and composite reconstruction (50%) and teeth with preexisting metalceramic crowns, called prosthetic retreatments (PR; 65%), were included as well. Of the 106 patients enrolled in the study, 25 (23.5%) were diagnosed with bruxism habits, and 7 of these patients (6.6% of all patients) received full-mouth single lithium disilicate restorations (FMR). The exclusion criteria for this retrospective clinical study were: monolithic lithium disilicate crowns, teeth with cast post and cores, implant-supported all-ceramic crowns, active periodontitis, and/or poor oral hygiene. Clinical reevaluation was performed by the clinicians who prepared and luted them during maintenance appointments between January 2012 and October 2013. Number of restoration failures and characteristics of failures were recorded. Marginal adaptation and marginal discoloration were evaluated based on the Cvar-Ryge criteria. The overall cumulative survival rate was 98.2%. The failures recorded were the result of either mechanical failure or debonding. Five crowns failed mechanically-three because of chipping and two because of core fracture-and were replaced. None of the failed crowns was associated with the bruxers with FMR. A total of 15 crowns debonded (5.5% of all crowns); however, 11 belonged to the same patient who had endodontically treated and reconstructed abutments. In this retrospective clinical evaluation of up to 132 months, veneered lithium disilicate single crowns had a low failure rate.

  20. Conducting Retrospective Ontological Clinical Trials in ICD-9-CM in the Age of ICD-10-CM

    Science.gov (United States)

    Venepalli, Neeta K; Shergill, Ardaman; Dorestani, Parvaneh; Boyd, Andrew D

    2014-01-01

    OBJECTIVE To quantify the impact of International Classification of Disease 10th Revision Clinical Modification (ICD-10-CM) transition in cancer clinical trials by comparing coding accuracy and data discontinuity in backward ICD-10-CM to ICD-9-CM mapping via two tools, and to develop a standard ICD-9-CM and ICD-10-CM bridging methodology for retrospective analyses. BACKGROUND While the transition to ICD-10-CM has been delayed until October 2015, its impact on cancer-related studies utilizing ICD-9-CM diagnoses has been inadequately explored. MATERIALS AND METHODS Three high impact journals with broad national and international readerships were reviewed for cancer-related studies utilizing ICD-9-CM diagnoses codes in study design, methods, or results. Forward ICD-9-CM to ICD-10-CM mapping was performing using a translational methodology with the Motif web portal ICD-9-CM conversion tool. Backward mapping from ICD-10-CM to ICD-9-CM was performed using both Centers for Medicare and Medicaid Services (CMS) general equivalence mappings (GEMs) files and the Motif web portal tool. Generated ICD-9-CM codes were compared with the original ICD-9-CM codes to assess data accuracy and discontinuity. RESULTS While both methods yielded additional ICD-9-CM codes, the CMS GEMs method provided incomplete coverage with 16 of the original ICD-9-CM codes missing, whereas the Motif web portal method provided complete coverage. Of these 16 codes, 12 ICD-9-CM codes were present in 2010 Illinois Medicaid data, and accounted for 0.52% of patient encounters and 0.35% of total Medicaid reimbursements. Extraneous ICD-9-CM codes from both methods (Centers for Medicare and Medicaid Services general equivalent mapping [CMS GEMs, n = 161; Motif web portal, n = 246]) in excess of original ICD-9-CM codes accounted for 2.1% and 2.3% of total patient encounters and 3.4% and 4.1% of total Medicaid reimbursements from the 2010 Illinois Medicare database. DISCUSSION Longitudinal data analyses post-ICD-10

  1. [Retrospective study on Latrodectus stings in Bahia, Brazil].

    Science.gov (United States)

    Lira-da-Silva, R M; Matos, G B; Sampaio, R O; Nunes, T B

    1995-01-01

    This work is a retrospective study of latrodectism in the State of Bahia, Brazil, from August 1980 to July 1990. The data concerning the accidents were obtained from file cards at the Antivenom Information Center of Bahia (AVICB). Latrodectus curacavienis was the ethiologic agent identified in 28% of the arachnid accidents. The major incidence was registered in urban area (57%) affecting men (70%) more than women, with 10 to 29 year-old age group (58%). Local pain (56%), erythematous papula (29%) and light oedema (17%) were the principal local symptoms. Pain in the limbs (29%), tremor and rigidities (29%), sweating (28%), limbs and arms paresthesia (21%) and abdominal pain (17%) were systemic ones. The treatment was mainly symptomatic (67%) and antivenin serum was used in 21% of the cases. After serotherapy, 64% of the patients left the hospital within less than 24 hours.

  2. A retrospective evaluation of haematological values in clinical cases of water buffaloes

    Directory of Open Access Journals (Sweden)

    Nittin D. Singh

    2013-04-01

    Full Text Available Aim: To evaluate the important haematological values of the retrospective clinical cases of buffaloes presented to the Teaching Veterinary Hospital of the College of Veterinary Science, Guru Angad Dev Veterinary and Animal Science University, Ludhiana over a period of 4 years from January 2007 to December 2010. Materials and methods: The blood was collected from jugular vein in EDTA containing vials. Statistical analysis of haematological values with different case history/clinical signs was performed using SPSS 16.0 version by applying one way ANOVA at P<0.05. Clinical pathology of these cases was monitored by comparing hemogram values with the reference range. Results: The most common disorders found in water buffaloes were digestive disorders followed by fever and respiratory disorders. Haematological values viz. TLC, DLC (neutrophil, lymphocyte and eosinophil counts showed significant differences depending upon the case history/clinical signs while haemoglobin count was found to be statistically nonsignificant. Conclusion: TLC and DLC are found to be the important indicators of health status of water buffaloes in general which are more related to clinical history/clinical signs of this species than other the haematological parameters viz. haemoglobin count. [Vet World 2013; 6(2.000: 103-105

  3. Retrospective analysis of the clinical behavior of oral hairy leukoplakia in 215 HIV-seropositive patients

    Directory of Open Access Journals (Sweden)

    Daniela Assis do VALE

    Full Text Available Abstract Oral manifestations are common findings in human immunodeficiency virus (HIV infected patients and frequently influence the overall health. Oral hairy leukoplakia (OHL is strongly associated with HIV infection demonstrating its relationship with the individual’s immune status and progression of immunosuppression. This study aims to retrospectively evaluate OHL in HIV patients, analyzing its incidence, demographic aspects and possible changes in clinical and epidemiological profile of the disease over 17 years. The records of 1600 HIV-infected patients were reviewed. The data were correlated and analyzed, considering HIV exposure category, age, gender, harmful habits, CD4 level, use and type of antiretroviral. OHL was observed in 215 (13.4% patients. Most were men in the fourth decade of life, 171 (79.5% and 112 (52,1% respectively, but an increase in the incidence of OHL among female patients and those in the fifth decade of life was observed. Tobacco smoking was the most frequent harmful habit reported by 114 (68% patients. OHL occurred mostly in patients with CD4 counts between 200 and 500 cells/mm3 35 (55.5%. The lower incidence of OHL was found among patients using at least one non-nucleoside reverse transcriptase inhibitor (NNRTI. OHL is related to CD4 count, use of ARVT and tobacco smoking and is also more prevalent in men in the fourth decade of life. These characteristics were recognized in absolute values, but when verifying the behavior over the years we noticed that the incidence of OHL is decreasing and its epidemiological characteristics changing.

  4. Generic substitution of antiepileptic drugs: a systematic review of prospective and retrospective studies.

    Science.gov (United States)

    Yamada, Mikiko; Welty, Timothy E

    2011-11-01

    To systematically review the literature on generic antiepileptic drugs (AEDs), evaluate the efficacy and safety of generic AED substitution, and perform pharmacokinetic (PK) analysis using the American Academy of Neurology (AAN) scheme to classify evidence. PubMed and Cumulative Index to Nursing and Allied Health Literature searches from January 1, 1980, to October 15, 2010, were performed using the search terms anticonvulsant, antiepileptic drug, carbamazepine, divalproex, ethosuximide, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, pheno-barbital, phenytoin, primidone, topiramate, valproate, valproic acid, and zonisamide; bioavailability, bioequivalence, bioequivalency, bioequivalent, and substitution; and generic. Retrospective and prospective controlled studies of generic substitution of AEDs were included in the review. Non-English-language articles and uncontrolled clinical studies were excluded. Published articles were categorized using the AAN criteria for systematic reviews. We identified 156 articles. Of these, 20 met our inclusion criteria; 7 were retrospective studies, 6 were prospective studies in patients with epilepsy, and 7 were prospective studies in healthy subjects. All articles were rated Class I to Class III, using AAN criteria. The retrospective studies were categorized as Class III and showed a significant relationship between generic substitution and increased use of health care resources because of seizures or AED toxicity. Prospective studies were categorized as Class I, II, and III. Prospective studies in patients showed no differences between brand and generic drugs in PK parameters of bioequivalence. Three prospective studies in healthy subjects reported significant differences in maximum drug concentrations. Comparison of brand and generic drugs revealed no significant difference in seizure frequency; however, some prospective studies showed significant differences in PK parameters, primarily those not used for bioequivalence

  5. 老年患者医院获得性血流感染的临床回顾性研究%Hospital-acquired bloodstream infections in geriatric wards: a retrospective clinical study

    Institute of Scientific and Technical Information of China (English)

    柏淑禹; 张伟

    2016-01-01

    目的 探讨老年病房医院感染血流感染病例的临床特点、病原学特征及其他相关因素,为临床诊疗提供科学依据.方法 对我院老年病房2010年6月至2015年10月医院获得性血流感染患者的相关因素及临床特征进行回顾性分析.结果 老年血流感染患者64例,基础疾病以恶性肿瘤(39.1%)及2型糖尿病(32.8%)为主;原发血流感染53例,占82.8%;继发性血流感染11例,占17.2%;原发感染病灶以呼吸道、泌尿道和肝胆系统为主.13例患者死亡,病死率高达20.3%.多因素条件Logistic逐步回归分析显示,中心静脉置管或输液港≥7 d(OR=49.51)、使用质子泵抑制剂药物≥3d(OR=13.63)是老年患者血流感染发生的独立危险因素;64例患者中,共检出66株病原菌.G+菌以凝固酶阴性葡萄球菌属最常见(18.2%);G-菌以埃希菌属(18.2%)和克雷伯菌属(15.2%)多见,二者产超广谱β-内酰胺酶株为54.5%.结论 血流感染严重影响老年患者的预后.减少侵袭性操作、积极防治肿瘤、改善内环境、保护重要脏器功能,是降低老年病房血流感染发生率的主要措施.%Objective To investigate the clinical and pathogenic features and other related factors of hospital-acquired bloodstream infections (HABSI) in geriatric wards,in order to provide the scientific basis for clinical diagnosis and therapy.Methods Clinical characteristics and other related factors of HABSI in patients admitted to the Department of Geriatrics of our hospital from June 2010 to October 2015 were retrospectively analyzed.Results Of the 64 elderly patients with HABSI,malignant tumor (39.1%) and type 2 diabetes mellitus (32.8%) were among the main disorders for their admission to the hospital.There were 53 cases of primary bloodstream infections and 11 cases of secondary bloodstream infections,accounting for 82.8% and 17.2%,respectively.Primary infections involved mostly the respiratory,urinary and

  6. Clinical and electrophysiological characteristics of Lambert-Eaton myasthenic syndrome: a retrospective study in forty-five patients%Lambert-Eaton肌无力综合征45例临床及电生理回顾性分析

    Institute of Scientific and Technical Information of China (English)

    管宇宙; 崔丽英; 张俊保; 刘明生; 王含

    2010-01-01

    目的 通过对我院Lambert-Eaton肌无力综合征(Lambert-Eaton myasthenia syndrome,LEMS)患者的回顾性分析,分析此病的临床表现和伴发的神经电生理异常.方法 总结1993-2008年我院诊断的45例LEMS患者的一般情况、神经系统临床表现和体征、伴发的内科和全身疾病的情况.所有患者均进行神经电生理检测,包括神经传导速度(NCV)和重复神经电刺激(RNS).部分患者行针极肌电图和皮肤交感反射(SSR)检查.结果 (1)患者出现神经系统症状的平均年龄为(51.2±6.8)岁.最常见临床表现为双下肢无力(35例),其后依次为双上肢无力(10例)、构音障碍(3例)和颈肌无力(2例).神经系统体征中最常见为双下肢或上肢轻度力弱(40例),双下肢腱反射或跟反射减低或消失(38例)以及口干或便秘等自主神经症状(30例).(2)神经电生理检查:所有患者尺神经高频刺激递增达156% ~636%,其中29例同时出现低频递减.所有患者行NCV检查,感觉神经传导速度(SCV)异常或SCV合并运动神经传导速度异常者19例(42%).30例患者行针极肌电图检查,有异常发现者20例.25例行SSR的患者中发现13例异常.结论 LEMS最常见的临床症状为双下肢无力,其次为自主神经症状.患者除了有重复神经电刺激的异常,还伴有周围神经和肌肉的电生理异常以及自主神经系统的异常,提示临床表现可能混杂有神经或肌肉病变的原因.%Objective To analyze the symptoms and signs in forty-five Lambert-Eaton myasthenia syndrome (LEMS) patients retrospectively. Characteristics of electrophysiological examinations were investgated. Methods Forty-five LEMS patients were reviewed and information gathered regarding clinical complains neurological symptoms, and other concomitant diseases. The records showed that repetitive nerve stimulation (RNS) and nerve conduction velocity (NCV) were performed in all patients. Needle electromyography (EMG) and skin

  7. Clinical and pathological features of intracranial meningiomas in children: A retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    Kun Yang; Lisheng He; Linsun Dai; Jian Chen; Zhixiong Lin

    2006-01-01

    BACKGROUND:The attack of meningiomas has sex and age differences.Previous studies indicated that children and adult patients had different clinical and pathological features.Due to the limitation of conditions and technique of diagnosis and treatment,some clinical and pathological features of meningiomas in children should be further recognized.OBJECTIVE:To summarize the clinical and pathological features in 15 children with intracranial meningiomas.DESIGN:A retrospective case analysis.SETTING:The hospitals which the first author had been working in.PARTIClPANTS:Fifteen children with intracranial meningiomas were selected from the hospitals the first author had been working in from June 1996 to June 2006.There were 9 boys and 6 gids,aged 1.8-15 years,with an average of 9.8 years.The duration from attack to diagnosis was 1 month to 2.5 years,with an average of 13months.Inclusive criteria:①Clinically diagnosed,operated and confirmed pathologically;②≤15 years;③The children and their relatives were all informed and agree with the detection.METHODS:The clinical manifestations,imaging data,preoperative diagnosis and misdiagnosis,site and size of tumor,operative treatment and pathological data were retrospectively summarized.Thirteen of 15 children with intracranial meningiomas were followed up by means of reexamination for 1-8 years.and the postoperative recurrence were observed.HAIN OUTCOME MEASURES:Clinical manifestations,imaging data,preoperative diagnosis and misdiagnosis,site and size of tumor,operative treatment,pathological data,recurrence conditions of 1 to 8 years follow-up.RESULTS:Thirteen of the 15 children with intracranial meningiomas were involved in the analysis of results.and 2 lost to the follow-up. ①The main clinical manifestations at diagnosis were headache in 11 cases(73%,11/5),vomiting in 8 cases(53%,8/15),papilledema in 9 cases(60%,9/15),hypopsia in 6 cases (40%,6/15),epilepsy in 5 cases(33%,5,15).hemiplegia in 4 cases(27%,4/15),cranial

  8. Quantitative Framework for Retrospective Assessment of Interim Decisions in Clinical Trials.

    Science.gov (United States)

    Stanev, Roger

    2016-11-01

    This article presents a quantitative way of modeling the interim decisions of clinical trials. While statistical approaches tend to focus on the epistemic aspects of statistical monitoring rules, often overlooking ethical considerations, ethical approaches tend to neglect the key epistemic dimension. The proposal is a second-order decision-analytic framework. The framework provides means for retrospective assessment of interim decisions based on a clear and consistent set of criteria that combines both ethical and epistemic considerations. The framework is broadly Bayesian and addresses a fundamental question behind many concerns about clinical trials: What does it take for an interim decision (e.g., whether to stop the trial or continue) to be a good decision? Simulations illustrating the modeling of interim decisions counterfactually are provided.

  9. A RETROSPECTIVE STUDY ON ACCEPTABILITY AND COMPLICATIONS OF PPIUCD INSERTION

    Directory of Open Access Journals (Sweden)

    Runjun

    2016-04-01

    Full Text Available BACKGROUND Purpose: To study the acceptance level of Post-Partum Intrauterine Contraceptive Device (PPIUCD insertion among women attending tertiary level hospital for delivery between January 2013 to July 2015 in relation to age, parity and mode of delivery, safety and their complaints/complications during followup visit. METHOD This is a retrospective study done in a tertiary care centre, Jorhat Medical College and Hospital, Assam, between January 2013 to July 2015. Women who had accepted PPIUCD after delivery (Vaginally or by Lower Segment Caesarean section were included in this study. The entire PPIUCD inserted patients were followed up to 6 weeks and 6 months after delivery. With the help of data collected, relevant parameters and data are critically analysed in our study. RESULTS Acceptance of PPIUCD showed an increasing trend, acceptance was more among patients undergoing caesarean section; 43.86% of the acceptors were in the age group of 21-25 years. More than 50% of the total acceptors in the study came for followup. The main complaints at followup were missing thread and bleeding. The main causes of removal were bleeding and pressure from family. CONCLUSION The acceptance of PPIUCD was high in this study. The PPIUCD was demonstrably safe having no serious complication reported after insertion or during followup and low rates of expulsion. The method may be particularly beneficial in our setting where women do not come for postnatal contraception counselling and usage.

  10. Retrospective Clinical Trial of Fusidic Acid versus Petrolatum in the Postprocedure Care of Clean Dermatologic Procedures

    OpenAIRE

    Lee, Dong Hun; Kim, Dong Young; Yoon, So Young; Park, Hyun Sun; Yoon, Hyun-Sun; Cho, Soyun

    2015-01-01

    Background Clean dermatologic procedures create wounds with a low risk of infection (usually up to 5%). Whether the use of topical antibiotics is advocated, with regard to its efficacy and safety issues such as antibiotic resistance and sensitizing potential, is controversial. Fusidic acid, a topical antibiotic against gram-positive bacteria, is a rare sensitizer and commonly used in postprocedure care in Korea. Objective This is a retrospective study aimed at comparing the efficacy and safet...

  11. Canine small clear cell/T-zone lymphoma: clinical presentation and outcome in a retrospective case series.

    Science.gov (United States)

    Martini, V; Marconato, L; Poggi, A; Riondato, F; Aresu, L; Cozzi, M; Comazzi, S

    2016-08-01

    Published studies, taken together, suggest the existence of a single canine lymphoma entity, with a small clear cell appearance by cytological evaluation, a histopathological T-zone pattern and an aberrant CD45-negative T-cell phenotype, mostly characterized by long-term survival. We describe clinical presentation and outcome in a retrospective case series of canine small clear cell/T-zone lymphoma. Despite the reported predisposition of Golden retriever, this breed was not represented in our case series. Most dogs presented with stage V disease, whereas only few had clinical signs or peripheral cytopenias. Blood was almost always more infiltrated than bone marrow. Median survival confirmed the favourable prognosis described in literature, but a few dogs died within a short time. Also, a subgroup of dogs developed second malignancies, eventually leading to death. We did not investigate possible prognostic factors because of the wide variety in treatments, and further studies are needed to identify high-risk animals.

  12. Hybrid total knee arthroplasty: a retrospective analysis of clinical and radiographic outcomes at average 10 years follow-up.

    Science.gov (United States)

    Illgen, Richard; Tueting, Jonathan; Enright, Timothy; Schreibman, Ken; McBeath, Andrew; Heiner, John

    2004-10-01

    Cemented total knee arthroplasty has demonstrated high success rates at 10-12 years. Although many cementless designs have demonstrated inferior outcomes, hybrid fixation has not been studied in detail. We retrospectively reviewed 112 hybrid total knee arthroplasties (PCA-67 and Duracon-45) after clinical and radiographic review using the SF-12 and Knee Society Scores at an average 10-year follow-up. The revision rate was 4.5%: 4 occurred in patients with metal-backed patellae and 1 in a patient with infection. No revisions were performed for aseptic loosening of the femoral component. Hybrid total knee arthroplasty with these designs provided excellent clinical and radiographic performance at 10 years comparable to cemented series. Aseptic loosening and radiographic failure rates were 0% if patients with metal-backed patellae were excluded. The durability of hybrid fixation beyond 10 years deserves further study.

  13. Prevalence of intestinal parasitic infections in Jenin Governorate, Palestine:a 10-year retrospective study

    Institute of Scientific and Technical Information of China (English)

    Sami Bdir; Ghaleb Adwan

    2010-01-01

    Objective:To assess the prevalence of intestinal parasites among Jenin Governorate (Northern Palestine) population.Methods:A retrospective laboratory analysis of stool specimens was carried out for intestinal parasite examination in Jenin Governmental Hospital, Jenin Governorate, Northern Palestine. The records were collected from the clinical microbiology laboratory of the Jenin Governmental Hospital between January2000and December2009. Results: Our retrospective study showed that the prevalence of intestinal parasite infection during10 years ranged from32.0-41.5%. There are at least7 different parasitesencountered. The most common pathogenic parasites identified were:Entamoeba histolytica(8.2-18.2%),Enterobius vermicularis(15.6-28.9%). The other parasites present wereGiardia lamblia, Ascaris lumbricoides, Strongyloides stercoralis,Taenia species andAncylostoma duodenale (Hookworms).Conclusions:Intestinal parasitic infection is an important public health problem in Jenin governorate, Palestine. It is necessary to develop effective prevention and control strategies including health education and environmental sanitation improvement.

  14. 上海市人类精子库捐精现状及临床应用回顾性分析%Retrospective study of sperm donation and its clinical use of Shanghai Human Sperm Bank

    Institute of Scientific and Technical Information of China (English)

    平萍; 曹小蓉; 闫峰; 徐迪萍; 关志刚; 刘勇; 胡洪亮; 李铮

    2011-01-01

    Objective Explore the current condition of sperm donation and outcome of its cinical use, so to provide suggestion for policy making. Methods The retrospective research was based on the data of donors from January 2003 to December 2010. The investigated items included: the intention about sperm donation; the factors of drop-out; the reasons of midway withdraw of qualified donors; parameters of cryostored samples pre- and post-frosing, assistant reproductive techniques(ART) cycle number, pregnant rate and birth rate. Results 12 858 sperm donors were screened and 2 083 donors (16.2%) were recruited. Main reasons of drop out were unqualified semen parameters and positive results in sexual transmitted disease tests. There were 6.9 % qualified donors breaking off the program because of frustration by unqualified semen parameters, intention of free medical examination or job transfer. There were 31 056 vials of donors' semen cryopreserved. In 7 341 AID cycles, the clinical pregnant rate was 20.13%, live-births 723. In 1 521IVF cycles, clinical pregnant rate was 38.66%, live-births 410. Conclusion The human semen banking in the China had developed into a regulary stage after the implementation of ' Rules and Guidelines'. The quality of donor sperm cryopreserved had increased. All the measures play an important roles in the goal that everyone enjoies reproductive health for all of the people in our country.%目的 探讨上海市人类精子库捐精现状与临床应用,为中国精子捐献制度的完善提供理论依据.方法 对上海市人类精子库自2003年3月至2010年12月间所有初次捐精者与合格捐精者的信息回顾性分析,研究内容包括:(1)捐精者筛查不合格原因;(2)合格捐精者脱失率及原因;(3)捐精动机;(4)精液标本冷冻前后参数;(5)捐献者精子用于辅助生殖治疗的结果.结果 1.研究期间,共有12 858名志愿者接受捐精筛查,只有2 083名(16.2%)入选.落选的主要原因为:(1)

  15. A 40-year Retrospective Clinicopathological Study of Ameloblastoma in Iran.

    Science.gov (United States)

    Saghravanian, Nasrollah; Salehinejad, Jahanshah; Ghazi, Narges; Shirdel, Mohammad; Razi, Mahsa

    2016-01-01

    Ameloblastoma is the most common epithelial odontogenic tumor. It may show locally invasive behavior resulting in recurrence and malignancy. Therefore, appropriate diagnosis of this tumor is necessary. The aim of this study was to evaluate clinicopathological characteristics of ameloblastomas in an Iranian population. We present a 40-year retrospective study of patients diagnosed from 1971 to 2010 in the Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mashhad, Iran. Information gathered from patient records included age, gender, tumor location and histologic type. The frequency of odontogenic tumors among all lesions was 2.08% and ameloblastoma with 88 samples demonstrated the greatest prevalence (41.5%). Regarding gender, 60% of samples occurred in males. The mean age of studied patients was 33.02± 15.74 years with a peak of occurrence in the third decade of life. The most frequent location of tumor was the mandibles (93.2%). Eighty five (96.6%) tumors were recorded as benign and 3 (3.4%) as malignant. Of benign tumors, 62 (72.9%), 20 (23.5%) and 3 (3.6%) cases were of conventional, unicyctic and peripheral types, respectively. In contrast to most previous studies, the most common histologic subtype in the present study was plexiform. Knowledge of the incidence of ameloblastoma and its clinicopathologic features including most common location, gender and age distribution in different ethnogeographic backgrounds is necessary for accurate diagnosis and proper treatment.

  16. Discriminating malaria from dengue fever in endemic areas: clinical and biological criteria, prognostic score and utility of the C-reactive protein: a retrospective matched-pair study in French Guiana.

    Directory of Open Access Journals (Sweden)

    Loïc Epelboin

    Full Text Available BACKGROUND: Dengue and malaria are two major public health concerns in tropical settings. Although the pathogeneses of these two arthropod-borne diseases differ, their clinical and biological presentations are unspecific. During dengue epidemics, several hundred patients with fever and diffuse pain are weekly admitted at the emergency room. It is difficult to discriminate them from patients presenting malaria attacks. Furthermore, it may be impossible to provide a parasitological microscopic examination for all patients. This study aimed to establish a diagnostic algorithm for communities where dengue fever and malaria occur at some frequency in adults. METHODOLOGY/PRINCIPAL FINDINGS: A sub-study using the control groups of a case-control study in French Guiana--originally designed to compare dengue and malaria co-infected cases to single infected cases--was performed between 2004 and 2010. In brief, 208 patients with malaria matched to 208 patients with dengue fever were compared in the present study. A predictive score of malaria versus dengue was established using .632 bootstrap procedures. Multivariate analysis showed that male gender, age, tachycardia, anemia, thrombocytopenia, and CRP>5 mg/l were independently associated with malaria. The predictive score using those variables had an AUC of 0.86 (95%CI: 0.82-0.89, and the CRP was the preponderant predictive factor. The sensitivity and specificity of CRP>5 mg/L to discriminate malaria from dengue were of 0.995 (95%CI: 0.991-1 and 0.35 (95%CI 0.32-0.39, respectively. CONCLUSIONS/SIGNIFICANCE: The clinical and biological score performed relatively well for discriminating cases of dengue versus malaria. Moreover, using only the CRP level turned to be a useful biomarker to discriminate feverish patients at low risk of malaria in an area where both infections exist. It would avoid more than 33% of unnecessary parasitological examinations with a very low risk of missing a malaria attack.

  17. Performance of the G4 Xpert(®) MTB/RIF assay for the detection of Mycobacterium tuberculosis and rifampin resistance: a retrospective case-control study of analytical and clinical samples from high- and low-tuberculosis prevalence settings.

    Science.gov (United States)

    Dharan, Nila J; Blakemore, Robert; Sloutsky, Alex; Kaur, Devinder; Alexander, Richard C; Ghajar, Minoo; Musser, Kimberlee A; Escuyer, Vincent E; Rowlinson, Marie-Claire; Crowe, Susanne; Laniado-Laborin, Rafael; Valli, Eloise; Nabeta, Pamela; Johnson, Pamela; Alland, David

    2016-12-20

    The Xpert(®) MTB/RIF (Xpert) assay is a rapid PCR-based assay for the detection of Mycobacterium tuberculosis complex DNA (MTBc) and mutations associated with rifampin resistance (RIF). An updated version introduced in 2011, the G4 Xpert, included modifications to probe B and updated analytic software. An analytical study was performed to assess Xpert detection of mutations associated with rifampin resistance in rifampin-susceptible and -resistant isolates. A clinical study was performed in which specimens from US and non-US persons suspected of tuberculosis (TB) were tested to determine Xpert performance characteristics. All specimens underwent smear microscopy, mycobacterial culture, conventional drug-susceptibility testing and Xpert testing; DNA from isolates with discordant rifampin resistance results was sequenced. Among 191 laboratory-prepared isolates in the analytical study, Xpert sensitivity for detection of rifampin resistance associated mutations was 97.7% and specificity was 90.8%, which increased to 99.0% after DNA sequencing analysis of the discordant samples. Of the 1,096 subjects in the four clinical studies, 49% were from the US. Overall, Xpert detected MTBc in 439 of 468 culture-positive specimens for a sensitivity of 93.8% (95% confidence interval [CI]: 91.2%-95.7%) and did not detect MTBc in 620 of 628 culture-negative specimens for a specificity of 98.7% (95% CI: 97.5%-99.4%). Sensitivity was 99.7% among smear-positive cases, and 76.1% among smear-negative cases. Non-determinate MTBc detection and false-positive RIF resistance results were low (1.2 and 0.9%, respectively). The updated Xpert assay retained the high sensitivity and specificity of the previous assay versions and demonstrated low rates of non-determinate and RIF resistance false positive results.

  18. Clinical outcomes in low risk coronary artery disease patients treated with different limus-based drug-eluting stents--a nationwide retrospective cohort study using insurance claims database.

    Directory of Open Access Journals (Sweden)

    Chao-Lun Lai

    Full Text Available The clinical outcomes of different limus-based drug-eluting stents (DES in a real-world setting have not been well defined. The aim of this study was to investigate the clinical outcomes of three different limus-based DES, namely sirolimus-eluting stent (SES, Endeavor zotarolimus-eluting stent (E-ZES and everolimus-eluting stent (EES, using a national insurance claims database. We identified all patients who received implantation of single SES, E-ZES or EES between January 1, 2007 and December 31, 2009 from the National Health Insurance claims database, Taiwan. Follow-up was through December 31, 2011 for all selected clinical outcomes. The primary end-point was all-cause mortality. Secondary end-points included acute coronary events, heart failure needing hospitalization, and cerebrovascular disease. Cox regression model adjusting for baseline characteristics was used to compare the relative risks of different outcomes among the three different limus-based DES. Totally, 6584 patients were evaluated (n=2142 for SES, n=3445 for E-ZES, and n=997 for EES. After adjusting for baseline characteristics, we found no statistically significant difference in the risk of all-cause mortality in three DES groups (adjusted hazard ratio [HR]: 1.14, 95% confidence interval [CI]: 0.94-1.38, p=0.20 in E-ZES group compared with SES group; adjusted HR: 0.77, 95% CI: 0.54-1.10, p=0.15 in EES group compared with SES group. Similarly, we found no difference in the three stent groups in risks of acute coronary events, heart failure needing hospitalization, and cerebrovascular disease. In conclusion, we observed no difference in all-cause mortality, acute coronary events, heart failure needing hospitalization, and cerebrovascular disease in patients treated with SES, E-ZES, and EES in a real-world population-based setting in Taiwan.

  19. Clinical outcomes in low risk coronary artery disease patients treated with different limus-based drug-eluting stents--a nationwide retrospective cohort study using insurance claims database.

    Science.gov (United States)

    Lai, Chao-Lun; Wu, Ching-Fen; Kuo, Raymond Nien-Chen; Yang, Yen-Yun; Chen, Ming-Fong; Chan, K Arnold; Lai, Mei-Shu

    2015-01-01

    The clinical outcomes of different limus-based drug-eluting stents (DES) in a real-world setting have not been well defined. The aim of this study was to investigate the clinical outcomes of three different limus-based DES, namely sirolimus-eluting stent (SES), Endeavor zotarolimus-eluting stent (E-ZES) and everolimus-eluting stent (EES), using a national insurance claims database. We identified all patients who received implantation of single SES, E-ZES or EES between January 1, 2007 and December 31, 2009 from the National Health Insurance claims database, Taiwan. Follow-up was through December 31, 2011 for all selected clinical outcomes. The primary end-point was all-cause mortality. Secondary end-points included acute coronary events, heart failure needing hospitalization, and cerebrovascular disease. Cox regression model adjusting for baseline characteristics was used to compare the relative risks of different outcomes among the three different limus-based DES. Totally, 6584 patients were evaluated (n=2142 for SES, n=3445 for E-ZES, and n=997 for EES). After adjusting for baseline characteristics, we found no statistically significant difference in the risk of all-cause mortality in three DES groups (adjusted hazard ratio [HR]: 1.14, 95% confidence interval [CI]: 0.94-1.38, p=0.20 in E-ZES group compared with SES group; adjusted HR: 0.77, 95% CI: 0.54-1.10, p=0.15 in EES group compared with SES group). Similarly, we found no difference in the three stent groups in risks of acute coronary events, heart failure needing hospitalization, and cerebrovascular disease. In conclusion, we observed no difference in all-cause mortality, acute coronary events, heart failure needing hospitalization, and cerebrovascular disease in patients treated with SES, E-ZES, and EES in a real-world population-based setting in Taiwan.

  20. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Children & Clinical Studies NHLBI Trials Clinical Trial Websites Children and Clinical Studies Learn more about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to ...

  1. Surgical outcome in monocular elevation deficit: A retrospective interventional study

    Directory of Open Access Journals (Sweden)

    Bandyopadhyay Rakhi

    2008-01-01

    Full Text Available Background and Aim: Monocular elevation deficiency (MED is characterized by a unilateral defect in elevation, caused by paretic, restrictive or combined etiology. Treatment of this multifactorial entity is therefore varied. In this study, we performed different surgical procedures in patients of MED and evaluated their outcome, based on ocular alignment, improvement in elevation and binocular functions. Study Design: Retrospective interventional study. Materials and Methods: Twenty-eight patients were included in this study, from June 2003 to August 2006. Five patients underwent Knapp procedure, with or without horizontal squint surgery, 17 patients had inferior rectus recession, with or without horizontal squint surgery, three patients had combined inferior rectus recession and Knapp procedure and three patients had inferior rectus recession combined with contralateral superior rectus or inferior oblique surgery. The choice of procedure was based on the results of forced duction test (FDT. Results: Forced duction test was positive in 23 cases (82%. Twenty-four of 28 patients (86% were aligned to within 10 prism diopters. Elevation improved in 10 patients (36% from no elevation above primary position (-4 to only slight limitation of elevation (-1. Five patients had preoperative binocular vision and none gained it postoperatively. No significant postoperative complications or duction abnormalities were observed during the follow-up period. Conclusion: Management of MED depends upon selection of the correct surgical technique based on employing the results of FDT, for a satisfactory outcome.

  2. DIAGNOSTIC IMAGING IN A DIRECT-ACCESS SPORTS PHYSICAL THERAPY CLINIC: A 2-YEAR RETROSPECTIVE PRACTICE ANALYSIS.

    Science.gov (United States)

    Crowell, Michael S; Dedekam, Erik A; Johnson, Michael R; Dembowski, Scott C; Westrick, Richard B; Goss, Donald L

    2016-10-01

    While advanced diagnostic imaging is a large contributor to the growth in health care costs, direct-access to physical therapy is associated with decreased rates of diagnostic imaging. No study has systematically evaluated with evidence-based criteria the appropriateness of advanced diagnostic imaging, including magnetic resonance imaging (MRI), when ordered by physical therapists. The primary purpose of this study was to describe the appropriateness of magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) exams ordered by physical therapists in a direct-access sports physical therapy clinic. Retrospective observational study of practice. Greater than 80% of advanced diagnostic imaging orders would have an American College of Radiology (ACR) Appropriateness Criteria rating of greater than 6, indicating an imaging order that is usually appropriate. A 2-year retrospective analysis identified 108 MRI/MRA examination orders from four physical therapists. A board-certified radiologist determined the appropriateness of each order based on ACR appropriateness criteria. The principal investigator and co-investigator radiologist assessed agreement between the clinical diagnosis and MRI/surgical findings. Knee (31%) and shoulder (25%) injuries were the most common. Overall, 55% of injuries were acute. The mean ACR rating was 7.7; scores from six to nine have been considered appropriate orders and higher ratings are better. The percentage of orders complying with ACR appropriateness criteria was 83.2%. Physical therapist's clinical diagnosis was confirmed by MRI/MRA findings in 64.8% of cases and was confirmed by surgical findings in 90% of cases. Physical therapists providing musculoskeletal primary care in a direct-access sports physical therapy clinic appropriately ordered advanced diagnostic imaging in over 80% of cases. Future research should prospectively compare physical therapist appropriateness and utilization to other groups of providers and

  3. Clinical characteristics and prognosis of traumatic basal ganglia hematomas: A retrospective analysis of 40 cases

    Institute of Scientific and Technical Information of China (English)

    Jialiang Li; Chunjiang Yu

    2006-01-01

    AIM: To retrospectively analyze the pathogenesis, clinical characteristics, treatment and prognostic characteristics in patients with traumatic basal ganglia hematomas (TBGH).METHODS: A retrospective analysis of the clinical data was performed in 40 patients with TBGH who were selected from 1 250 patients with closed brain injury, who admitted to the Department of Neurosurgery of Shangqiu First People's Hospital from January 1990 to January 2004. The pathogenesis, clinical characteristics and signs, results of radiological examination, treatment and prognostic characteristics were analyzed. The patients all had definite history of brain injury, manifested by neurological functional disturbance to different extent after brain injury, and basal ganglia hemorrhage was identified by CT after brain injury, and hemorrhagic volume were more than or equal to 2 mL. Totally 34 males and 6 females were enrolled, aged 16-72 years and 28 cases of them were younger than 40 years old. The prognosis of the patients was evaluated with Glasgow outcome scale (GOS) at 6 months after injury, and GOS scoring standard was 1-5 points (1 for dead; 2 for vegetative survival, long-term coma, manifestations of decorticate rigidity or decerebrate rigidity; 3 for severely disabled, should be look after by others; 4 for moderately disabled, be able in self-care; 5 for good recovery, adults can work and study).RESULTS: The enrolled cases accounted for 3.20% of the 1250 patients with closed brain injury admitted at the same period. ① The causes of injury included traffic accident in 36 cases, fall in 2 cases, and assault in 2 cases. ② At admission, the Glasgow coma scale (GCS) scores were as follow: 13-15 scores (mild) in 10 cases,9-12 scores (moderate)in 20 cases, and 3-8 scores (severe) in 10 cases. Hemiplegia presented in 37 cases,aphasia in 20 cases, conscious disturbance in 10 cases, unilateral mydriasis in 6 cases, and decerebrate rigidity in 2 cases. ③ TBGH was detected by CT within

  4. Mortality in patients with psoriasis. A retrospective cohort study.

    Science.gov (United States)

    Masson, Walter; Rossi, Emiliano; Galimberti, María Laura; Krauss, Juan; Navarro Estrada, José; Galimberti, Ricardo; Cagide, Arturo

    2017-06-07

    The immune and inflammatory pathways involved in psoriasis could favor the development of atherosclerosis, consequently increasing mortality. The objectives of this study were: 1) to assess the mortality of a population with psoriasis compared to a control group, and 2) to assess the prevalence of cardiovascular risk factors. A retrospective cohort was analyzed from a secondary database (electronic medical record). All patients with a diagnosis of psoriasis at 1-01-2010 were included in the study and compared to a control group of the same health system, selected randomly (1:1). Subjects with a history of cardiovascular disease were excluded from the study. A survival analysis was performed considering death from any cause as an event. Follow-up was extended until 30-06-2015. We included 1,481 subjects with psoriasis and 1,500 controls. Prevalence of cardiovascular risk factors was higher in the group with psoriasis. The average follow-up time was 4.6±1.7 years. Mortality was higher in psoriasis patients compared to controls (15.1 vs. 9.6 events per 1,000 person-year, Pcardiovascular risk factors (HR 1.48, 95% CI 1.08-2.3, P=.014). In this population, patients with psoriasis showed a higher prevalence for the onset of cardiovascular risk factors as well as higher mortality rates during follow-up. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  5. Bilateral Traumatic Intracranial Hematomas and its Outcome: a Retrospective Study.

    Science.gov (United States)

    Pandey, Sharad; Sharma, Vivek; Singh, Kulwant; Pandey, Deepa; Sharma, Mukesh; Patil, Deepak Bhanudas; Shende, Neeraj; Chauhan, Richa Singh

    2017-02-01

    The objective of this study was to evaluate the age distribution, mode of injury, type of hematomas, and their surgical outcome in patients with bilateral traumatic head injuries. The present study included 669 cases of traumatic head injury who presented at the neurosurgery emergency out