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Sample records for follow-up year post

  1. Bobath or motor relearning programme? A follow-up one and four years post stroke.

    Science.gov (United States)

    Langhammer, Birgitta; Stanghelle, Johan K

    2003-11-01

    The purpose of this follow-up one and four years post stroke was to find out whether the initial physiotherapy approach had had any long-term effects on mortality, motor function, postural control, activities of daily living, life quality, follow-up from community services and living conditions. A randomized controlled trial of first time ever stroke patients. Group 1 (n = 33) and group 2 (n = 28) had initial physiotherapy according to the Motor Relearning Programme and Bobath, respectively. The Motor Assessment Scale (MAS), the Sødring Motor Evaluation Scale (SMES), the Barthel ADL Index, the Nottingham Health Profile (NHP) and Berg Balance Scale were used. The following parameters were also registered: incidence of new strokes, other diseases, use of assistive devices, the patient's accommodation and use of services from the community. The mortality rates were similar in the two groups. In both groups the motor function, postural control and ADL had decreased rapidly, leaving many of the patients dependent and with a high risk of falling. Life quality had increased compared to the acute stage, but was still low in comparison with healthy persons. Patients in both groups lived at home, but were dependent on help from relatives and community services. Physiotherapy as follow-up service was seldom used. The initial physiotherapy approach did not seem to have a major influence on the patients' ability to cope in the long-term. This follow-up at one and four years post stroke showed no major influence of two different initial physiotherapy regimens on long-term function. The study confirmed a rapid deterioration of ADL and motor function and an increased dependence on relatives. The study reveals a gap between the intense treatment in the acute phase and little or no follow-up of physiotherapy treatment or other rehabilitation activities later.

  2. Adherence to vaccination guidelines post splenectomy: A five year follow up study.

    Science.gov (United States)

    Boam, Tristan; Sellars, Peter; Isherwood, John; Hollobone, Chloe; Pollard, Cristina; Lloyd, David M; Dennison, Ashley R; Garcea, Giuseppe

    2017-02-08

    Following a splenectomy patients are at increased risk of significant infections. In its most severe form, overwhelming post-splenectomy infection (OPSI) has a mortality rate of up to 80%. In this study we aim to establish the adherence to vaccination and antibiotic national guidelines in splenectomised patients. A retrospective study of 100 patients who underwent splenectomy (21 emergency, 79 elective), in two teaching hospitals was undertaken over a five-year period. Patients were followed up for five years. Hospital and GP records were reviewed for adherence to pre, intra and postoperative vaccination, thromboprophylaxis and antibiotic guidance. Eighty-six eligible patients (91.5%) received their Haemophilus influenzae B, meningococcal C and pneumococcus vaccinations peri-operatively. Eighty-one (86%) received post-operative antibiotics. Ninety-nine percent of patients received thromboprophylaxis treatment. Eighty-nine (95%) were treated with long-term antibiotic prophylaxis. Only 20 patients (23%) had an emergency supply of antibiotics. Ninety-five percent of patients were administered an annual influenza vaccination and 84% of eligible patients received a five-year pneumococcal booster vaccination. Improvement in the management of this patient cohort can be achieved by a multidisciplinary approach involving adherence to national guidelines, standardised trust protocols, patient information leaflets and advice detailing risk of infection, standardised GP letters and a splenectomy register to monitor and manage this vulnerable group of patients. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Years Follow-Up

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    Atooshe Rohani

    2013-05-01

    Full Text Available   Inroduction: Heart failure (HF is an important cause of morbidity and mortality in the cases of Beta-thalassemia major. The purpose of this study was to estimate HF prevalence in these patients and to assess the survivability of those who were treated with intensive chelating therapy.   Design and methods: This cross sectional study included 72 beta-thalassemia major cases, the mean age at the time of referral was 15.7±6.2 years (range 6-35 years and were followed in a prospective 2 year study. A self-reporting symptom questionnaire was administered, a 12-lead ECG was taken and an echocardiography was obtained from all participants. Echocardiography was performed at 6 month intervals or when a new symptom developed. Results: Risk factors (except for iron overload in the study population were hypothyroidism and diabetes mellitus. The male to female ratio was0.75.Twelve patients had left ventricular (LV systolic dysfunction and 57,79% had LV diastolic dysfunction whereas 11,15% had RV failure. Fifty-nine (81% patients had cardiac disease of which diastolic dysfunction was the most common manifestation .Those with systolic dysfunction were older at presentation (22 ± 6 years versus 31 ± 4 years; P

  4. Quality of life in post-stroke patients at one year follow-up

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    Yoany Mesa Barrera

    2016-10-01

    Full Text Available Foundation: Cerebrovascular diseases impact on quality of life. Factors associated to a greater impairment vary from one study to another. Objective: To describe the factors that affect Quality of life in stroke survivors at one year.Methods: It is a longitudinal descriptive study of a cohort of 110 stroke survivors with outpatient follow-up for one year after the initial evaluation. Quality of life was assessed using the Quality of Life Scale for Stroke.Results: Women predominated with 52.3%. The degree of neurological involvement was moderate to severe in more than two thirds of patients and at a year follow up, it improved (slight to moderate, with average score of 3.5 ± 3.8. More than one third presented high burden of depressive symptoms for an average score of 7.8 ± 3.6, which increased to 56% per year. Factors associated with the impairment of quality of life were: worse neurological status (OR: 2.63, CI: 1.48, 2.82, major depressive symptoms (OR: 1.94, CI: 1 17; 1.89 and older (OR: 1.14, CI: 1.04, 1.25. Conclusion: Quality of life was determined by the degree of neurological impairment, cognitive status, older age and the presence of depressive symptoms. The only factors associated with quality of life which were modified at a year of follow-up were the neurological involvement and the presence of depressive symptoms.

  5. Post-gastrectomy patients need to be followed up for 20-30 years

    Institute of Scientific and Technical Information of China (English)

    Frank I. Tovey; Michael Hobsley

    2000-01-01

    AIM To investigate the incidence andmanagement of nutritional deficiencies followinga gastrectomy.METHODS A gastrectomy population of 227patients in London was followed up for 30 years after operation to detect and treat nutritional deficiencies.RESULTS By the end of the first decade iron deficiency was the commonest problem. Vitamin B12 deficiency became more important in the second decade. During the third decade both reached equal prevalence, being found in some 90% of the female and 70% of the male residual population. Vitamin D deficiency was a lesser problem, reaching its climax in the second decade. Overall, all women fared worse than men.CONCLUSION The importance of long-term follow-up of gastrectomy patients for iron,Vitamin B12 and Vitamin D deficiencies is emphasised.

  6. Pediatric fibromatosis involving mandible: case reportand a five-year post-operative follow-up

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    Vilson Lacerda Brasileiro Junior

    2013-06-01

    Full Text Available Extra-abdominal fibromatosis is a benign fibrous neoplasm of locally aggressive behavior. Surgical excision with a wide margin is the treatment of choice. The aim of the present work is to report the case of fibromatosis in an 11-year-old melanodermic patient, who showed swelling in the area of the right mandible. Conservative surgery was performed based on the initial histopathological diagnosis of benign lesion suggestive of neural origin. The new anatomopathological examination of the surgical specimen was compatible with fibromatosis. The patient is still under periodic observation as part of the five-year surgical follow-up, showing no signs of recurrence.

  7. Dimensions of post-stroke fatigue: a two-year follow-up study

    DEFF Research Database (Denmark)

    Christensen, Doris; Johnsen, Soeren Paaske; Watt, Torquil;

    2008-01-01

    , Reduced Activity, Reduced Motivation, and Mental Fatigue). RESULTS: Compared to the general population, stroke patients reported higher levels of Physical Fatigue. Minor or no differences were found for the other fatigue scales. Pathological fatigue, defined as a score >or=12 on the General Fatigue scale......BACKGROUND: The aim of this study was to examine the course of poststroke fatigue in a cohort of first-time stroke patients compared to the general population, and to identify clinically relevant features of post-stroke fatigue. METHODS: We performed a follow-up study of 165 patients with first......-time stroke admitted to acute stroke units at the Aarhus University Hospital, Denmark. A reference group of 1,069 persons was sampled from the general population. Fatigue was assessed using the Multidimensional Fatigue Inventory (MFI-20) covering five scales of fatigue (General Fatigue, Physical Fatigue...

  8. Post-bronchiolitis Use of Asthma Medication: A Prospective 1-year Follow-up Study.

    Science.gov (United States)

    Bergroth, Eija; Aakula, Matilda; Korppi, Matti; Remes, Sami; Kivistö, Juho E; Piedra, Pedro A; Camargo, Carlos A; Jartti, Tuomas

    2016-04-01

    Our aim was to evaluate the association between viral findings during bronchiolitis and the use of asthma controller medication (primary outcome) and systemic corticosteroids (secondary outcome) during the first post-bronchiolitis year. We enrolled 408 children hospitalized for bronchiolitis at bronchiolitis used long-term asthma controller medication more often than those hospitalized for rhinovirus-negative bronchiolitis during first year after hospitalization.

  9. Hypofractionation in post-mastectomy breast cancer patients: seven-year follow-up.

    Science.gov (United States)

    Eldeeb, Hany; Awad, Iman; Elhanafy, Osman

    2012-12-01

    To compare three fractionation schedules in post-mastectomy patients treated with radiotherapy as regard acute and early late effects as well as local recurrence rates. One hundred and seven breast cancer patients treated with modified radical mastectomy and adjuvant radiotherapy±adjuvant systemic treatments between November 2001 and July 2004 were enrolled in this study. Patients were categorized into three groups. Group A (41 patients) received conventional fractionation 50 Gy over 25 fractions. Group B (36 patients) received other fractionation regimen 45 Gy over 17 fractions. Group C (30 patients) received 40 Gy over 15 fractions. The median follow-up period was 23 months. There has been no statistical significant difference in local control (P=0.88), pain (P=0.98), telangectasis (P=0.23), fibrosis (P=0.13), arm oedema (P=0.96) or pigmentation (P=0.80) between the three groups. GII-III Erythema was significantly higher in the two hypofractionation arms compared to the control arm (P=0.001). Although acute skin reactions were higher in the hypofractionated arms, there was no significant difference in the local recurrence rates or late radiation effects. A national randomized multicentre study is recommended to explore this further.

  10. Multimethod psychoeducational intervention for preschool children with disruptive behavior: two-year post-treatment follow-up.

    Science.gov (United States)

    Shelton, T L; Barkley, R A; Crosswait, C; Moorehouse, M; Fletcher, K; Barrett, S; Jenkins, L; Metevia, L

    2000-06-01

    This paper describes the 2-year post-treatment follow-up of preschool children identified as having high levels of disruptive behavior at kindergarten entry. They were assigned to four treatment conditions: A no-treatment group, parent-training only, treatment classroom only, and the combination of parent training with the treatment classroom. Interventions lasted the entire kindergarten academic year. Initial post-treatment results reported previously indicated no effects for the parent-training program but some efficacy for the classroom intervention program. For this report, the disruptive behavior (DB) children were subdivided into those who did (n = 74) and did not (n = 77) receive the treatment classroom. Two-year post-treatment follow-up results indicated no differences between the classroom treated and untreated DB groups. These groups also failed to differ in the percentage of children using available treatments across the follow-up period. The DB children in both groups had significantly more symptoms of ADHD and ODD than a community control group (N = 47) at follow-up. They also received higher ratings of externalizing problems on the parent Child Behavior Checklist, more severe ratings of behavior problems at home, and ratings of more pervasive behavior problems at school, and had poorer academic skills. Results suggested that early intervention classrooms for DB children may not produce enduring effects once treatment is withdrawn, and that better approaches are needed for identifying those DB children at greatest risk for later maladjustment.

  11. Post-traumatic pelvic deformity with old injuries of rectum and urogenital tract: 18-year follow-up

    Directory of Open Access Journals (Sweden)

    A. V. Runkov

    2015-01-01

    Full Text Available The authors described a case of management the severe combined pelvis trauma in female patient with 18 years follow-up. At the age of seven, the patient was injured: the open vertical unstable pelvis injury with severe damage of urogenital tract and rectum. Numerous operations on the pelvic organs without surgical treatment of pelvic ring fractures were accompanied by complications. At the age of 21 (14 years later the patient was subjected to the surgery according to the techniques designed in the Chaklin Ural Scientific Research Institute of Traumatology and Orthopaedics: percutaneous osteotomy of posterior and anterior pelvis, external pelvis fixation using circular device with a further gradual (within 1.5 months correction of the deformity with apparatus and subsequent internal fixation with screws. There were achieved partially elimination of shortening of the right lower limb, correction of the pelvic ring form, increasing the pelvic cavity volume, elimination of vaginal impingement, that allowed to correct urological problems with the possibility of further recovery of the vagina and hip replacement surgery. This case showed that the management of patients with complicated pelvis injuries required a multidisciplinary approach: emergency fixation of the unstable injuries and application of techniques to correct long-standing pelvis deformities to restore stability and shape of the pelvic ring, which created the more favorable conditions for reconstructive surgery of the pelvic organs.

  12. Use of quartz fiber post for reattachment of complex crown root fractures: A 4-year follow-up

    Directory of Open Access Journals (Sweden)

    Shubha G Hegde

    2014-01-01

    Full Text Available Dental hard tissue trauma is among the most common cases encountered in dental practice. Simple tooth fractures, which occur due to sharp blows, are widely seen in all age groups, especially in young adults. If in case of complex fractures the fractured tooth fragments are available to the dentist in a clean and hydrated state, reattachment of the tooth fragment is the most conservative and biological treatment option possible. Cases of enamel and dentin fractures not involving pulp are treated by reattaching the fragment with adhesives and composite resin. However, fractures involving the pulp require reinforcement by quartz fiber posts and resin luting cement. In cases of fractures extending subgingivally, an envelope flap helps to achieve the desired isolation and visibility. This article presents 2 case reports of reattachment of fractured tooth fragments. The first case showing a 4-year success was treated without raising a flap. The second case with a subgingival fracture was treated by raising a flap. Reattachment is the most economical, biologically acceptable and esthetic restorative option for dental trauma.

  13. [Post-ligation syndrome: a follow-up of 556 cases, 5 to 8 years after tubal sterilization].

    Science.gov (United States)

    Desrosiers, J A; Ianni, F

    1989-01-01

    Five to eight years later, we obtained an answer in 66.3% of 556 patients who had a sterilization between January 1978 and end of December 1981, in order to find any complication forming the so called Post-sterilization Syndrome. We traced back 80.6% of 62 patients who showed a genital pathology at the time of their surgery. We also could obtain an answer in 64.6% of 494 patients who had no apparent genital pathology at the time of their sterilization. We found that 12 patients of the first and 25 patients of the second group (10%) had suffered a major gynecological surgery since their sterilization. But in studying their records, we found that all their surgery was surgically indicated like for fibroids, prolapse, cervical cancer, etc. Three patients of the first and 16 patients of the second group (5%) showed bleeding problems which necessitated a D & C. In all, considering the age of the patients, there was no relationship between the sterilization and the rate of complications.

  14. Post-hospitalization course and predictive signs of suicidal behavior of suicidal patients admitted to a psychiatric hospital: a 2-year prospective follow-up study

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    Hayashi Naoki

    2012-10-01

    Full Text Available Abstract Background Suicidal patients admitted to a psychiatric hospital are considered to be at risk of suicidal behavior (SB and suicide. The present study aimed to seek predictors of SB recurrence of the high-risk patients by examining their post-hospitalization course. Method The design was 2-year prospective follow-up study of patients consecutively admitted with SB to a psychiatric center in Tokyo. The DSM-IV diagnoses and SB-related features of subjects were determined in structured interviews. Subsequently, the subjects underwent a series of follow-up assessments at 6-month intervals. The assessment included inquiries into SB recurrence, its accompanying suicidal intent (SI and SF-8 health survey. Analyses of serial change over time in the follow-up data and Cox proportional hazards regression analyses of SB recurrence were performed. Results 106 patients participated in this study. The dropout rate during the follow-up was 9%. Within 2 years, incidences of SB as a whole, SB with certain SI (suicide attempt and suicide were 67% (95% CI 58 - 75%, 38% (95% CI 29 - 47% and 6% (95% CI 3 - 12%, respectively. Younger age, number of lifetime SBs and maltreatment in the developmental period were predictive of SB as a whole, and younger age and hopelessness prior to index admission were predictive of suicide attempt. Regarding diagnostic variables, anxiety disorders and personality disorders appeared to have predictive value for SB. Additionally, poor physical health assessed during the follow-up was indicated as a possible short-term predictor of SB recurrence. Conclusions This study demonstrated a high incidence of SB and suicide and possible predictors of SB recurrence in the post-hospitalization period of psychiatric suicidal patients. Specialized interventions should be developed to reduce the suicide risk of this patient population.

  15. Long-term efficacy follow-up on two cryolipolysis case studies: 6 and 9 years post-treatment.

    Science.gov (United States)

    Bernstein, Eric F

    2016-12-01

    Cryolipolysis is a noninvasive esthetic procedure that utilizes controlled cooling to reduce subcutaneous fat. Clinical studies have established its safety, efficacy, and tolerability for fat reduction in a variety of areas including the abdomen, flanks, thighs, submental area, arms, back, and chest. Because of obvious esthetic concerns, long-term unilateral studies leaving an untreated flank, thigh, or arm are not performed, but serve as ideal controls for weight gain or loss or re-distribution of fat for other reasons. This article follows two patients previously documented in a case report to demonstrate their ongoing treatment efficacy at 6 and 9 years after treatment. Clinical photographs of the treated flanks and untreated contralateral controls demonstrate long-term durability in these two subjects. © 2016 The Author. Journal of Cosmetic Dermatology Published by Wiley Periodicals, Inc.

  16. Mutans streptococci genetic strains in children with severe early childhood caries: follow-up study at one-year post-dental rehabilitation therapy

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Palmer

    2012-12-01

    Full Text Available Background: Genotypic strains of cariogenic mutans streptococci (MS may vary in important virulence properties. In previous published studies, we identified 39 MS strains from pediatric patients undergoing full-mouth dental rehabilitation, including the removal and/or repair of carious lesions and application of antimicrobial rinse and fluoride varnish. Objectives: The objectives of this current 1-year follow-up study are to assess the variability of MS strains that occur at 1-year post-rehabilitation and characterize the xylitol-resistance properties of MS strains that predominate. Methods: Plaque from five children with severe early childhood caries was collected 1-year post-rehabilitation. MS isolates were subjected to arbitrarily primed-polymerase chain reaction (AP-PCR for identification of genetic strains and in vitro xylitol-inhibition experiments. To more precisely define strain distributions within each patient, we isolated large numbers of isolates per patient. Results: MS strains diminished from several strains pre-rehabilitation, to one dominant strain at 1-year post-rehabilitation, with several new emergent strains. The majority of the clinical MS strains, as well as the Streptococcus mutans laboratory strains ATCC 25175 and 35668, were predicted to undergo 50% inhibition with 2.48–5.58% xylitol, with some clinical MS strains being significantly more resistant in vitro. Conclusions: Our follow-up study using patients from the original cohort demonstrates that specific MS strains are dominant at 1-year post-dental rehabilitation. Most of the clinical MS strains are similar in xylitol resistance to the attenuated S. mutans ATCC control strains, with some strains being more resistant to xylitol in vitro.

  17. Assessment of effectiveness of percutaneous adhesiolysis and caudal epidural injections in managing post lumbar surgery syndrome: 2-year follow-up of a randomized, controlled trial.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Singh, Vijay; Cash, Kimberly A; Pampati, Vidyasagar

    2012-01-01

    The literature is replete with evaluations of failed surgery, illustrating a 9.5%-25% reoperation rate. Speculated causes of post lumbar surgery syndrome include epidural fibrosis, acquired stenosis, recurrent disc herniation, sacroiliac joint pain, and facet joint pain among other causes. Patients (n = 120) were randomly assigned to two groups with a 2-year follow-up. Group I (control group, n = 60) received caudal epidural injections with catheterization up to S3 with local anesthetic (lidocaine 2%, 5 mL), nonparticulate betamethasone (6 mg, 1 mL), and 6 mL of 0.9% sodium chloride solution. Group II (intervention group, n = 60) received percutaneous adhesiolysis of the targeted area, with targeted delivery of lidocaine 2% (5 mL), 10% hypertonic sodium chloride solution (6 mL), and nonparticulate betamethasone (6 mg). The multiple outcome measures included the Numeric Rating Scale, the Oswestry Disability Index 2.0, employment status, and opioid intake with assessments at 3, 6, 12, 18, and 24 months posttreatment. Primary outcome was defined as 50% improvement in pain and Oswestry Disability Index scores. Significant improvement with at least 50% relief with pain and improvement in functional status was illustrated in 82% of patients at the 2-year follow-up in the intervention group compared to 5% in the control group receiving caudal epidural injections. The average number of procedures over a period of 2 years in Group II was 6.4 ± 2.35 with overall total relief of approximately 78 weeks out of 104 weeks. The results of this study show significant improvement in 82% of patients over a period of 2 years with an average of six to seven procedures of 1-day percutaneous adhesiolysis in patients with failed back surgery syndrome.

  18. Prevalence and predictors of post-traumatic stress symptoms in adolescent and young adult cancer survivors: a 1-year follow-up study.

    Science.gov (United States)

    Kwak, Minyoung; Zebrack, Brad J; Meeske, Kathleen A; Embry, Leanne; Aguilar, Christine; Block, Rebecca; Hayes-Lattin, Brandon; Li, Yun; Butler, Melissa; Cole, Steven

    2013-08-01

    Post-traumatic stress symptoms (PTSS) have been identified as a meaningful indicator of distress in cancer survivors. Distinct from young adult survivors of childhood cancer, young people diagnosed with cancer as adolescents and young adults (AYAs) face unique psychosocial issues; however, there is little published research of PTSS in the AYA population. This study examines prevalence and predictors of PTSS among AYAs with cancer. As part of a longitudinal study of AYAs with cancer, 151 patients aged 15-39 years completed mailed surveys at 6 and 12 months post-diagnosis. Severity of PTSS was estimated at 6 and 12 months post-diagnosis. Multiple regression analyses were conducted to investigate the predictive effects of socio-demographic and clinical characteristics on changes in PTSS over time. At 6 and 12 months, respectively, 39% and 44% of participants reported moderate to severe levels of PTSS; 29% had PTSS levels suggestive of post-traumatic stress disorder. No significant differences in severity of PTSS between 6 and 12 months were observed. Regression analyses suggested that a greater number of side effects were associated with higher levels of PTSS at 6 months. Currently receiving treatment, having surgical treatment, diagnosis of a cancer type with a 90-100% survival rate, remaining unemployed/not in school, and greater PTSS at 6 months were associated with higher levels of PTSS at 12 months. Post-traumatic stress symptoms were observed as early as 6 months following diagnosis and remained stable at 12-month follow-up. The development of early interventions for reducing distress among AYA patients in treatment is recommended. Copyright © 2012 John Wiley & Sons, Ltd.

  19. Post-Discharge Follow-Up Visits and Hospital Utilization

    Data.gov (United States)

    U.S. Department of Health & Human Services — Analysis reported in Post-Discharge Follow-Up Visits and Hospital Utilization by Medicare Patients, 2007-2010, published in Volume 4, Issue 2 of Medicare and...

  20. Assessment of effectiveness of percutaneous adhesiolysis and caudal epidural injections in managing post lumbar surgery syndrome: 2-year follow-up of a randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Manchikanti L

    2012-12-01

    Full Text Available Laxmaiah Manchikanti,1,2 Vijay Singh,3 Kimberly A Cash,1 Vidyasagar Pampati11Pain Management Center of Paducah, Paducah, KY, 2Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, 3Pain Diagnostics Associates, Niagara, WI, USABackground: The literature is replete with evaluations of failed surgery, illustrating a 9.5%–25% reoperation rate. Speculated causes of post lumbar surgery syndrome include epidural fibrosis, acquired stenosis, recurrent disc herniation, sacroiliac joint pain, and facet joint pain among other causes.Methods: Patients (n = 120 were randomly assigned to two groups with a 2-year follow-up. Group I (control group, n = 60 received caudal epidural injections with catheterization up to S3 with local anesthetic (lidocaine 2%, 5 mL, nonparticulate betamethasone (6 mg, 1 mL, and 6 mL of 0.9% sodium chloride solution. Group II (intervention group, n = 60 received percutaneous adhesiolysis of the targeted area, with targeted delivery of lidocaine 2% (5 mL, 10% hypertonic sodium chloride solution (6 mL, and nonparticulate betamethasone (6 mg. The multiple outcome measures included the Numeric Rating Scale, the Oswestry Disability Index 2.0, employment status, and opioid intake with assessments at 3, 6, 12, 18, and 24 months posttreatment. Primary outcome was defined as 50% improvement in pain and Oswestry Disability Index scores.Results: Significant improvement with at least 50% relief with pain and improvement in functional status was illustrated in 82% of patients at the 2-year follow-up in the intervention group compared to 5% in the control group receiving caudal epidural injections. The average number of procedures over a period of 2 years in Group II was 6.4 ± 2.35 with overall total relief of approximately 78 weeks out of 104 weeks.Conclusion: The results of this study show significant improvement in 82% of patients over a period of 2 years with an average of six to seven

  1. Predictors of recovery from post-traumatic stress disorder after the dongting lake flood in China: a 13–14 year follow-up study

    OpenAIRE

    Dai, Wenjie; Wang, Jieru; KAMINGA, Atipatsa C; Chen, Long; Tan, Hongzhuan; Lai, Zhiwei; Deng, Jing; Liu, Aizhong

    2016-01-01

    Background Floods are some of the most common and destructive natural disasters in the world, potentially leading to both physical injuries and psychological disorders, including post-traumatic stress disorder (PTSD). PTSD can damage functional capacity and interfere with social functioning. However, little is known about recovery from PTSD after floods. This study used 2013–2014 follow-up data on survivors of the 1998 Dongting Lake flood who were diagnosed with PTSD in 2000 to measure the pr...

  2. Intravenous immunoglobulin treatment of the post-polio syndrome: sustained effects on quality of life variables and cytokine expression after one year follow up

    Directory of Open Access Journals (Sweden)

    Gonzalez Henrik

    2012-07-01

    Full Text Available Abstract Background Expression of inflammatory cytokines in cerebrospinal fluid (CSF has led to the hypothesis of intrathecal chronic inflammation to explain the denervation observed in post-polio syndrome (PPS. It has been shown that therapy with intravenous immunoglobulin (IVIG improves physical performance and dampens down the inflammatory process at 6 months in PPS patients. We here examined the effects of IVIG on cytokine expression and clinical outcome one year after IVIG treatment. Methods From a previous study with 135 PPS patients included, 41 patients were further evaluated before un-blinding for one year (21 placebo and 20 treated with IVIG, Xepol® 50 mg/ml, and were assessed for clinical variables by performing the Short Form-36 survey (SF-36 questionnaire assessment, the 6 minute walk distance test (6MWT and registering pain level by Visual Analogue Scale (VAS after IVIG treatment. A separate cohort of 37 PPS patients went through lumbar puncture (LP at baseline and 20 patients, treated with IVIG, repeated the LP one year later. Thirty patients affected with other neurological diseases (OND were used as control group. Inflammatory cytokines TNF, TGFβ, IFNγ, IL-23, IL-13 and IL-10 were measured in blood cells and CSF cells with RT-PCR. Results Scores of the physical components of SF-36 were significantly higher at the one year follow up time-point in the IVIG-treated patients when compared to baseline as well as to the control subjects. Pain VAS score and 6MWT improved significantly in the IVIG-treated patients when compared with baseline Relative expression of TNF and IFN-γ in both PBMCs and CSF from PPS patients were increased compared to OND subjects at baseline (p  Conclusions IVIG has effects on relevant QoL variables and inflammatory cytokines up to one year in patients with PPS. This gives a basis for scheduling IVIG in upcoming trials with this therapy.

  3. Life expectancy in a follow-up study of a birth cohort of boxer dogs from post weaning to 10-years of age

    NARCIS (Netherlands)

    Hagen, van M.A.E.; Ducro, B.J.; Knol, B.W.

    2005-01-01

    Objective-To determine mortality rate over time, risk factors for death, and heritability of life expectancy in Boxers. Animals-1,733 purebred Boxers born in The Netherlands between January 1994 and March 1995. Procedure-Dogs were followed up from weaning (ie, 49 days of age) to 10 years of age thro

  4. Resilience, post-traumatic growth, and work engagement among health care professionals after the Great East Japan Earthquake: A 4-year prospective follow-up study.

    Science.gov (United States)

    Nishi, Daisuke; Kawashima, Yuzuru; Noguchi, Hiroko; Usuki, Masato; Yamashita, Akihiro; Koido, Yuichi; Matsuoka, Yutaka J

    2016-07-22

    Although attention has been paid to post-traumatic stress disorder (PTSD) among health care professionals after disasters, the impact of traumatic events on their work has not been elucidated. The aim of this study was to examine whether disaster-related distress, resilience, and post-traumatic growth (PTG) affect work engagement among health care professionals who had been deployed to the areas affected by the Great East Japan Earthquake that occurred on March 11, 2011. We recruited disaster medical assistance team members who were engaged in rescue activities after the earthquake. The short version of the Resilience Scale (RS-14) and Peritraumatic Distress Inventory (PDI) were administered one month after the earthquake, and the short form of Posttraumatic Growth Inventory (SF-PTGI) and Utrecht Work Engagement Scale (UWES) were administered four years after the earthquake. Work engagement is composed of vigor, dedication, and absorption. Regression analyses were used to examine the relationship of UWES with RS-14, PDI, and SF-PTGI. We obtained baseline data of 254 participants in April 2011, and 191 (75.2%) completed the follow-up assessment between December 2014 and March 2015. The results showed that RS-14 predicted vigor, dedication, and absorption; in addition, SF-PTGI was positively related with these three parameters (p<0.01 for all). Resilience at baseline and PTG after rescue activities may increase work engagement among health care professionals after disasters. These findings could be useful for establishing a support system after rescue activities during a large-scale disaster and for managing work-related stress among health care professionals.

  5. SAPHO syndrome: 20-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Davies, A.M. [Department of Radiology, Royal Orthopaedic Hospital, Birmingham (United Kingdom)]|[MRI Centre, Birmingham (United Kingdom); Marino, A.J.; Grimer, R.J. [Department of Orthopaedic Oncology, Royal Orthopaedic Hospital, Birmingham (United Kingdom); Evans, N. [Department of Radiology, Royal Orthopaedic Hospital, Birmingham (United Kingdom); Deshmukh, N.; Mangham, D.C. [Department of Pathology, Royal Orthopaedic Hospital, Birmingham (United Kingdom)

    1999-03-01

    Considerable attention has been paid in the past 10 years to the radiological spectrum of disease entities belonging to the SAPHO syndrome. We report an unusual case presenting with an extra-axial (femoral) lesion, prior to description of this syndrome, which was radiologically and histologically mistaken for a parosteal osteosarcoma. Nineteen years later, a further lesion developed in the scapula together with the typical sternoclavicular manifestations, at which stage the correct diagnosis of SAPHO syndrome was established. (orig.) With 6 figs., 18 refs.

  6. Predictors of recovery from post-traumatic stress disorder after the dongting lake flood in China: a 13-14 year follow-up study.

    Science.gov (United States)

    Dai, Wenjie; Wang, Jieru; Kaminga, Atipatsa C; Chen, Long; Tan, Hongzhuan; Lai, Zhiwei; Deng, Jing; Liu, Aizhong

    2016-11-08

    Floods are some of the most common and destructive natural disasters in the world, potentially leading to both physical injuries and psychological disorders, including post-traumatic stress disorder (PTSD). PTSD can damage functional capacity and interfere with social functioning. However, little is known about recovery from PTSD after floods. This study used 2013-2014 follow-up data on survivors of the 1998 Dongting Lake flood who were diagnosed with PTSD in 2000 to measure the prevalence rate of PTSD at follow-up and identify predictors of recovery from the PTSD diagnosis in 2000. Participants included survivors who had been diagnosed as having PTSD in 2000 after the 1998 Dongting Lake flood. PTSD at follow-up was reassessed using the PTSD Checklist-Civilian version. Information on demographics, trauma-related stressors, post-trauma stressors, social support, and coping style were collected through face-to-face interviews. The association between the independent variables and PTSD at follow-up was analyzed using logistic regression analyses. A total of 201 participants with a PTSD diagnosis in 2000 were included in this study. A total of 19.4 % of the flood survivors with PTSD in 2000 continued to suffer from PTSD in 2013-2014. In the multivariable logistic regression model, individuals who had lost relatives (OR = 12.37, 95 % CI = 2.46-62.16), suffered from bodily injury (OR = 5.01, 95 % CI = 1.92-13.08), had a low level of social support (OR = 5.47, 95 % CI = 1.07-27.80), or had a negative coping style (OR = 4.92, 95 % CI = 1.89-12.81) were less likely to recover from PTSD. The prevalence rate of PTSD at follow-up indicates that natural disasters such as floods may have a negative influence on survivors' mental health for an extended period of time. Individuals who have lost relatives, suffered from bodily injury, had a low level of social support, or had a negative coping style were less likely to recover from PTSD. Therefore

  7. Kidney function and specific mortality in 60-80 years old post-myocardial infarction patients: A 10-year follow-up study

    Science.gov (United States)

    Geleijnse, Johanna M.; Giltay, Erik J.; Soedamah-Muthu, Sabita S.; de Goede, Janette; Oude Griep, Linda M.; Stijnen, Theo; Kromhout, Daan

    2017-01-01

    Chronic kidney disease (CKD) is highly prevalent among older post-myocardial infarction (MI) patients. It is not known whether CKD is an independent risk factor for mortality in older post-MI patients with optimal cardiovascular drug-treatment. Therefore, we studied the relation between kidney function and all-cause and specific mortality among older post-MI patients, without severe heart failure, who are treated with state-of-the-art pharmacotherapy. From 2002–2006, 4,561 Dutch post-MI patients were enrolled and followed until death or January 2012. We estimated Glomerular Filtration Rate (eGFR) with cystatin C (cysC) and creatinine (cr) using the CKD-EPI equations and analyzed the relation with any and major causes of death using Cox models and restricted cubic splines. Mean (SD) for age was 69 years (5.6), 79% were men, 17% smoked, 21% had diabetes, 90% used antihypertensive drugs, 98% used antithrombotic drugs and 85% used statins. Patients were divided into four categories of baseline eGFRcysC: ≥90 (33%; reference), 60–89 (47%), 30–59 (18%), and cancer, and 194 (22%) from other causes. After adjustment for age, sex and classic cardiovascular risk factor, hazard ratios (95%-confidence intervals) for any death according to the four eGFRcysC categories were: 1 (reference), 1.4 (1.1–1.7), 2.9 (2.3–3.6) and 4.4 (3.0–6.4). The hazard ratios of all-cause and cause-specific mortality increased linearly below kidney functions of 80 ml/min/1.73 m2. Weaker results were obtained for eGFRcr. To conclude, we found in optimal cardiovascular drug-treated post-MI patients an inverse graded relation between kidney function and mortality for both cardiovascular as well as non-cardiovascular causes. Risk of mortality increased linearly below kidney function of about 80 ml/min/1.73 m2. PMID:28182761

  8. The beneficial effects of exercise on BMD are lost after cessation: a 5-year follow-up in older post-menopausal women.

    Science.gov (United States)

    Englund, U; Littbrand, H; Sondell, A; Bucht, G; Pettersson, U

    2009-06-01

    This study investigates whether the positive effects on bone mineral density (BMD, g/cm(2)) and neuromuscular function following a combined weight-bearing program are sustained in older women, a longer period after cessation of training. Thirty-four women (18 exercisers and 16 controls) aged 73-88 years, who completed a 12-month randomized-controlled trial, were invited to a 5-year follow-up assessment of BMD and neuromuscular function. Both groups sustained significant losses in BMD of the femoral neck, trochanter, and Ward's triangle during the follow-up period. Significant losses were also seen in all neuromuscular function tests. The inter-group change was, however, significant only for maximal walking speed where the exercise group had a significantly greater loss. In conclusion, this study suggests that gains in bone density and neuromuscular functions achieved by training are lost after cessation of training. Continuous high-intensity weight-loading physical activity is probably necessary to preserve bone density and neuromuscular function in older women.

  9. Shelf acetabuloplasty for Perthes' disease: 12-year follow-up.

    NARCIS (Netherlands)

    Geest, I.C.M. van der; Kooijman, H.M.; Spruit, M.; Anderson, P.G.; Smet, P.A.G.M. de

    2001-01-01

    The goal of all therapies for Perthes' disease is to achieve an optimal shape of the acetabulum and an optimal coverage of the femoral head. Thirty patients who were included in this follow-up study (mean follow-up 12 years) underwent a shelf acetabuloplasty for Catterall group III or IV. The mean I

  10. Clinical expression and morbidity of systemic lupus erythematosus during a post-diagnostic 5-year follow-up: a male:female comparison.

    Science.gov (United States)

    Stefanidou, S; Benos, A; Galanopoulou, V; Chatziyannis, I; Kanakoudi, F; Aslanidis, S; Boura, P; Sfetsios, T; Settas, L; Katsounaros, M; Papadopoulou, D; Giamalis, P; Dombros, N; Chatzistilianou, M; Garyfallos, A

    2011-10-01

    The aim of this study was to analyse the prevalence of the most relevant clinical features of the diagnosis of systemic lupus erythematosus (SLE) in a sample of male patients with lupus as well as the incidence of the main causes of morbidity in a 5-year period after the diagnosis. A further aim of this study was to investigate the impact of gender on expression and morbidity of SLE. Data were collected from the medical records of 59 male and 535 female patients with SLE who were diagnosed at the hospitals in the region of Thessaloniki. Several differences in the expression and morbidity of the disease were found in relation to the gender of the patient. Male patients had a higher prevalence of thromboses, nephropathy, strokes, gastrointestinal tract symptoms and antiphospholipid syndrome when compared with female patients, but tended to present less often with arthralgia, hair loss, Raynaud's phenomenon and photosensitivity as the initial clinical manifestations. During the 5-year follow-up, positive associations have been found between male gender and the incidence of tendonitis, myositis, nephropathy and infections, particularly of the respiratory tract. In conclusion, this study has provided information regarding the features of clinical expression and morbidity in male patients, and has shown that gender is a possible factor that can influence the clinical expression of SLE.

  11. Translucent quartz-fiber post luted in vivo with self-curing composite cement: case report and microscopic examination at a two-year clinical follow-up.

    Science.gov (United States)

    Dallari, Adriano; Rovatti, Laura; Dallari, Beatrice; Mason, Pier Nicola; Suh, Byoung In

    2006-06-01

    A maxillary central incisor with mild periodontitis and extensive loss of coronal tooth structure was endodontically treated and restored with a translucent quartz-fiber post and a composite core. Treatment was completed with the cementation of full-ceramic crowns on teeth 11 and 21. Informed consent was obtained from the patient. Due to the extent of the periodontal disease, tooth 11 was extracted two years later. With the patient's consent, the tooth was used for research. The tooth was sectioned at 11 levels perpendicularly to the long axis and investigated by means of optical microscopy and scanning electron microscope (SEM). The visual examination showed perfect adhesion between the various interfaces (restoration-dentin-post) at both the coronal and root levels. The adhesion between the post and dentin appeared to be free of gaps, and even where the composite cement showed a nonhomogeneous thickness, voids were not apparent. The tooth under examination allowed the authors to check the effectiveness of the adhesion and the integrity of the hybrid layer after exposure to the oral cavity for two years. The results of this investigation show that there were no gaps between the adhesive resin and dentin and no hydrolysis of the adhesive bond. This case suggests that it is possible to obtain good results in the short term from the cementation of quartz-fiber posts with composite resin cements.

  12. Urological outcome after myelomeningocele: 20 years of follow-up

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Biering-Sorensen, Fin; Cortes, Dina

    2011-01-01

    Study Type - Therapy (case series)¿Level of Evidence 4 OBJECTIVES: To evaluate the urological outcome in a long-term follow-up of individuals with myelomeningocele and relate the findings obtained to urodynamic variables in childhood. MATERIAL AND METHODS: Individuals with myelomeningocele born....... In childhood and at follow-up, kidney function was estimated with renography and isotope-glomerular filtration rate examinations. RESULTS: In total, 52 individuals (28 boys and 24 girls) aged 19-41 years (median, 29 years) had follow-up. Of these, 37 (71%) individuals had bilateral normal kidney function...

  13. Avoidable iatrogenic complications of male urethral catheterisation and inadequate intern training: a 4-year follow-up post implementation of an intern training programme.

    Science.gov (United States)

    Sullivan, J F; Forde, J C; Thomas, A Z; Creagh, T A

    2015-02-01

    To assess the impact of a structured training programme in urethral catheterisation (UC) targeted at newly qualified junior doctors on rates of iatrogenic catheter morbidity within a tertiary care referral centre. Male UC-related morbidities were retrospectively identified from our computerised inpatient urology consultation system over a 1-year period from July 2010 to June 2011. Relevant medical records were also reviewed. Results were compared with an initial study performed between July 2006 and June 2007, prior the introduction of a structured training programme in our institution. An anonymous questionnaire was used for the subjective assessment of interns about confidence in catheterising post introduction of the programme. Of 725 urological consultations, 29 (4%) were related to complications arising from male UC during the 1 year period. This reflected a statistically significant decrease when compared to our 2007 figures, 51/864 (6%) (p interns performing UC, a decrease of 12% from our original paper. A drop of 27% was seen in the rates of UC related morbidity attributable to interns during the first 6 months of internship (July-December). Overall, 70% (vs 40% original study) of interns felt that their practical training was adequate since introduction of the programme (p intern year has been shown to result in a significant decrease in the amount of iatrogenic UC related morbidity. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  14. Exercise-Induced Ventricular Fibrillation: Seven Years Follow-Up

    Directory of Open Access Journals (Sweden)

    Gökmen Gemici

    2011-11-01

    Full Text Available We present a 7-year follow-up of a 55-year-old male who experienced ventricular fibrillation during the recovery period of exercise testing and refused implantation of an ICD. Normal left ventricular systolic function was found on echocardiographic examination, and coronary angiography revealed only a side branch disease with a vessel diameter of less than 2 millimeters. The patient was discharged on metoprolol and ASA in addition to his previous treatment with lisinopril and simvastatin. Outpatient cardiac evaluation by repeated 24-hour ECG monitorizations (Holter revealed normal findings. On follow up visits every six months for the past seven years, the patient was found to be asymptomatic.

  15. Post-surgical tympanostomy tube follow up with audiology: experience at the Freeman Hospital.

    Science.gov (United States)

    Davies-Husband, C R; Harker, C; Davison, T; Yates, P D

    2012-02-01

    Tympanostomy tube (grommet) insertion is a common procedure, with little guidance in the current literature regarding post-operative surveillance. Our institution implemented a protocol to follow up post-surgical grommet patients via audiology at six weeks. A retrospective audit of all patients less than 16 years old who had undergone grommet insertion during a three-month period. A total of 149 patients had grommets inserted. Exclusion criteria left a cohort of 123 individuals; 82 (67 per cent) were followed up by audiology. Of these, 13 (11 per cent) did not attend follow up, and were discharged; 53 (43 per cent) were discharged from audiology with normal thresholds; and 16 (13 per cent) were referred back to a consultant. Therefore, the overall reduction in patients followed up by an otolaryngologist was 54 per cent. We recommend a six-week follow up with audiology following grommet insertion, allowing for referral back to ENT services in the event of related complications.

  16. Three-year follow-up of bibliotherapy for depression.

    Science.gov (United States)

    Smith, N M; Floyd, M R; Scogin, F; Jamison, C S

    1997-04-01

    This study examined the durability of cognitive bibliotherapy for mild to moderately depressed adults by conducting a 3-year follow-up of participants from a previous study (C. Jamison & F. Scogin, 1995). The Hamilton Rating Scale for Depression, Beck Depression Inventory, and questions relating to participants' perceptions of the program were administered. Results indicated that treatment gains were maintained over the 3-year follow-up period and support the usefulness of cognitive bibliotherapy as an adjunct to traditional treatment modalities in a general adult population.

  17. Eight to ten years follow-up after carotid endarterectomy

    DEFF Research Database (Denmark)

    Knudsen Rathenborg, Lisbet; Sillesen, H; Schroeder, T

    1990-01-01

    Follow-up information was obtained on 185 patients who consecutively underwent carotid endarterectomy eight to ten years previously. Doppler ultrasound examination was performed in 59 patients who were still alive and living within 100 miles of the hospital. Using lifetable analysis, the annual r...

  18. Recovery from post-traumatic stress disorder after a flood in China: a 13-year follow-up and its prediction by degree of collective action.

    Science.gov (United States)

    Hu, Shimin; Tan, Hongzhuan; Cofie, Reuben; Zhou, Jia; Yang, Tubao; Tang, Xuemin; Liu, Aizhong

    2015-07-07

    Victims exposed to serious traumatic experiences may develop post-traumatic stress disorder (PTSD) and suffer this mental health problem for a long time. Different types of trauma displayed a chronicity rate of PTSD within the range of 6.3-68.9 %. As one of the most common and severe natural disasters, the natural progression of flood related PTSD has not been revealed. The aim of this study was to estimate the chronicity rate and identify the prognostic factors of PTSD in flood victims. Flood victims, who were over the age of 16 and diagnosed with PTSD in 2000 in Huarong, Ziyang, and Anxiang counties of Hunan province, China, were enrolled in this survey. Current probable PTSD was analyzed using the PTSD Checklist-Civilian version. Data were collected in face-to-face interviews and analyzed using univariate analysis and multiple logistic regression models. The rate of current probable PTSD was 15.4 %. The current occurrences of re-experiencing, avoidance/numbing, and hyper-arousal symptom groups were 69.3 %, 17.2 %, and 50.2 %, respectively. Significant prognostic factors for current probable PTSD were flood-related stressors (e.g., life-threatening experiences, extreme physical adversity, and extreme psychological adversity) and frequency of general collective action. The relationships still existed when taking the fluctuation of frequency of general collective action into consideration. Gender and education level showed no influence on the recovery from PTSD. The impact of age in this study was inconsistent; in the 2000 model, around 2006 model, around 2013 model, and all FGCA model, older age was positive prognosis factor for PTSD; in the univariate analysis and fluctuation model, age showed no influence on the recovery from PTSD. Our findings indicated that PTSD can persist 13 years after a flood. Demographic characteristics (e.g., age, gender, and education level) seem to have no influence on the recovery from PTSD. Trauma-related stressors and social

  19. Trismus-pseudocamptodactyly syndrome: a 20 year follow-up.

    Science.gov (United States)

    Marianetti, T M; Dall'Asta, L; Torroni, A; Gasparini, G; Pelo, S

    2014-07-01

    Trismus-Pseudocamptodactyly Syndrome (TPS) is a rare autosomal syndrome characterised by the inability to open the mouth fully, pseudocamptodactyly, short stature and foot deformities. The maxillofacial feature entails hyperplasia of the coronoid processes which mechanically interfere with the zygomatic processes during mouth opening. A 22-year- old girl affected by a severe form of TPS was followed from the age of three years. Bone reossification was observed after two coronoidotomies of both hyperplasic coronoid processes. After the decision to perform a coronoidectomy, the four-year follow-up showed a favourable outcome. Meanwhile the patient developed an anterior open bite which was treated with a fourth orthognathic surgery. The follow-up underscores how the correction of malformation leads to the generation of EMG activity of the masticatory muscles after many years of passiveness.

  20. The Safe Dates program: 1-year follow-up results.

    Science.gov (United States)

    Foshee, V A; Bauman, K E; Greene, W F; Koch, G G; Linder, G F; MacDougall, J E

    2000-01-01

    OBJECTIVES: An earlier report described desirable 1-month follow-up effects of the Safe Dates program on psychological, physical, and sexual dating violence. Mediators of the program-behavior relationship also were identified. The present report describes the 1-year follow-up effects of the Safe Dates program. METHODS: Fourteen schools were in the randomized experiment. Data were gathered by questionnaires in schools before program activities and 1 year after the program ended. RESULTS: The short-term behavioral effects had disappeared at 1 year, but effects on mediating variables such as dating violence norms, conflict management skills, and awareness of community services for dating violence were maintained. CONCLUSIONS: The findings are considered in the context of why program effects might have decayed and the possible role of boosters for effect maintenance. PMID:11029999

  1. Serial extraction: 20 years of follow-up

    OpenAIRE

    Renato Rodrigues de Almeida; Marcio Rodrigues de Almeida; Paula Vanessa Pedron Oltramari-Navarro; Ana Cláudia de Castro Ferreira Conti; Ricardo de Lima Navarro; Karen Regina Siqueira de Souza

    2012-01-01

    This paper reports a case treated by a serial extraction program at the mixed dentition stage followed by a corrective orthodontic treatment, with a long-term follow-up period. Twenty years after the interceptive treatment, a harmonious face was observed along with treatment stability in the anterior posterior direction, deep overbite (which has been mentioned as a disadvantage of the serial extraction program), and a small relapse of anterior tooth crowding. All these conditions have been re...

  2. Cold urticaria: a 20-year follow-up study.

    Science.gov (United States)

    Jain, S V; Mullins, R J

    2016-12-01

    Chronic cold urticaria results in significant morbidity, yet information on its natural history is limited. We examined the natural history of chronic cold urticaria and its impact on quality of life. We analysed the characteristics of patients diagnosed with cold urticaria at a community-based specialist allergy practice in the Australian Capital Territory (ACT) between 1995 and 2015. Follow-up data were obtained using a mailed questionnaire. Possible predictive factors of disease severity and symptom duration were evaluated. A total of 99 patients were assessed with a median age of 42 (range 5-81 years); 63% were female and the median age of onset of symptoms was 22 years. Of 41 questionnaire responders (14 ± 10.9 years follow-up; median 12 years), 5- and 10-year resolution rates were 17.9% ± 6.2% and 24.5% ± 7.2%, respectively. Whereas 22% reported resolution and 23% described improvement, the remaining 55% reported stable or worsening disease. Most individuals relied on lifestyle modification to ameliorate symptoms rather than medication. Risk factors for persistent disease were intercurrent atopic disease (P = 0.025) and those with longer duration of symptoms at the time of initial assessment (P urticaria were identified in only two patients, both with B-cell malignancy. In a subset of patients, cold urticaria has low rates of spontaneous resolution and results in lifestyle changes and impaired quality of life. © 2016 European Academy of Dermatology and Venereology.

  3. Colonic resection for colovesical fistula: 5-year follow-up.

    Science.gov (United States)

    Walker, K. G; Anderson, J. H; Iskander, N; McKee, R. F; Finlay, I. G

    2002-07-01

    OBJECTIVES: The outcome of colovesical fistula management may be unsatisfactory; complications are reported in up to 45% of patients. Published studies are retrospective and tend to lack standardized management strategies and long-term follow-up. This cohort study assesses a policy of resection of colovesical fistulae in continuity with any distal colorectal stricture, and includes 5-year follow-up. METHOD: All patients undergoing surgery in our institution for colovesical fistula between February 1991 and April 1995 were entered into the study. The fistulae were resected in continuity with any distal bowel stricture, according to a standard single-stage operative protocol. Postoperative mortality and morbidity were recorded, and prospective review was undertaken at April 2000. RESULTS: Nineteen consecutive patients entered the study. The source of the fistula was diverticular disease (n = 14), colorectal cancer (n = 3), trauma (n = 1) or Crohn's (n = 1) disease. Thirteen patients had a colorectal stricture. One patient died due to ischaemic colitis within 30 days of surgery. Eleven other patients died of unrelated causes before April 2000, in whom there was no evidence of fistula recurrence before death at a median of 37 months after operation (range 2-95 months). At 5-year follow-up there was no evidence of fistula recurrence in the seven remaining patients. CONCLUSIONS: A policy of resection of the fistula and associated colorectal stricture with primary bowel anastomosis and bladder drainage, resulted in no recurrences and low morbidity. However comorbidity is important in this patient population, most of whom will die from unrelated causes within a few years.

  4. Cervical disc prosthesis: 2-year follow-up

    Directory of Open Access Journals (Sweden)

    Romero Pinto de Oliveira Bilhar

    2015-06-01

    Full Text Available OBJECTIVE: To review the medical records of patients who underwent surgery for placement of cervical disc prosthesis after two years of postoperative follow-up, showing the basic epidemiological data, the technical aspects and the incidence of complications.METHODS: Medical records of seven patients who underwent surgery for placement of cervical disc prosthesis were reviewed after two years of follow-up, at the Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo.RESULTS: The average age of patients participating in this study was 43.86 years. Six patients (85.7% had one level approached while one patient (14.3% had two levels addressed. The level C5-C6 has been approached in one patient (14.3% while the C6-C7 level was addressed in five patients (71.4%. One patient (14.3% had these two levels being addressed, C5-C6 and C6-C7. The mean operative time was 164.29±40 minutes. Three patients were hospitalized for 2 days and four for 3 days making an average of 2.57±0.535 days. Two patients (28.6% underwent a new surgical intervention due to loosening of the prosthesis. The mean follow-up was 28.14±5.178 months (23-35 months.CONCLUSIONS: Although cervical arthroplasty appears to be a safe procedure and present promising results in our study as well as in many other studies, it requires long-term studies.

  5. Rothmund-Thomson Syndrome: A 13-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Guillermo Antonio Guerrero-González

    2014-07-01

    Full Text Available Rothmund-Thomson syndrome (RTS is a rare autosomal recessive disorder presenting with poikiloderma and other clinical features, affecting the bones and eyes and, in type II RTS, presenting an increased risk for malignancy. With about 300 cases reported so far, we present a 13-year follow-up including clinical images, X-rays and genetic analysis. A 13-month-old female started with a facial rash with blisters on her cheeks and limbs at the age of 3 months along with congenital hypoplastic thumbs, frontal bossing and fine hair, eyebrows and eyelashes. The patient was lost to follow-up and returned 12 years later with palmoplantar hyperkeratotic lesions, short stature, disseminated poikiloderma and sparse scalp hair, with absence of eyelashes and eyebrows. Radiographic analysis showed radial ray defect, absence of the thumb and three wrist carpal bones, and reduced bone density. Gene sequencing for the RECQL4 helicase gene revealed a mutation on each allele. RTS is a rare disease, and in this patient we observed the evolution of her skin lesions and other clinical features, which were important for the classification of type II RTS. The next years will provide even more information on this rare disease.

  6. Serial extraction: 20 years of follow-up

    Science.gov (United States)

    de ALMEIDA, Renato Rodrigues; de ALMEIDA, Marcio Rodrigues; OLTRAMARI-NAVARRO, Paula Vanessa Pedron; CONTI, Ana Cláudia de Castro Ferreira; NAVARRO, Ricardo de Lima; de SOUZA, Karen Regina Siqueira

    2012-01-01

    This paper reports a case treated by a serial extraction program at the mixed dentition stage followed by a corrective orthodontic treatment, with a long-term follow-up period. Twenty years after the interceptive treatment, a harmonious face was observed along with treatment stability in the anterior posterior direction, deep overbite (which has been mentioned as a disadvantage of the serial extraction program), and a small relapse of anterior tooth crowding. All these conditions have been regarded as normal occurrences for most orthodontic treatments with a long-term follow-up period. This case report demonstrated that the establishment of a serial extraction protocol determined relevant esthetic changes that afforded an improvement of the patient's self-esteem, with a positive social impact. Furthermore, the low cost of this protocol permits the use of this therapy with underprivileged populations. It is important to emphasize that an early correction of tooth crowding by this protocol does not guarantee stability, but small relapses do not invalidate its accomplishment. PMID:23032213

  7. Serial extraction: 20 years of follow-up.

    Science.gov (United States)

    Almeida, Renato Rodrigues de; Almeida, Marcio Rodrigues de; Oltramari-Navarro, Paula Vanessa Pedron; Conti, Ana Cláudia de Castro Ferreira; Navarro, Ricardo de Lima; Souza, Karen Regina Siqueira de

    2012-01-01

    This paper reports a case treated by a serial extraction program at the mixed dentition stage followed by a corrective orthodontic treatment, with a long-term follow-up period. Twenty years after the interceptive treatment, a harmonious face was observed along with treatment stability in the anterior posterior direction, deep overbite (which has been mentioned as a disadvantage of the serial extraction program), and a small relapse of anterior tooth crowding. All these conditions have been regarded as normal occurrences for most orthodontic treatments with a long-term follow-up period. This case report demonstrated that the establishment of a serial extraction protocol determined relevant esthetic changes that afforded an improvement of the patient's self-esteem, with a positive social impact. Furthermore, the low cost of this protocol permits the use of this therapy with underprivileged populations. It is important to emphasize that an early correction of tooth crowding by this protocol does not guarantee stability, but small relapses do not invalidate its accomplishment.

  8. Serial extraction: 20 years of follow-up

    Directory of Open Access Journals (Sweden)

    Renato Rodrigues de Almeida

    2012-08-01

    Full Text Available This paper reports a case treated by a serial extraction program at the mixed dentition stage followed by a corrective orthodontic treatment, with a long-term follow-up period. Twenty years after the interceptive treatment, a harmonious face was observed along with treatment stability in the anterior posterior direction, deep overbite (which has been mentioned as a disadvantage of the serial extraction program, and a small relapse of anterior tooth crowding. All these conditions have been regarded as normal occurrences for most orthodontic treatments with a long-term follow-up period. This case report demonstrated that the establishment of a serial extraction protocol determined relevant esthetic changes that afforded an improvement of the patient's self-esteem, with a positive social impact. Furthermore, the low cost of this protocol permits the use of this therapy with underprivileged populations. It is important to emphasize that an early correction of tooth crowding by this protocol does not guarantee stability, but small relapses do not invalidate its accomplishment.

  9. MANDIBULAR INCISOR EXTRACTION: A 5-YEAR FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    Kadir BEYCAN

    2016-10-01

    Full Text Available This case report presents the mandibular incisor extraction treatment of a patient with dental Class I malocclusion and lower crowding, in whom one mandibular incisor extraction was selected as the treatment of choice to improve the dental occlusion. A 19-year-old male patient’s chief complaint was the crowding of lower incisors. He had a straight profile with normal upper and lower lip projection. Upper and lower dental midlines were coincident with the facial midline. The patient had Class I molar and canine relationships on both sides. He had Class I skeletal relationship, low angle vertical pattern, and proclined upper and lower incisors. The treatment plan included the extraction of lower right central incisor to resolve the crowding. At the end of 16-month active fixed treatment, lower dental crowding was resolved. At the 5-year follow-up, the patient had a stable occlusion, with the results of the orthodontic treatment maintained.

  10. Alberta Euthanasia Survey: 3-year follow-up.

    OpenAIRE

    Verhoef, M.J.; Kinsella, T D

    1996-01-01

    OBJECTIVE: To determine whether the opinions of Alberta physicians about active euthanasia had changed and to assess the determinants of potential changes in opinion. DESIGN: Follow-up survey (mailed questionnaire) of physicians included in the 1991 Alberta Euthanasia Survey. SETTING: Alberta. PARTICIPANTS: Of the 1391 physicians who participated in the 1991 survey 1291 (93%) had indicated that they were willing to take part in a follow-up survey. A follow-up questionnaire was mailed in 1994 ...

  11. Two-year follow-up of self-examination therapy for generalized anxiety disorder.

    Science.gov (United States)

    Floyd, Mark; McKendree-Smith, Nancy; Bailey, Elaine; Stump, Jamie; Scogin, Forrest; Bowman, Daniel

    2002-01-01

    This study examined the stability of treatment gains after receiving self-examination therapy (SET) [Bowman, D. (1995). Innovations in clinical practice: a source book. Professional Resource Press.] for generalized anxiety disorder. A 2-year follow-up of 16 participants from Bowman, Scogin, Floyd, Patton, and Gist [J. Counsel. Psychol. 44 (1997) 267] was conducted by comparing pre- and post-treatment measures with follow-up measures from the Hamilton Anxiety Rating Scale-Revised (HARS-R), the State-Trait Anxiety Inventory (STAI), and the SET quiz. Results indicated treatment gains from baseline to the 2-year follow-up period were maintained on all measures, and there was not a significant decline from post-treatment to follow-up on the HARS-R and STAI. These results suggest that SET for treatment of generalized anxiety disorder (GAD) may be effective in both the immediate and long-term reduction of GAD symptoms.

  12. Spheroid degeneration of conjunctiva and cornea. Two years' follow up.

    Science.gov (United States)

    Norn, M

    1980-10-01

    Twenty-six subjects with spheroid degeneration were followed up after two years. The number of colourless conjunctival droplets was seen to have increased by on an average 46% (2 alpha = 0.05) and that of autofluorescent conjunctival droplets by 223% (2 alpha less than 0.01). Counting within the individual sites sites disclosed that some droplets will disappear (not less than 30 and 21% respectivelY), while recently formed will constitute at least 76 and 243%. The number of areas with band-shaped keratopathy was found to rise from 3 to 26 (P less than 0.001) out of 104 possibilities, (nasally and temporally of right and left eye). Vital staining (fluorescein, rose bengal, tetrazolium, alcian blue) showed the epithelium above the droplets to be intact, and the droplet-containing eyes were found not to be abnormally dry (break up time, tear production).

  13. Rectal leiomyosarcoma, three-year follow-up

    Directory of Open Access Journals (Sweden)

    Juliano Alves Figueiredo

    2012-03-01

    Full Text Available Rectal leiomyosarcomas are rare tumors originated from smooth muscle cells. Differential diagnosis includes gastrointestinal stromal tumors (GIST, leiomyomas or schwannomas, and the differentiation of these tumors is usually made through immunohistochemistry. Due to its rarity, the standard treatment has not been defined. The purpose of this study was to present the follow-up of a patient with leiomyosarcoma of medium rectum submitted to exclusive operative treatment. The tumor size was 6 cm and it had a high mitotic index. The patient remains with good urinary function and good sphincter function, and free of the disease after a three-year follow-up.Os leiomiossarcomas retais são tumores raros e originários de células de músculo liso. O diagnóstico diferencial inclui tumores estromais do trato gastrointestinal (GIST, leiomiomas ou schwannomas, e a diferenciação desses tumores normalmente é feita por imunohistoquímica. Devido a sua raridade, o tratamento-padrão ainda não está bem definido. O objetivo deste relato foi mostrar o seguimento de um paciente com leiomiossarcoma de reto médio submetido a tratamento operatório exclusivo. O paciente se manteve com bom controle urinário e boa função evacuatória. O tumor tinha alto índice mitótico e tamanho de 6 cm, mas não há sinais de recidiva após três anos da operação.

  14. Measles vaccine: a 27-year follow-up.

    LENUS (Irish Health Repository)

    Ramsay, M E

    1994-04-01

    In 1964, the Medical Research Council undertook a trial of measles vaccine in over 36,000 United Kingdom children; 9577 of whom received live vaccine, 10,625 received inactivated followed by live vaccines, and 16,328 acted as unvaccinated controls. Participants in this study have been followed to determine the long term protection from measles vaccine and follow-up data were available on 4194, 4638 and 274 respectively. During the 5-year period 1986-90, the protective efficacy of live measles vaccine has remained high at 87%, but the 95% confidence interval was wide (-43 to 99%) due to the small numbers of cases. Between 1976 and 1990, however, the overall efficacy of the live vaccine was 92% (95% confidence interval 86 to 95%) and there was no evidence of a decline in efficacy (P = 0.13) over the 15-year period. This study suggests that the protection from live measles vaccine persists for up to 27 years after vaccination, and that no change in the current United Kingdom measles immunization policy should be made on the grounds of waning immunity.

  15. Congenital hypothyroidism: follow up of a case for 13 years.

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    Sudhir M Naik

    2014-04-01

    Full Text Available Background/objectives: Congenital hypothyroidism is one of the most common preventable causes of mental retardation in children. The prognosis of infants detected by neonatal screening and started on treatment early is excellent, with intelligence quotients similar to sibling or classmate without the disease. Setting: Department of ENT, Head and Neck Surgery, KVG Medical College, Sullia. 1Case report: A 15 year old boy came with history of head ache, generalized body ache and lack of concentration in school. He was a case of congenital hypothyroidism and was on irregular treatment for the last 13 years. Intervention: The patient was advised strictly to continue the oral l-thyroxine 100μg one hour before food and come for regular follow-up. Conclusion: Definite intellectual deterioration is seen if oral l-thyroxine is not started within 50 days of life and the deterioration is irreversible. So in India newborn screening programs should be implemented as a national program as it is very important to diagnose and treatcongenital hypothyroidism as soon as possible and to treat it effectively.

  16. Results of Arthroscopic Bankart Lesion Repair in Patients with Post-Traumatic Anterior Instability of the Shoulder and a Non-Engaging Hill-Sachs Lesion with a Suture Anchor after a Minimum of 6-Year Follow-Up.

    Science.gov (United States)

    Szyluk, Karol; Jasiński, Andrzej; Widuchowski, Wojciech; Mielnik, Michał; Koczy, Bogdan

    2015-08-10

    Shoulder instability is an important clinical problem. Arthroscopic surgery is an established treatment modality in shoulder instability, but it continues to be associated with a high rate of recurrences and complications. The purpose of the study was to analyze late outcomes of arthroscopic repair of Bankart lesions in patients with post-traumatic anterior shoulder instability and non-engaging Hill-Sachs lesion, with special focus on the incidence and causes of recurrences and complications. We investigated 92 patients (92 shoulders) who underwent surgery on account of post-traumatic anterior shoulder instability. The duration of follow-up ranged from 6 to 12.5 years (mean: 8.2 years). All patients were operated on in the lateral decubitus position using FASTak 2.8-mm suture anchors (FASTak, Arthrex, Naples, Florida). Treatment outcomes were evaluated using the Rowe and University of California at Los Angeles rating system (UCLA). According to Rowe scores, there were 71 (81.5%) excellent, 12 (12.6%) good, 5 (5.3%) satisfactory, and 2 (2.1%) poor results. Rowe scores improved in a statistically significant manner (p=0.00) post-surgery, to a mean of 90 (range: 25-100). Treatment outcomes measured as UCLA scores improved in a statistically significant manner (p=0.00), reaching post-operative levels of 12-35 (mean: 33.5). There were 9 recurrences, 1 case of axillary nerve praxia, and 1 case of anchor loosening. With rigorous criteria for qualifying patients for surgery, arthroscopic treatment of post-traumatic anterior shoulder instability produces good outcomes and low recurrence and complication rates irrespective of the number of previous dislocations, age, or sex.

  17. COPD and microalbuminuria: a 12-year follow-up study.

    Science.gov (United States)

    Romundstad, Solfrid; Naustdal, Thor; Romundstad, Pål Richard; Sorger, Hanne; Langhammer, Arnulf

    2014-04-01

    Chronic obstructive pulmonary disease (COPD), low lung function independent of diagnosis and markers of inflammation are all associated with increased morbidity and mortality. Microalbuminuria, reflecting endothelial dysfunction, could be a relevant inflammatory marker of potential systemic effects of COPD. We hypothesised that there was a positive association between microalbuminuria and mortality in individuals with COPD. We conducted a 12-year follow-up study of 3129 participants in the second survey of the Nord-Trøndelag Health Study (HUNT), Norway. At baseline, albuminuria was analysed in three urine samples and spirometry was performed. Among the participants, 136 had COPD and microalbuminuria, defined as a urinary albumin/creatinine ratio between 2.5 and 30.0 mg·mmol(-1). The main outcome measures were hazard ratio of all-cause mortality according to microalbuminuria. Compared to those with COPD without microalbuminuria, the adjusted hazard ratio for all-cause mortality in those with COPD and microalbuminuria was 1.54, 95% CI 1.16-2.04. This result was similar after excluding cardiovascular disease at baseline. Classifying COPD severity by Global Initiative for Chronic Obstructive Lung Disease, there was a positive association trend with increasing severity stages. Microalbuminuria is associated with all-cause mortality in individuals with COPD and could be a relevant tool in identification of patients with poor prognosis.

  18. Small peripheral lung carcinomas with five-year post-surgical follow-up: assessment by semi-automated volumetric measurement of tumour size, CT value and growth rate on TSCT

    Energy Technology Data Exchange (ETDEWEB)

    Sone, Shusuke [JA Nagano Azumi General Hospital, Ikeda, Nagano (Japan); Nagano Health Promotion Corporation, Inasato, Nagano (Japan); Hanaoka, Takaomi [JA Nagano Azumi General Hospital, Department of Chest Surgery, Ikeda, Nagano (Japan); Ogata, Hiroyuki [JA Nagano Azumi General Hospital, Division of Clinical Laboratory and Pathology, Ikeda, Nagano (Japan); Takayama, Fumiyoshi [JA Nagano Azumi General Hospital, Department of Radiology, Ikeda, Nagano (Japan); Ichinose Neurosurgery Hospital, Matsumoto, Nagano (Japan); Watanabe, Tomofumi [Iida Municipal Hospital, Iida, Nagano (Japan); Haniuda, Masayuki [Aichi Medical University, Division of Chest Surgery, Aichi (Japan); Kaneko, Kazuhiko [Shinshu University School of Medicine, Department of Surgery, Matsumoto (Japan); Okaya-Enrei Hospital, Okaya, Nagano (Japan); Kondo, Ryoichi [National Chushin Matsumoto Hospital, Matsumoto (Japan); Yoshida, Kazuo [Shinshu University School of Medicine, Department of Surgery, Matsumoto (Japan); Honda, Takayuki [Shinshu University School of Medicine, Department of Laboratory Medicine, Matsumoto (Japan)

    2012-01-15

    To retrospectively assess the utility of semi-automated measurements by stratification of CT values of tumour size, CT value and doubling time (DT) using thin-section computed tomography (CT) images. The post-surgical outcomes of favourable and problematic tumours (more advanced p stage than IA, post-surgical recurrence or mortality from lung cancer) were compared using the measured values. The computed DTs were compared with manually measured values. The study subjects comprised 85 patients (aged 33-80 years, 48 women, 37 men), followed-up for more than 5 years postoperatively, with 89 lung lesions, including 17 atypical adenomatous hyperplasias and 72 lung cancers. DTs were determined in 45 lesions. For problematic lesions, whole tumour diameter and density were >18 mm and >-400 HU, respectively. The respective values for the tumour core (with CT values of -350 to 150 HU) were >15 mm and >-70 HU. Analysis of tumour core DTs showed interval tumour progression even if little progress was seen by standard tumour volume DT (TVDT). Software-based volumetric measurements by stratification of CT values provide valuable information on tumour core and help estimate tumour aggressiveness and interval tumour progression better than standard manually measured 2D-VDTs. (orig.)

  19. Mitochondrial encephalomyopathy - two years follow-up by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hausegger, K.A.; Ebner, F.; Flueckiger, F.; Justich, E. (Graz Univ. (Austria). Radiologische Klinik); Millner, M.M. (Graz Univ. (Austria). Paediatrische Klinik)

    1991-04-01

    A case of mitochondrial encephalomyopathy (MEM) followed-up by MRI for 2 1/2 y is presented. MRI showed gross, diffusely distributed white matter lesions in both hemispheres predominantly in frontal, parietal, temporal and occipital locations a marked ventriculomegaly indicative of cerebral atrophy. Except a slight increase of the cerebral atrophy there were no changes in the follow-up examinations. There are no specific MRI findings in MEM, the diagnosis is established by the synopsis of MRI, laboratory data and muscle biopsy. (orig.).

  20. Sixteen-year follow-up of childhood avalanche survivors

    Science.gov (United States)

    Thordardottir, Edda Bjork; Valdimarsdottir, Unnur Anna; Hansdottir, Ingunn; Hauksdóttir, Arna; Dyregrov, Atle; Shipherd, Jillian C.; Elklit, Ask; Resnick, Heidi; Gudmundsdottir, Berglind

    2016-01-01

    Background Every year a substantial number of children are affected by natural disasters worldwide. However, data are scarce on long-term psychological impact of natural disasters on children's health. Identifying risk factors and outcomes associated with the long-term sequelae of posttraumatic stress disorder (PTSD) can provide a gateway to recovery as well as enhancement of preventive measures. Objective Among childhood avalanche survivors, we aimed to investigate risk factors for PTSD symptoms and the relationship between socioeconomic status (SES) and PTSD symptoms in adulthood. Methods Childhood survivors (aged 2–19 at the time of exposure) of two avalanches were identified through nationwide registers 16 years later. The Posttraumatic Diagnostic Scale was used to assess current PTSD symptoms. One-way ANOVA was used to explore PTSD symptoms by background and trauma-specific factors, as well as associations with current SES. Predictors of PTSD symptoms were examined by multivariable regression analysis. Results Response rate was 66% (108/163). Results from univariate ANOVA analysis revealed that female sex was associated with PTSD symptoms (F=5.96, punemployment and/or disability (F=3.04, p<0.05). In a multivariable regression model, when adjusting for age and sex, lack of social support (t=4.22, p<0.001) and traumatic reactions of caregivers (t=2.49, p<0.05) in the aftermath of the disaster independently predicted PTSD 16 years post-trauma. Conclusions Lingering PTSD symptoms after childhood exposure to a disaster may negatively influence socioeconomic development in adulthood. Strengthening children's support systems post-disaster may prevent the long-term sequelae of symptoms. Highlights of the article PTSD symptoms following avalanche exposure during childhood were associated with poorer socioeconomic status in adulthood. Lack of social support and traumatic reactions of caregivers in the aftermath of avalanches predicted PTSD symptoms among childhood

  1. Alberta Euthanasia Survey: 3-year follow-up.

    Science.gov (United States)

    Verhoef, M J; Kinsella, T D

    1996-01-01

    OBJECTIVE: To determine whether the opinions of Alberta physicians about active euthanasia had changed and to assess the determinants of potential changes in opinion. DESIGN: Follow-up survey (mailed questionnaire) of physicians included in the 1991 Alberta Euthanasia Survey. SETTING: Alberta. PARTICIPANTS: Of the 1391 physicians who participated in the 1991 survey 1291 (93%) had indicated that they were willing to take part in a follow-up survey. A follow-up questionnaire was mailed in 1994 to 1146 physicians who could be traced through the 1994 Medical Directory of the provincial college of physicians and surgeons; 25 questionnaires were returned because they could not be delivered. OUTCOME MEASURES: Physicians' opinions about (a) the morality of active euthanasia, (b) changes in the law to permit active euthanasia and (c) the practice of legalized euthanasia. RESULTS: Of the 1121 physicians sent a follow-up questionnaire 866 (77%) returned it completed. The responses of these same 866 physicians in 1991 provided a basis for comparison. Of the 866, 360 (42%) stated in the 1994 survey that it is sometimes right to practise active euthanasia; a similar proportion (384 [44%]) gave this response in 1991. However, other opinions changed significantly. In 1991, 250 of the respondents (29%) indicated that they would practise active euthanasia if it were legalized, as compared with 128 (15%) in 1994 (p euthanasia, as compared with 316 (37%) in 1994 (p euthanasia between 1991 and 1994, in both surveys at least 70% of those who responded to this question indicated that active euthanasia, if it were legalized, should be performed only by physicians and should be taught at medical sites. CONCLUSION: Alberta physicians' support for the practice and legalization of active euthanasia decreased considerably between 1991 and 1994. However, most physicians remain in favour of restricting active euthanasia, if it were legalized, to the medical profession. These results suggest a

  2. Sixteen-year follow-up of childhood avalanche survivors

    Directory of Open Access Journals (Sweden)

    Edda Bjork Thordardottir

    2016-08-01

    Full Text Available Background: Every year a substantial number of children are affected by natural disasters worldwide. However, data are scarce on long-term psychological impact of natural disasters on children's health. Identifying risk factors and outcomes associated with the long-term sequelae of posttraumatic stress disorder (PTSD can provide a gateway to recovery as well as enhancement of preventive measures. Objective: Among childhood avalanche survivors, we aimed to investigate risk factors for PTSD symptoms and the relationship between socioeconomic status (SES and PTSD symptoms in adulthood. Methods: Childhood survivors (aged 2–19 at the time of exposure of two avalanches were identified through nationwide registers 16 years later. The Posttraumatic Diagnostic Scale was used to assess current PTSD symptoms. One-way ANOVA was used to explore PTSD symptoms by background and trauma-specific factors, as well as associations with current SES. Predictors of PTSD symptoms were examined by multivariable regression analysis. Results: Response rate was 66% (108/163. Results from univariate ANOVA analysis revealed that female sex was associated with PTSD symptoms (F=5.96, p<0.05. When adjusted for age and sex, PTSD symptoms were associated with lower education (F=7.62, p<0.001, poor financial status (F=12.21, p<0.001, and unemployment and/or disability (F=3.04, p<0.05. In a multivariable regression model, when adjusting for age and sex, lack of social support (t=4.22, p<0.001 and traumatic reactions of caregivers (t=2.49, p<0.05 in the aftermath of the disaster independently predicted PTSD 16 years post-trauma. Conclusions: Lingering PTSD symptoms after childhood exposure to a disaster may negatively influence socioeconomic development in adulthood. Strengthening children's support systems post-disaster may prevent the long-term sequelae of symptoms.

  3. Periapical endodontic surgery: a 3-year follow-up study.

    Science.gov (United States)

    Maddalone, M; Gagliani, M

    2003-03-01

    To monitor the outcome of periradicular surgery in a group of teeth treated with microsurgical technology and ultrasonic root-end preparation. One hundred and twenty-eight teeth with failed conventional root canal treatment were included. The surgical procedure was completed using ultrasonic retrotips and a zinc oxide-EBA (Super Seal, Ogna Pharmaceuticals. Milan, Italy)-reinforced material was used to seal the root end cavities. Lesions were examined radiologically at 1. 3. 6. 12, 24 and 36-month intervals. Radiographs were independently analysed according to a previously published classification. Eight teeth were extracted due to fracture or perforations undetected radiologically: these cases were excluded from the study. Of the 120 teeth examined. the overall success rate was 92.5%; 94 healed with complete bone filling of the surgical cavity, 17 were considered to have healed by apical scar formation, four demonstrated uncertain healing and five were considered failures. Eighty of 120 teeth examined had successfully healed from a radiological point of view within 12 months. No differences in outcome occurred between anterior, premolar and molar teeth. Although all failures occurred in teeth with posts, no statistically significant difference was noted (Mann-Whitney U-test, P = 0.37). Modern surgical endodontic procedures associated and ERA (Super Seal, Ogna Pharmaceuticals, Milan, Italy) root end fillings were successful over 3 years in 92.5% of cases.

  4. Banked cadaveric fascia lata: 3-year follow-up.

    Science.gov (United States)

    Almeida, S H M; Gregório, E P; Rodrigues, M A F; Grando, J P S; Moreira, H A; Fraga, F C

    2004-05-01

    Autologous fascial and synthetic materials have been widely used to repair the stress form of urinary incontinence (SUI) as well as pelvic floor prolapse. The safety and long-term durability of cadaveric fascia lata in orthopedic and ophthalmologic surgery have encouraged urogynecologists to use this material for a sling material. The rationale of placement of a sling from cadaveric fascia lata is based upon decreasing the complication rates caused by autologous and synthetic materials. However, the high costs of the commercially available tissues in Brazil have limited its use in public health. In our institution we developed a cadaveric fascia lata bank, harvesting the material according to the Brazilian Transplantation Legislation and storing it at -70 degrees C. The safety of the tissue is achieved by 25-kGy irradiation. Since 1999, 30 patients have undergone surgery using material from five donors in repairs for stress urinary incontinence and pelvic floor prolapse at a mean of 34 months' follow-up (ranging from 30 to 40 months), there was no evidence of rejection. Therefore, we have shown the safety of cadaveric fascia lata harvested and treated as described above in our group of patients.

  5. Control of Blood Pressure and Risk Attenuation: Post Trial Follow-Up of Randomized Groups.

    Directory of Open Access Journals (Sweden)

    Tazeen H Jafar

    Full Text Available Evidence on long term effectiveness of public health strategies for lowering blood pressure (BP is scarce. In the Control of Blood Pressure and Risk Attenuation (COBRA Trial, a 2 x 2 factorial, cluster randomized controlled trial, the combined home health education (HHE and trained general practitioner (GP intervention delivered over 2 years was more effective than no intervention (usual care in lowering systolic BP among adults with hypertension in urban Pakistan. However, it was not clear whether the effect would be sustained after the cessation of intervention. We conducted 7 years follow-up inclusive of 5 years of post intervention period of COBRA trial participants to assess the effectiveness of the interventions on BP during extended follow-up.A total of 1341 individuals 40 years or older with hypertension (systolic BP 140 mm Hg or greater, diastolic BP 90 mm Hg or greater, or already receiving treatment were followed by trained research staff masked to randomization status. BP was measured thrice with a calibrated automated device (Omron HEM-737 IntelliSense in the sitting position after 5 minutes of rest. BP measurements were repeated after two weeks. Generalized estimating equations (GEE were used to analyze the primary outcome of change in systolic BP from baseline to 7- year follow-up. The multivariable model was adjusted for clustering, age at baseline, sex, baseline systolic and diastolic BP, and presence of diabetes.After 7 years of follow-up, systolic BP levels among those randomised to combined HHE plus trained GP intervention were significantly lower (2.1 [4.1-0.1] mm Hg compared to those randomised to usual care, (P = 0.04. Participants receiving the combined intervention compared to usual care had a greater reduction in LDL-cholesterol (2.7 [4.8 to 0.6] mg/dl.The benefit in systolic BP reduction observed in the original cohort assigned to the combined intervention was attenuated but still evident at 7- year follow-up. These

  6. Liver Cirrhosis: A Seven Year Follow-Up

    Directory of Open Access Journals (Sweden)

    TS Paul Tran

    1991-01-01

    Full Text Available The status of 121 patients who were found to have liver cirrhosis on liver biopsy in 1981 was assessed seven years later. The etiology of the cirrhosis was alcoholic in 52%, cryptogenic in 29.8%, hepatitis B-related in 9.1% and miscellaneous in 9.1%. In 1981, jaundice was present in 55 patients (45.8%, ascites in 52 (43%, gastrointestinal bleeding in 25 (20.7% and encephalopathy in 10 (8.3%. During the following seven years an additional 20 patients developed ascites, 15 gastrointestinal bleeding, 32 encephalopathy and three hepatocellular carcinoma. The mortality race was 43.8% at five years and 53.7% at seven years. The principal cause of death was liver failure (40%, followed by nonliver causes (32.3% and gastrointestinal bleeding (13.9%. One patient died of hepatocellular carcinoma. Patients who survived seven years had fewer complications when seen in 1981 than those who died during this period (P<0.025. It is concluded that, in Toronto, cirrhosis is often caused by ethanol abuse and hepatitis B infection; that it is associated with significant morbidity and mortality; and that the number of complications when the patient is first seen may be a useful indicator of prognosis. Since many cases of cirrhosis are preventable, the authors suggest that efforts directed towards prevention of cirrhosis may be more rewarding than those directed towards therapy.

  7. Ten-year follow-up of a giant prolactinoma.

    Science.gov (United States)

    Fernandes, Vera; Santos, Maria Joana; Almeida, Rui; Marques, Olinda

    2015-11-20

    Giant prolactinomas are rare pituitary tumours of which management can be a challenge. A 28-year-old man presented with headaches, visual impairment and behavioural changes. Clinically, the patient was found to have hypogonadism and bitemporal hemianopsia. A MRI demonstrated a pituitary tumour 76 mm in diameter and blood tests revealed a serum prolactin of 158,700 µU/mL (reference range 58-254). Initially, a craniotomy was performed. Immunohistochemistry of the tumour identified a prolactinoma with a high proliferative index and the patient was started on treatment with a dopamine agonist. A year later, neurological symptoms worsened due to regrowth of the lesion's cystic component, and so further surgery was performed. After 10 years of treatment with dopamine agonists, the prolactin levels decreased by 96.8%, there was an effective reduction in tumour size, and the neurological signs and symptoms resolved.

  8. Sixteen-year follow-up of childhood avalanche survivors

    DEFF Research Database (Denmark)

    Thordardottir, E.B.; Valdimarsdóttir, Unnur A; Hansdottir, Ingunn

    2016-01-01

    Background: Every year a substantial number of children are affected by natural disasters worldwide. However, data are scarce on long-term psychological impact of natural disasters on children’s health. Identifying risk factors and outcomes associated with the long-term sequelae of posttraumatic ...

  9. MR angiography follow-up 10 years after cryptogenic nonperimesencephalic subarachnoid hemorrhage.

    Directory of Open Access Journals (Sweden)

    Holger Wenz

    Full Text Available Long-term magnetic resonance angiography (MRA follow-up studies regarding cryptogenic nonperimesencephalic subarachnoid hemorrhage (nSAH are scarce. This single-centre study identified all patients with angiographically verified cryptogenic nSAH from 1998 to 2007: The two main objectives were to prospectively assess the incidence of de novo aneurysm with 3.0-MRI years after cryptogenic nSAH in patients without evidence for further hemorrhage, and retrospectively assess patient demographics and outcome.From prospectively maintained report databases all patients with angiographically verified cryptogenic nSAH were identified. 21 of 29 patients received high-resolution 3T-MRI including time-of-flight and contrast-enhanced angiography, 10.2 ± 2.8 years after cryptogenic nSAH. MRA follow-up imaging was compared with initial digital subtraction angiography (DSA and CT/MRA. Post-hemorrhage images were related to current MRI with reference to persistent lesions resulting from delayed cerebral ischemia (DCI and post-hemorrhagic siderosis. Patient-based objectives were retrospectively abstracted from clinical databases.29 patients were identified with cryptogenic nSAH, 17 (59% were male. Mean age at time of hemorrhage was 52.9 ± 14.4 years (range 4 - 74 years. 21 persons were available for long-term follow-up. In these, there were 213.5 person years of MRI-follow-up. No de novo aneurysm was detected. Mean modified Rankin Scale (mRS during discharge was 1.28. Post-hemorrhage radiographic vasospasm was found in three patients (10.3%; DCI-related lesions occurred in one patient (3.4%. Five patients (17.2% needed temporary external ventricular drainage; long-term CSF shunt dependency was necessary only in one patient (3.4%. Initial DSA retrospectively showed a 2 x 2 mm aneurysm of the right distal ICA in one patient, which remained stable. Post-hemorrhage siderosis was detected 8.1 years after the initial bleeding in one patient (4.8%.Patients with

  10. Hyperphosphatasia with massive osteoectasia: a 45-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    McCarthy, E.F. [Division of Surgical Pathology, Department of Pathology and Orthopaedic Surgery, Baltimore, MD (United States); Sack, G.H. [Department of Internal Medicine, Baltimore, MD (United States)

    2007-06-15

    Hyperphosphatasia is a heterogeneous group of disorders characterized by a generalized skeletal disease and increased alkaline phosphatase. Increased bone remodeling secondary to increased osteoclastic activity appears to be the underlying feature of these disorders. These disorders include juvenile Paget's disease, expansile skeletal hyperphosphatasia, hyperostosis generalisata with striations, and Camurati-Engelmann's disease, type II. The genetic mutations for a number of these disorders have been identified. We present a patient with congenital hyperphosphatasia whose clinical and radiographic features were somewhat different from these other well-defined syndromes. The patient was followed for 45 years until his death of at age 49. The patient had massive osteoectasia with dense striations involving the entire shaft of his long bones. His spine, pelvis, short tubular bones, and calvarium were also involved. He suffered hearing loss and optic atrophy, but he kept his teeth throughout his life. He was tall with a marfanoid habitus, and he had hypogonadism and hypothyroidism. There was no evidence of mental retardation, and other laboratory studies where within normal limits. This case, as well as other manifestations of hyperphosphatasia, attests to the complexity of the bone remodeling system. (orig.)

  11. Callosal apraxia: a 34-year follow-up study.

    Science.gov (United States)

    Falchook, Adam D; Watson, Robert T; Heilman, Kenneth M

    2016-06-01

    Loss of ability of the left upper limb (LUL) to correctly produce spatial and temporal components of skilled purposeful movements was reported 34 years ago in a woman with a callosal infarction. To learn about recovery, we recently reexamined this woman. This woman was tested for ideomotor apraxia by asking her to pantomime to command and to seeing pictures of tools. Whereas she performed normally with her right upper limb, her LUL remained severely apraxic, making many spatial (postural and movement) errors. Initially, she did not reveal loss of finger-hand deftness (limb-kinetic apraxia), and when tested again with the coin rotation task, her left hand performance was normal. Without vision, she could name objects placed in her left hand but not name numbers written in this hand. Since this woman had a callosal lesion, failure to recover cannot be accounted for by left hemisphere inhibition of her right hemisphere. Although failure for her LUL to improve may have been related to not using her LUL for skilled actions, her right hemisphere was able to observe transitive actions, and this failure of her LUL to produce skilled purposeful movements suggests her right hemisphere may have not had the capacity to learn these movement representations. Without vision, her ability to recognize objects with her left hand, but not numbers written on her left palm, suggests graphesthesia may require that her left hand did not have access to movement representations important for programming these numbers when writing.

  12. One-Year Follow-Up of Patients Undergoing Transvenous Extraction of Pacemaker and Defibrillator Leads.

    Directory of Open Access Journals (Sweden)

    Maciej Kempa

    Full Text Available The number of pacemaker and ICD implantations has increased substantially in the recent years. Therefore, complications are also observed in a greater number. In many cases, transvenous extraction of the previously implanted device (pacemaker or ICD is the only solution. One may find in the literature information about the efficacy and safety of that procedure, but data concerning the results of long-term follow up are still limited.The aim of the study was to assess the one-year mortality in the cohort of patients undergoing transvenous lead extraction procedures in our centre.Records of the patients undergoing transvenous lead removal in the Department of Cardiology and Electrotherapy of the Medical University of Gdańsk were analyzed. We collected detailed information about 192 patients that had undergone the procedure from January 2003 until June 2012. Data were collected from medical and surgical records. We analyzed concomitant diseases, indications, and possible complications. Long-term follow-up data were gathered in the follow-up ambulatory records and over-the-phone interviews with patients or families. In several cases, we consulted the database of the Polish National Health Fund.During the early post-operative period 5 patients died, although none of those deaths was associated with the procedure itself. No other major complications were observed. During one-year follow-up other 5 patients died, which gave the overall one-year survival rate of 92.7%. Heart failure, renal failure and an infective indication showed significant association with increased mortality.Results of transvenous lead extraction, a relatively safe procedure, should be assessed over time extending beyond the sole perioperative period. Some complications may be delayed in their nature, and may be observed only during the long-term follow up.

  13. Four-year follow-up of endoscopic gastroplication for the treatment of gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Matthijs; P; Schwartz; J; Rieneke; C; Schreinemakers; André; J; P; M; Smout

    2013-01-01

    AIM:To evaluate the long-term effect of Endocinch treatment for gastroesophageal reflux disease(GERD).METHODS:After unblinding and crossover,50 patients(32 males,18 females; mean age 46 years) with pH-proven chronic GERD were recruited from an initial randomized,placebo-controlled,single-center study,and included in the present prospective open-label follow-up study.Initially,three gastroplications using the Endocinch device were placed under deep sedation in a standardized manner.Optional retreatment was offered in the first year with 1 or 2 extra gastroplications.At baseline,3 mo after(re) treatment and yearly proton pump inhibitor(PPI) use,GERD symptoms,quality of life(QoL) scores,adverse events and treatment failures(defined as:patients using > 50% of their baseline PPI dose or receiving alternative antireflux therapy) were assessed.Intention-to-treat analysis was performed.RESULTS:Median follow-up was 48 mo [interquartile range(IQR):38-52].Three patients were lost to follow-up.In 44% of patients retreatment was done after a median of 4 mo(IQR:3-8).No serious adverse events occurred.At the end of follow-up,symptom scores and4 out of 6 QoL subscales were improved(all P < 0.01compared to baseline).However,80% of patients required PPIs for their GERD symptoms.Ultimately,64% of patients were classified as treatment failures.In 60% a post-procedural endoscopy was carried out,of which in 16% reflux esophagitis was diagnosed.CONCLUSION:In the 4-year follow-up period,the subset of GERD patients that benefit from endoscopic gastroplication kept declining gradually,nearly half opted for retreatment and 80% required PPIs eventually.

  14. Cytokines as a predictor of clinical response following hip arthroscopy: minimum 2-year follow-up.

    Science.gov (United States)

    Shapiro, Lauren M; Safran, Marc R; Maloney, William J; Goodman, Stuart B; Huddleston, James I; Bellino, Michael J; Scuderi, Gaetano J; Abrams, Geoffrey D

    2016-08-01

    Hip arthroscopy in patients with osteoarthritis has been shown to have suboptimal outcomes. Elevated cytokine concentrations in hip synovial fluid have previously been shown to be associated with cartilage pathology. The purpose of this study was to determine whether a relationship exists between hip synovial fluid cytokine concentration and clinical outcomes at a minimum of 2 years following hip arthroscopy. Seventeen patients without radiographic evidence of osteoarthritis had synovial fluid aspirated at time of portal establishment during hip arthroscopy. Analytes included fibronectin-aggrecan complex as well as a multiplex cytokine array. Patients completed the modified Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index and the International Hip Outcomes Tool pre-operatively and at a minimum of 2 years following surgery. Pre and post-operative scores were compared with a paired t-test, and the association between cytokine values and clinical outcome scores was performed with Pearson's correlation coefficient with an alpha value of 0.05 set as significant. Sixteen of seventeen patients completed 2-year follow-up questionnaires (94%). There was a significant increase in pre-operative to post-operative score for each clinical outcome measure. No statistically significant correlation was seen between any of the intra-operative cytokine values and either the 2-year follow-up scores or the change from pre-operative to final follow-up outcome values. No statistically significant associations were seen between hip synovial fluid cytokine concentrations and 2-year follow-up clinical outcome assessment scores for those undergoing hip arthroscopy.

  15. Percutaneous closure of secundum type atrial septal defects:More than 5-year follow-up

    Institute of Scientific and Technical Information of China (English)

    Roel; JR; Snijder; Maarten; J; Suttorp; Jurri?n; M; Ten; Berg; Martijn; C; Post

    2015-01-01

    AIM: To investigate long-term efficacy of two different devices more than five years after percutaneous atrial septal defect(ASD) closure in adults.METHODS: All patients who underwent percutaneous closure of an ASD in the St. Antonius Hospital, Nieuwegein, The Netherlands, between February 1998 and December 2006 were included. Percutaneous closure took place under general anaesthesia and transesophageal echocardiographic moni toring. Transthoracic echocardiography(TTE) was performed 24 h post-procedure to visualize the device position and to look for residual shunting using color Doppler. All complications were registered. All patients were invited for an outpatient visit and contrast TTE more than 5-years after closure. Efficacy was based on the presence of a residual right-to-left shunt(RLS), graded as minimal, moderate or severe. The presence of a residual left-to-right shunt(LRS) was diagnosed using color Doppler, and was not graded. Descriptive statistics were used for patients’ characteristics. Univariate analysis was used to identify predictors for residual shunting.RESULTS: In total, 104 patients(mean age 45.5 ± 17.1 years) underwent percutaneous ASD closure using an Amplatzer device(ASO) in 76 patients and a Cardioseal/Starflex device(CS/SF) in 28 patients. The mean follow-up was 6.4 ± 3.4 years. Device migration occurred in 4 patients of whom two cases occurred during the index hospitalization(1 ASO, 1 CS/SF). The other 2 cases of device migration occurred during the first 6 mo of follow-up(2 CS/SF). The recurrent thrombo-embolic event rate was similar in both groups: 0.4% per follow-up year. More than 12 mo post-ASD closure and latest follow-up, new-onset supraventricular tachyarrhythmia’s occurred in 3.9% and 0% for the ASO and CS/SF group, respectively. The RLS rate at latest follow-up was 17.4%(minimal 10.9%, moderate 2.2%, severe 4.3%) and 45.5%(minimal 27.3%, moderate 18.2%, severe 0%) for the ASO- and CS/SF groups, respectively. There was no

  16. Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik;

    2012-01-01

    To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

  17. Endodontic surgery with ultrasonic retrotips: one-year follow-up.

    Science.gov (United States)

    Taschieri, Silvio; Del Fabbro, Massimo; Testori, Tiziano; Francetti, Luca; Weinstein, Roberto

    2005-09-01

    The purpose of this prospective clinical study was to monitor the outcome of ultrasonic root-end preparation, in relation to tooth type and location, presence of post restoration and type of retrotip. Teeth treated surgically showed a periradicular lesion of strictly endodontic origin. Fifty teeth were included in the study, according to specific selection criteria. Cases were followed for a period of 1 year and then classified in 3 groups (success, uncertain healing, and failure) according to radiographic and clinical criteria. Of the 46 teeth evaluated at 1-year follow-up, 42 teeth (91.3%) successfully healed, 1 tooth had uncertain healing, and 3 failed. We found no statistically significant differences in treatment results related to the type of tooth, tooth location, post restoration, and type of retrotip. Adherence to a strict endodontic surgical protocol and the use of contemporary techniques and materials can lead to a predictable outcome.

  18. Periodontal disease-associated micro-organisms in peri-menopausal and post-menopausal women using or not using hormone replacement therapy. A two-year follow-up study

    Directory of Open Access Journals (Sweden)

    Furuholm Jussi

    2010-04-01

    Full Text Available Abstract Background Despite conflicting results on the use of hormone replacement therapy (HRT there is no doubt that many women benefit from it. Women using HRT are known to be more health conscious in general with putative positive implications in the mouth. However, we observed recently in our cohort hardly any difference in oral health status between HRT-users and non-users. There are only a few studies about HRT and oral microbiota. We hypothesized that counts of periodontal micro-organisms are lower in health-conscious HRT-users than non-users. Methods Two-year open follow-up study was conducted on originally 200 HRT-users and 200 non-users from age cohorts of 50-58 years. After clinical examination pooled subgingival plaque samples were taken for polymerase chain reaction analyses. The results of finally 135 women meeting the inclusion criteria were analyzed with cross-tabulation and chi-square test. Explanatory factors were studied by step-wise logistic regression analysis. Results In HRT group, the numbers of positive samples for Porphyromonas gingivalis (P. gingivalis, p Prevotella intermedia (P. intermedia, p Tannerella forsythia (T. forsythia, p P. gingivalis (p T. forsythia (p Conclusion Although use of HRT did not correlate with periodontal health status, HRT led to decreasing numbers of positive samples of the periodontal pathogens P. gingivalis and T. forsythia. Further studies with longer observation time are needed to observe the clinical relevance of the results.

  19. Back posture education in elementary schoolchildren: a 2-year follow-up study.

    Science.gov (United States)

    Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

    2007-06-01

    Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in youngsters aged 13-14 years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters' lifestyles. At 2-year follow-up, the study sample included 94 secondary schoolchildren in the intervention group (mean age 13.3 +/- 0.8 years) and 101 controls (mean age 13.2 +/- 0.7 years). The back posture program that had been implemented for two school years consisted of back education and the stimulation of postural dynamism in the class through support and environmental changes. A questionnaire was completed comparable to the pretest, posttest and follow-up evaluations. The current study demonstrated at 2-year follow-up stability of the improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture knowledge in children who had received early back posture education. Back posture education did not result in increased fear-avoidance beliefs (F = 1.163, ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-reports for postural behavior, youngsters who had received the back posture program in the elementary school curriculum integrated crucial sitting and lifting principles conform to biomechanical favorable postural behavior. The steady intervention effects 2-year post-intervention demonstrated that intensive back posture education through the elementary school curriculum is effective till adolescence. Future research on the impact of early

  20. Maternal dioxin exposure and pregnancy outcomes over 30 years of follow-up in Seveso.

    Science.gov (United States)

    Wesselink, Amelia; Warner, Marcella; Samuels, Steven; Parigi, Aliza; Brambilla, Paolo; Mocarelli, Paolo; Eskenazi, Brenda

    2014-02-01

    Animal evidence suggests an association between exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and adverse pregnancy outcomes. Epidemiologic studies report inconsistent results, but are limited by narrow range of exposure, small sample size, and lack of a biologic measure of highest lifetime exposure. On July 10, 1976, a chemical explosion in Seveso, Italy resulted in the highest known residential exposure to TCDD. In 1996, we initiated the Seveso Women's Health Study (SWHS), a retrospective cohort of TCDD exposure and reproductive health. Individual-level TCDD was measured in serum collected soon after the explosion. After 20years of follow-up, we found no association between maternal TCDD in 1976 serum or estimated at pregnancy and spontaneous abortion (SAB), fetal growth, or gestational length. Here, we present an updated analysis of TCDD exposure and adverse pregnancy outcomes from a subsequent follow-up of the SWHS cohort in 2008-2009. SWHS women had 1211 post-explosion pregnancies through the 2008-2009 follow-up. We found no association between TCDD estimated at pregnancy and SAB, fetal growth, or gestational length. However, we found a non-significant inverse association between maternal 1976 serum TCDD and birthweight (adjusted β=-22.8, 95% CI: -80.1, 34.6). The association was stronger among first post-explosion births, but remained non-significant (adjusted β=-47.7, 95% CI: -107.3, 11.9). SWHS is the first study to be able to consider two potentially relevant measures of TCDD exposure: highest lifetime dose and in utero. Our results, although non-significant, suggest that highest dose may be more relevant in epidemiologic studies of TCDD and pregnancy outcomes.

  1. Two-Year Follow-Up of Bibliotherapy and Individual Cognitive Therapy for Depressed Older Adults

    Science.gov (United States)

    Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A. M.; Hubbard, Karen L.; Parnell, Marsha B.; Scogin, Forrest; Coates, Adriana

    2006-01-01

    This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre- and posttreatment scores with follow-up scores…

  2. Two-Year Follow-Up of Bibliotherapy and Individual Cognitive Therapy for Depressed Older Adults

    Science.gov (United States)

    Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A. M.; Hubbard, Karen L.; Parnell, Marsha B.; Scogin, Forrest; Coates, Adriana

    2006-01-01

    This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre- and posttreatment scores with follow-up scores…

  3. Acute Glomerulonephritis: A 7 Years Follow up of Children in Center of Iran

    Directory of Open Access Journals (Sweden)

    Mohsen Akhavan Sepahi

    2011-06-01

    Full Text Available Acute glomerulonephritis (AGN is a type of renal disease which indicates the inflammation of glomerulus and nephrons. This study was carried on 94 children, <15 years old with the diagnosis of AGN who were admitted to Qom and Yazd's hospitals between 2000 and 2006. Data were collected using hospital records on admission, progression notes and outpatient follow up. Among 94 patients, 55.3% were male and 44.6% were female. Mean age of patients was 8.2±2.7 years old. Acute post streptococcal glomerulonephritis (APSGN was reported in 92.5%, membranoproliferative glomerulonephritis in 4.2%, hemolytic uremic syndrome in 2.1% and IgA nephropathy in 1.06%. There was no significant differences between GN types and gender (P=0.54. Clinical manifestation included edema in 68.8%, oliguria in 36.3%, gross hematuria in 69.1%, HTN in 61.7% and anuria in 1.06%. Microscopic hematuria was detected in all patients. In the time of follow up none of patients had hypertension, 3.1% had proteinuria and 6.3% had microscopic hematuria. APSGN is the most common causes of AGN in Qom and Yazd's children. Early diagnosis and treatment of APSGN may protect children from long term morbidity and mortality and improve quality of life.

  4. Effectiveness and Persistence of Liraglutide Treatment Among Patients with Type 2 Diabetes Treated in Primary Care and Specialist Settings: A Subgroup Analysis from the EVIDENCE Study, a Prospective, 2-Year Follow-up, Observational, Post-Marketing Study.

    Science.gov (United States)

    Martinez, Luc; Penfornis, Alfred; Gautier, Jean-Francois; Eschwège, Eveline; Charpentier, Guillaume; Bouzidi, Amira; Gourdy, Pierre

    2017-03-01

    The objective of this subgroup analysis is to investigate the effectiveness of liraglutide in people with type 2 diabetes (T2D) treated within the primary care physician (PCP) and specialist care settings. EVIDENCE is a prospective, observational study of 3152 adults with T2D recently starting or about to start liraglutide treatment in France. We followed patients in the PCP and specialist settings for 2 years to evaluate the effectiveness of liraglutide in glycemic control and body weight reduction. Furthermore, we evaluated the changes in combined antihyperglycemic treatments, the reasons for prescribing liraglutide, patient satisfaction, and safety of liraglutide in these two treatment settings. After 2 years of follow-up, 477 out of 1209 (39.0%) of PCP and 297 out of 1398 (21.2%) of specialist-treated patients still used liraglutide and maintained the glycated hemoglobin (HbA1c) target of <7.0%. Significant reductions from baseline were observed in both PCP- and specialist-treated cohorts in mean HbA1c (-1.22% and -0.8%, respectively), fasting plasma glucose (FPG) concentration (-39 and -23 mg/dL), body weight (-4.4 and -3.8 kg), and body mass index (BMI) (-1.5 and -1.4 kg/m(2)), all p < 0.0001. Reductions in HbA1c and FPG were significantly greater among PCP- compared with specialist-treated patients, p < 0.0001 for both. Patient treatment satisfaction was also significantly increased in both cohorts. Reported gastrointestinal adverse events were less frequent among PCP-treated patients compared with specialist-treated patients (4.5% vs. 16.1%). Despite differences in demography and clinical characteristics of patients treated for T2D in PCP and specialty care, greater reduction in HbA1c and increased glycemic control durability were observed with liraglutide in primary care, compared with specialist care. These data suggest that liraglutide treatment could benefit patients in primary care by delaying the need for further treatment intensification

  5. Short-tem Post Renal Trasplant Follow-up at Madinah Al Munawarah.

    Science.gov (United States)

    Bernieh, B; Nezamuddin, N; Sirwal, I A; Wafa, A; Abbade, M A; Nasser, B; Al Razzaz, Z

    1999-01-01

    We reviewed the records of the renal transplant patients followed at our hospital to determine short-term outcome and complications. Sixty-five renal transplant patients, follow-up for two years were included in this study. Of these patients 40 (61.5%) were males, 33 (50.7%) were Saudis with mean age of 37.2 +/- 11.7 years. Donors were living related (LRD) in 23 (35%), living non-related (LNRD) in 27 (42%) and cadaveric (CAD) in 15 (23%). Thirty-two transplants were carried out at Medinah, 21 in India and the rest in other centers inside Saudi Arabia. Immunosuppression was based on a triple therapy (Cyclosporin, Azathioprine, and Prednisone). At two years, 52 (80%) patients were alive, with functioning graft in 31 (58%). Causes of death among 13 patients (11 LNRD & 2 CAD) were infections in 7 (54%), immediate post transplant in three (22.7%), acute myocardial infarction in two (15.7%), CVA in one (7.6%). Complications encountered were acute rejection (23 episodes) in 18 923.6%) patients, infections in 19 (25%), chronic rejection in 16 (21.5%), surgical in 13 917.1%), diabetes mellitus in 5 (6.5%) primary non-function in three (3.8%) and Kaposi Sarcoma in two (2.4%). Twenty-six (81.25%) out of 32 transplants performed in Madinah were functioning, four (12.5%) patients returned to dialysis and two (6.25%) patients died. Among the 21 transplants done in India 11 (52%) patients died, six (28.6%) returned to dialysis, and four (19.4%) had function deteriorated in all patients. We conclude that despite limitations, results of renal transplantation carried out at Madinah are encouraging on short-term basis. Live related transplant has a very good outcome, while commercial transplantation carries poor prognosis.

  6. Short-tem Post Renal Trasplant Follow-up at Madinah Al Munawarah

    Directory of Open Access Journals (Sweden)

    Bernieh Bassam

    1999-01-01

    Full Text Available We reviewed the records of the renal transplant patients followed at our hospital to determine short-term outcome and complications. Sixty-five renal transplant patients, follow-up for two years were included in this study. Of these patients 40 (61.5% were males, 33 (50.7% were Saudis with mean age of 37.2 ± 11.7 years. Donors were living related (LRD in 23 (35%, living non-related (LNRD in 27 (42% and cadaveric (CAD in 15 (23%. Thirty-two transplants were carried out at Medinah, 21 in India and the rest in other centers inside Saudi Arabia. Immunosuppression was based on a triple therapy (Cyclosporin, Azathioprine, and Prednisone. At two years, 52 (80% patients were alive, with functioning graft in 31 (58%. Causes of death among 13 patients (11 LNRD & 2 CAD were infections in 7 (54%, immediate post transplant in three (22.7%, acute myocardial infarction in two (15.7%, CVA in one (7.6%. Complications encountered were acute rejection (23 episodes in 18 923.6% patients, infections in 19 (25%, chronic rejection in 16 (21.5%, surgical in 13 917.1%, diabetes mellitus in 5 (6.5% primary non-function in three (3.8% and Kaposi Sarcoma in two (2.4%. Twenty-six (81.25% out of 32 transplants performed in Madinah were functioning, four (12.5% patients returned to dialysis and two (6.25% patients died. Among the 21 transplants done in India 11 (52% patients died, six (28.6% returned to dialysis, and four (19.4% had function deteriorated in all patients. We conclude that despite limitations, results of renal transplantation carried out at Madinah are encouraging on short-term basis. Live related transplant has a very good outcome, while commercial transplantation carries poor prognosis.

  7. Association between subjective memory complaints and nursing home placement: a four-year follow-up

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Siersma, Volkert; Waldemar, Gunhild

    2009-01-01

    OBJECTIVE: In order to evaluate whether elderly persons with subjective memory complaints may be regarded as a group of potentially vulnerable patients who need close follow-up, we investigated the risk of nursing home placement during a 4-year follow-up period. METHODS: Prospective cohort survey...... with 4-year follow-up in general practice. Cox proportional hazard models were used to examine the influence of risk factors on nursing home placement. RESULTS: A total 758 non-nursing home residents aged 65 years and older consulted the General Practitioners in October and November 2002 of whom 50...

  8. Suicide risk in schizophrenia – a follow-up study after 20 years ...

    African Journals Online (AJOL)

    Suicide risk in schizophrenia – a follow-up study after 20 years. ... South African Journal of Psychiatry. Journal Home · ABOUT ... Crosstabulations were then performed to identify factors associated with increased suicide risk. For those subjects ...

  9. Course of adolescent headache: 4-year annual face-to-face follow-up study

    OpenAIRE

    Karlı, Necdet; Bican, Aylin; Zarifoğlu, Mehmet

    2010-01-01

    The objective of this study is to investigate the course of the diagnosis and characteristics of headache in 12- to 17-year-old adolescents during a follow-up period of 4 years. Headache prevalence and characteristics, and even the type of headache show important changes during adolescence. The course of adolescent headache might reveal important insight into the pathophysiology of headache. Subjects who received a single headache diagnosis were invited to participate in a follow-up study con...

  10. Sleep complaints in adolescent depression: one year naturalistic follow-up study

    OpenAIRE

    Anna S. Urrila; Karlsson, Linnea; Kiviruusu, Olli; Pankakoski, Maiju; Pelkonen, Mirjami; Strandholm, Thea; Marttunen, Mauri; ,

    2014-01-01

    Background Sleep complaints are highly prevalent in adolescents suffering from major depressive disorder (MDD). The aims of this study were to describe the longitudinal course of sleep complaints, and to assess the association between sleep complaints and clinical outcome in a sample of adolescents with MDD during naturalistic follow-up. Methods A sample of adolescent outpatients (n = 166; age 13–19 years, 17.5% boys) diagnosed with MDD was followed-up during one year in naturalistic settings...

  11. Impact of follow-up consultations for ICU survivors on post-ICU syndrome

    DEFF Research Database (Denmark)

    Jensen, J. F.; Thomsen, Thordis; Overgaard, D

    2015-01-01

    /unpublished trials. Randomized controlled trials investigating post-ICU consultations in adults with outcomes such as quality of life (QOL), anxiety, depression, posttraumatic stress disorder (PTSD), physical ability, cognitive function, and return to work were included. Two reviewers extracted data and assessed...... ratio 0.49, 95 % CI 0.26-0.95). There was no effect on other outcomes. CONCLUSIONS: The evidence indicates that follow-up consultations might reduce symptoms of PTSD at 3-6 months after ICU discharge in ICU survivors, but without affecting QOL and other outcomes investigated. This review highlights...

  12. Venous coronary artery bypass surgery: a more than 20-year follow-up study.

    Science.gov (United States)

    van Brussel, B L; Voors, A A; Ernst, J M P G; Knaepen, P J; Plokker, H W M

    2003-05-01

    Atherosclerosis in venous coronary artery bypass grafts begins early and accelerates from the fifth post-operative year. We studied the influence of 18 variables existing at the time of operation, and of 'classical' risk factors present at 1 and 5 years after operation on the long-term outcome of this type of surgery. Four hundred twenty-eight consecutive patients who underwent isolated venous coronary bypass surgery between April 1, 1976 and April 1, 1977 were followed prospectively. Follow-up was 99.3% complete with a mean duration of 22.8 years for the survivors. Multivariate analysis was performed using the Cox regression model. Actuarial survival after 5, 10, 15 and 20 years is 95, 83, 63 and 47%, respectively. The cumulative probability of event-free survival for cardiac death, acute myocardial infarction and re-intervention at 5, 10, 15 and 20 years, respectively, are 98, 90, 74, 60%; 99, 91, 83, 77%; and 97, 86, 67, 57%. Age and left ventricular functions are continuous incremental risk factors for mortality. Left ventricular function and completeness of revascularization, and age and vessel disease are independent predictors of cardiac death and re-intervention, respectively. Hypertension, diabetes mellitus, hypertriglyceridemia, obesity and smoking, present after operation have an independent influence on the occurrence of cardiac events. Risk factors (still) existing 1 and 5 years after operation have a negative influence on the long-term results. This emphasizes the need of treatment of these 'classical' risk factors still present after operation.

  13. Group versus individual cognitive treatment for Obsessive-Compulsive Disorder: changes in non-OCD symptoms and cognitions at post-treatment and one-year follow-up.

    Science.gov (United States)

    Belloch, Amparo; Cabedo, Elena; Carrió, Carmen; Fernández-Alvarez, Héctor; García, Fernando; Larsson, Christina

    2011-05-15

    Current cognitive approaches postulate that obsessions and compulsions are caused and/or maintained by misinterpretations about their meaning. This assumption has led to the development of cognitive therapeutic (CT) procedures designed to challenge the dysfunctional appraisals and beliefs patients have about their obsessions. Nonetheless, few studies have compared the efficacy of individual and group CT in changing the dysfunctional cognitions that hypothetically underlie Obsessive-Compulsive Disorder (OCD). In this study, 44 OCD patients were assigned to individual (n=18) or group (n=24) CT. Sixteen completed the individual CT, and 22 completed the group CT. The effects of the two CT conditions on depression and worry tendencies were comparable. Individual treatment was more effective than group treatment in decreasing scores on dysfunctional beliefs (responsibility, overestimation of threat, and intolerance to uncertainty) and the use of suppression as a thought control strategy. The post-treatment changes were maintained one year later. The correlations between symptom improvement (OCD severity change) and belief changes were moderate: in the individual treatment the greatest associations were with beliefs about thoughts (importance and control), whereas in the group treatment the greatest associations were with beliefs related to anxiety in general (threat overestimation and intolerance to uncertainty). Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Behavioural treatment of trichotillomania : two-year follow-up results : predictors of treatment outcome

    NARCIS (Netherlands)

    Keijsers, G.P.J.; Minnen, A. van; Hoogduin, C.A.L.; Klaassen, B.N.W.; Hendriks, G.J.; Tanis-Jacobs, J.

    2006-01-01

    Post-treatment evaluation studies of behaviour therapy (BT) for trichotillomania (TTM) have shown that BT is successful in reducing symptoms in this impulse-control disorder. The present study was aimed at investigating gain maintenance at long-term follow-up. TTM-related symptoms and other symptom

  15. A Prospective Controlled Study of Living Kidney Donors: Three-Year Follow-up

    Science.gov (United States)

    Kasiske, Bertram L.; Anderson-Haag, Teresa; Israni, Ajay K.; Kalil, Roberto S.; Kimmel, Paul L.; Kraus, Edward S.; Kumar, Rajiv; Posselt, Andrew A.; Pesavento, Todd E.; Rabb, Hamid; Steffes, Michael W.; Snyder, Jon J.; Weir, Matthew R.

    2015-01-01

    Background There have been few prospective controlled studies of kidney donors. Understanding the pathophysiological effects of kidney donation is important for judging donor safety and for improving our understanding of the consequences of reduced kidney function in chronic kidney disease. Study Design Prospective, controlled, observational cohort study. Setting & Participants Three-year follow-up of kidney donors and paired controls suitable for donation at their donor’s center. Predictor Kidney donation. Outcomes Medical history, vital signs, glomerular filtration rate and other measurements at 6, 12, 24 and 36 months after donation. Results At 36 months, 182 of 203 (89.7%) original donors and 173 of 201 (86.1%) original controls continue to participate in follow-up visits. The linear slope of the glomerular filtration rate measured by plasma iohexol clearance declined 0.36±7.55 mL/min per year in 194 controls, but increased 1.47±5.02 mL/min per year in 198 donors (P = 0.005) between 6 and 36 months. Blood pressure was not different between donors and controls at any visit, and at 36 months all 24-hour ambulatory blood pressure parameters were similar in 126 controls and 135 donors (mean systolic: 120.0±11.2 [SD] v. 120.7±9.7 mmHg [P=0.6]; mean diastolic: 73.4±7.0 v. 74.5±6.5 mmHg [P=0.2]). Mean arterial pressure nocturnal dipping was manifest in 11.2%±6.6% of controls and 11.3%±6.1% donors (P=0.9). Urinary protein-creatinine and albumin-creatinine ratios were not increased in donors compared to controls. From 6 to 36 months post-donation, serum parathyroid hormone, uric acid, homocysteine and potassium levels were higher, whereas hemoglobin was lower in donors compared to controls. Limitations Possible bias resulting from an inability to select controls screened to be as healthy as donors, short follow-up duration, and drop-outs. Conclusions Kidney donors manifest several of the findings of mild chronic kidney disease. However, at 36 months after

  16. Outcome of knee injuries in general practice: 1-year follow-up

    OpenAIRE

    2010-01-01

    Background Knee injuries may lead to pain and to functional limitations in the activities of daily living. Patients with knee injuries are frequently seen in general practice; however, the outcome and management in these patients is not known. Aim To assess the outcome and management of knee injuries at 12 months' follow-up in general practice. Design of study A prospective observational cohort study with a 1-year follow-up. Setting. Primary health care. Method Adult patients consulting their...

  17. Depressive symptoms in first-episode psychosis: a 10-year follow-up study.

    Science.gov (United States)

    Sönmez, Nasrettin; Røssberg, Jan Ivar; Evensen, Julie; Barder, Helene Eidsmo; Haahr, Ulrik; Ten Velden Hegelstad, Wenche; Joa, Inge; Johannessen, Jan Olav; Langeveld, Hans; Larsen, Tor Ketil; Melle, Ingrid; Opjordsmoen, Stein; Rund, Bjørn Rishovd; Simonsen, Erik; Vaglum, Per; McGlashan, Thomas; Friis, Svein

    2016-06-01

    The present study examined if any patient characteristics at baseline predicted depressive symptoms at 10 years and whether patients prone to depressive symptoms in the first year of treatment had a different prognosis in the following years. A total of 299 first-episode psychosis (FEP) patients with schizophrenia spectrum disorders were assessed for depressive symptoms with PANSS depression item (g6) at baseline, and 1, 2, 5 and 10 years of follow up. At 10 years, depressive symptoms were also assessed with Calgary Depression Scale for Schizophrenia (CDSS). A PANSS g6 ≥ 4 and CDSS score ≥ 6 were used as a cut-off score for depression. A total of 122 (41%) patients were scored as depressed at baseline, 75 (28%) at 1 year, 50 (20%) at 2 years, 33 (16%) at 5 years, and 35 (19%) at 10 years of follow up. Poor childhood social functioning and alcohol use at baseline predicted depression at 10 years of follow up. Thirty-eight patients were depressed at both baseline and 1 year follow up. This group had poorer symptomatic and functional outcome in the follow-up period compared to a group of patients with no depression in the first year of treatment. Depressive symptoms are frequent among FEP patients at baseline but decrease after treatment because their general symptoms have been initiated. Patients with poor social functioning in childhood and alcohol use at baseline are more prone to have depressive symptoms at 10 years of follow up. Patients struggling with depressive symptoms in the first year of treatment should be identified as having poorer long-term prognosis. © 2014 Wiley Publishing Asia Pty Ltd.

  18. Four years follow-up of 101 children with melamine-related urinary stones.

    Science.gov (United States)

    Yang, Li; Wen, Jian Guo; Wen, Jian Jun; Su, Zhi Qiang; Zhu, Wen; Huang, Chen Xu; Yu, Si Long; Guo, Zhan

    2013-06-01

    The melamine-contaminated milk powder incidence occurred in China in 2008. Many studies have been published regarding the epidemiology, clinical symptoms, diagnosis and treatment of melamine-related urinary stones. The objective of this study is to follow-up the effects of melamine-contaminated milk powder consumption on kidney and body growth in children with melamine-related urinary stones 4 years ago. One hundred and one children with melamine-related urinary stones were followed up by urinalysis, renal function tests and urinary ultrasonography. The data of body weight and height, clinical signs and complications were collected. Eighty normal children without the history of consuming melamine-contaminated milk powder were collected as controls. Eighty-one children with melamine-related urinary stones were successfully followed up. Of 45 cases with melamine-related urinary stones treated conservatively after discharge, 34 disappeared completely, 6 dissolved partially, 1 increased in size and 4 did not change at 4 years follow-up. The percentages of under-height and under-weight infants were significantly higher in melamine-related urinary stones group compared to the controls, respectively (p urinary stones on kidney and bladder was found at 4 years follow-up. However, whether or not melamine-related urinary stones had effect on body growth needs follow-up in future.

  19. Dr. Leary's Concord Prison Experiment: a 34-year follow-up study.

    Science.gov (United States)

    Doblin, R

    1998-01-01

    This study is a long-term follow-up to the Concord Prison Experiment, one of the best-known studies in the psychedelic psychotherapy literature. The Concord Prison Experiment was conducted from 1961 to 1963 by a team of researchers at Harvard University under the direction of Timothy Leary. The original study involved the administration of psilocybin-assisted group psychotherapy to 32 prisoners in an effort to reduce recidivism rates. This follow-up study involved a search through the state and federal criminal justice system records of 21 of the original 32 subjects, as well as personal interviews with two of the subjects and three of the researchers: Timothy Leary, Ralph Metzner and Gunther Weil. The results of the follow-up study indicate that published claims of a treatment effect were erroneous. This follow-up study supports the emphasis in the original reports on the necessity of embedding psilocybin-assisted psychotherapy with inmates within a comprehensive treatment plan that includes post-release, nondrug group support programs. Despite substantial efforts by the experimental team to provide post-release support, these services were not made sufficiently available to the subjects in this study. Whether a new program of psilocybin-assisted group psychotherapy and post-release programs would significantly reduce recidivism rates is an empirical question that deserves to be addressed within the context of a new experiment.

  20. Short-tem Post Renal Trasplant Follow-up at Madinah Al Munawarah

    OpenAIRE

    Bernieh Bassam; Nezamuddin Nabil; Sirwal Irshad; Wafa Adel; Abbade M; Nasser Baker; Al Razzaz Zakaria

    1999-01-01

    We reviewed the records of the renal transplant patients followed at our hospital to determine short-term outcome and complications. Sixty-five renal transplant patients, follow-up for two years were included in this study. Of these patients 40 (61.5%) were males, 33 (50.7%) were Saudis with mean age of 37.2 ± 11.7 years. Donors were living related (LRD) in 23 (35%), living non-related (LNRD) in 27 (42%) and cadaveric (CAD) in 15 (23%). Thirty-two tra...

  1. Research Update: Two-Year Follow-up Report for the Wilderness Therapy Program.

    Science.gov (United States)

    Davis-Berman, Jennifer; Berman, Dene S.

    1994-01-01

    Follow-up surveys of 23 adolescent participants in the Wilderness Therapy Program examined self-efficacy, behavioral symptoms, and locus of control at 4 months, 1 year, and 2 years after the program. Results suggest a regression to pretest levels at 4 months, with a return to the original posttest change levels at 1 and 2 years. (Author/SV)

  2. Internet-based treatment of pathological gambling with a three-year follow-up.

    Science.gov (United States)

    Carlbring, Per; Degerman, Nicklas; Jonsson, Jakob; Andersson, Gerhard

    2012-01-01

    Effective therapies for pathological gambling exist, but their use is limited to about 10% of the target population. In an attempt to lower the barriers for help, Internet-based cognitive behavioural therapy (ICBT) has been shown to be effective when delivered to a non-depressed sample with pathological gambling. This study sought to extend this finding to a larger, more representative population, and also test a model to predict responder status. Following advertisement, a total of 284 participants started an 8-week ICBT programme with minimal therapist contact via e-mail and weekly telephone calls of less than 15 min. The average time spent on each participant, including telephone conversations, e-mail, and administration, was 4 h. In addition to a mixed effects model to evaluate the effectiveness of the treatment, two logistic regression analyses were performed with the following eight pre-defined response predictor variables: work-life satisfaction, primary gambling activity, debts due to gambling, social support, personal yearly salary, alcohol consumption, stage of change, and dissociative gambling. ICBT resulted in statistically significant reductions in the scores of pathological gambling, anxiety, and depression as well as an increase in quality of life compared to pre-treatment levels. Follow-ups carried out in the treatment group at 6, 18, and 36 months indicated that treatment effects were sustained. Using the eight predictor variable model rendered an acceptable predictive ability to identify responders both at post-test (AUC = .72, p < .01) and at 36-month follow-up (AUC = .70, p < .01). We conclude that ICBT for pathological gamblers, even if depressed, can be effective and that outcome can partly be predicted by pre-treatment characteristics.

  3. Postural education program for elementary school: a one-year follow-up study

    Directory of Open Access Journals (Sweden)

    Alexandre Luis Ritter

    2015-09-01

    Full Text Available AbstractThe objective of this study was to verify the short- and long-term effectiveness of the Elementary School Postural Program in the performance, generalization, and perception of daily school activities. The final sample consisted of 61 subjects divided into experimental (14 years ±0.93; ♀=22; ♂=10 and control group (15.38 years ±0.97; ♀=16; ♂=13, all participants attended a Brazilian public school in Porto Alegre, State of Rio Grande do Sul. The postural program included 20 sessions over a 10-week period. In each session, participants discussed and practiced routine actions that typically occurred at schools. Eight other meetings were required for the completion of the pre- and post-tests. The experimental group performed significantly better than the control group in the short-term evaluations, although there were no significant statistical differences in the long-term follow-up evaluations. The children demonstrated a good behavioral response to the postural program; nevertheless, the knowledge had not been completely mastered after a year.

  4. Radiofrequency Ablation of Renal Tumors: Four-Year Follow-Up Results in 47 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soo Dong; Yoon, Seong Guk; Sung, Gyung Tak [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2012-09-15

    To retrospectively evaluate the intermediate results of radiofrequency ablation (RFA) of small renal masses (SRMs). Percutaneous or laparoscopic RFA was performed on 48 renal tumors in 47 patients. The follow-up studies included a physical examination, chest radiography, creatinine level, and contrast-enhanced CT or MRI. To confirm the pathologic criteria of complete ablation, 35 patients underwent a follow-up biopsy. Recurrence was defined as contrast enhancement on imaging studies after 3 months, lesion growth at subsequent imaging, or viable cancer cells on follow-up biopsy. Technical success was achieved in 43 (89.6%) of 48 renal tumors. The mean tumor size was 2.3 cm and the mean follow-up period was 49.6 months. Repeated RFA was necessary in 5 tumors due to incomplete ablation. The overall complication rate was 35.8%, of which 96.2% were mild complications. Serum creatinine levels at 12 months after RFA did not differ from those before RFA (1.28 vs. 1.36 mg/dL). Four patients were found to have recurrence at various follow-up intervals, and distant metastasis was not found in any cases. RFA appears to be a useful treatment for selected patients with SRMs. Our 4-year follow-up results disclose an excellent therapeutic outcome with RFA, while achieving effective local tumor control.

  5. Measures and time points relevant for post-surgical follow-up in patients with inflammatory arthritis: a pilot study

    Directory of Open Access Journals (Sweden)

    Tägil Magnus

    2009-05-01

    Full Text Available Abstract Background Rheumatic diseases commonly affect joints and other structures in the hand. Surgery is a traditional way to treat hand problems in inflammatory rheumatic diseases with the purposes of pain relief, restore function and prevent progression. There are numerous measures to choose from, and a combination of outcome measures is recommended. This study evaluated if instruments commonly used in rheumatologic clinical practice are suitable to measure outcome of hand surgery and to identify time points relevant for follow-up. Methods Thirty-one patients (median age 56 years, median disease duration 15 years with inflammatory rheumatic disease and need for post-surgical occupational therapy intervention formed this pilot study group. Hand function was assessed regarding grip strength (Grippit, pain (VAS, range of motion (ROM (Signals of Functional Impairment (SOFI and grip ability (Grip Ability Test (GAT. Activities of daily life (ADL were assessed by means of Disabilities of the Arm, Shoulder and Hand Outcome (DASH and Canadian Occupational Performance Measure (COPM. The instruments were evaluated by responsiveness and feasibility; follow-up points were 0, 3, 6 and 12 months. Results All instruments showed significant change at one or more follow-up points. Satisfaction with activities (COPM showed the best responsiveness (SMR>0.8, while ROM measured with SOFI had low responsiveness at most follow-up time points. The responsiveness of the instruments was stable between 6 and 12 month follow-up which imply that 6 month is an appropriate time for evaluating short-term effect of hand surgery in rheumatic diseases. Conclusion We suggest a core set of instruments measuring pain, grip strength, grip ability, perceived symptoms and self-defined daily activities. This study has shown that VAS pain, the Grippit instrument, GAT, DASH symptom scale and COPM are suitable outcome instruments for hand surgery, while SOFI may be a more insensitive

  6. Brazilian hepatitis B vaccine: a six-year follow-up in adolescents

    Directory of Open Access Journals (Sweden)

    Kamilla Vêncio Frauzino Alexandre

    2012-12-01

    Full Text Available The protective anti-HBs titres were examined six-year post-immunisation with the Brazilian recombinant hepatitis B vaccine. After the primary vaccination, all adolescents (n = 89 responded with protective anti-HBs titres and had a geometric mean titre (GMT of 4031.8 mIU/mL. In 2010, 94.5% maintained protective anti-HBs (> 10 mIU/mL antibodies, with a GMT of 236.0 mIU/mL. A positive correlation was observed between the anti-HBs titres after the primary vaccination and the titres at the six-year follow-up (p < 0.01. Eleven subjects showed anti-HBs titres suggestive of a natural booster. Prostitution and tattoos/piercings were marginally associated with natural boosters in the multivariate analysis. This study showed the first data on anti-HBs persistence following the Brazilian hepatitis B vaccine in sexually active individuals and highlights its effectiveness in the medium term.

  7. Randomized Trial of Treatment for Children with Sexual Behavior Problems: Ten-Year Follow-Up

    Science.gov (United States)

    Carpentier, Melissa Y.; Silovsky, Jane F.; Chaffin, Mark

    2006-01-01

    This study prospectively follows 135 children 5-12 years of age with sexual behavior problems from a randomized trial comparing a 12-session group cognitive-behavioral therapy (CBT) with group play therapy and follows 156 general clinic children with nonsexual behavior problems. Ten-year follow-up data on future juvenile and adult arrests and…

  8. Predictors of ADHD Persistence in Girls at 5-Year Follow-Up

    Science.gov (United States)

    Mick, Eric; Byrne, Deirdre; Fried, Ronna; Monuteaux, Michael; Faraone, Stephen V.; Biederman, Joseph

    2011-01-01

    Objective: The main aim of this study was to examine the age-dependent remission from ADHD in girls transitioning through childhood into adolescence and early adulthood. Method: We conducted a 5-year prospective follow-up study of 123 girls with ADHD and 106 non-ADHD control girls aged between 6 and 17 years at ascertainment. ADHD was considered…

  9. Implant-based rehabilitation of a large mandibular odontogenic keratocyst with 7-year follow-up

    Directory of Open Access Journals (Sweden)

    Janardan B Garde

    2010-01-01

    Full Text Available Odontogenic keratocyst is a unique cyst because of its locally aggressive behavior, high recurrence rate, and characteristic histological appearance. In this case report we present a 25-year-old male patient with a large odontogenic keratocyst and treatment with enucleation and chemical cauterization followed by dental implants with a 7-year follow-up.

  10. Neurocognitive development in first episode psychosis 5 years follow-up

    DEFF Research Database (Denmark)

    Barder, Helene Eidsmo; Sundet, Kjetil; Rund, Bjørn Rishovd

    2013-01-01

    Cognitive deficits are documented in first-episode psychosis (FEP), but the continuing course is not fully understood. The present study examines the longitudinal development of neurocognitive function in a five year follow-up of FEP-patients, focusing on the relation to illness severity, as meas......Cognitive deficits are documented in first-episode psychosis (FEP), but the continuing course is not fully understood. The present study examines the longitudinal development of neurocognitive function in a five year follow-up of FEP-patients, focusing on the relation to illness severity...

  11. Maturogenesis of Two Maxillary Central Incisors: A Case Report with 10 Years of Follow Up.

    Science.gov (United States)

    Ghorbanzadeh, Abdollah; Ghorbanzadeh, Atiyeh

    2015-04-01

    This case report describes the treatment of two immature maxillary central incisors in a 7-year-old female patient. She suffered complicated crown fracture because of trauma, and the root formation was incomplete. White mineral trioxide aggregate (MTA) was selected as the pulp-capping material after cervical pulpotomy to preserve the pulp tissue vitality and achieve maturogenesis. Follow-up evaluations showed successful treatment in terms of preservation of pulp vitality and demonstrated marked continuous physiological root development. During 10 years of follow-up, both teeth were clinically asymptomatic, and radiographic evaluations showed apparent root regeneration with apical root-end closure without pulp or periapical pathosis.

  12. Ameloblastic fibroma: a rare case report with 7-year follow-up.

    Science.gov (United States)

    Melo, Leonardo de Araújo; Barros, Adna Conceição; Sardinha, Sandra de Cássia Santana; Cerqueira, Arlei; dos Santos, Jean Nunes

    2015-01-01

    Ameloblastic fibroma (AF) is a rare benign odontogenic tumor that usually occurs in the fi two decades of life. It affects adolescents and young adults and is found in the mandible and with a high frequency in the posterior region of this segment. There are rare case reports with a long-term follow-up. We report the case of a 6-year-old boy with extensive ameloblastic fibroma in the man ble. Treatment consisted of enucleation and bone curettage, with the preservation of permanent teE adjacent to the tumor. Clinical and radiographic follow-up of the patient over a period of 7 years show no signs of recurrence or malignant transformation. Patients with AF should be under follow-up for prolonged periods of time, even in ca! exhibiting a low proliferation index, because of the potential for recurrence and malignant transformation of this tumor.

  13. Ameloblastic fibroma: A rare case report with 7-year follow-up

    Directory of Open Access Journals (Sweden)

    de Araújo Melo Leonardo

    2015-01-01

    Full Text Available Introduction. Ameloblastic fibroma (AF is a rare benign odontogenic tumor that usually occurs in the first two decades of life. It affects adolescents and young adults and is found in the mandible and with a higher frequency in the posterior region of this segment. There are rare case reports with a long-term follow-up. Case Outline. We report the case of a 6-year-old boy with extensive ameloblastic fibroma in the mandible. Treatment consisted of enucleation and bone curettage, with the preservation of permanent teeth adjacent to the tumor. Clinical and radiographic follow-up of the patient over a period of 7 years showed no signs of recurrence or malignant transformation. Conclusion. Patients with AF should be under follow-up for prolonged periods of time, even in cases exhibiting a low proliferation index, because of the potential for recurrence and malignant transformation of this tumor.

  14. Six-Year Experience of a Nurse-Led Colorectal Cancer Follow-Up Clinic

    Directory of Open Access Journals (Sweden)

    Hasan Al Chalabi

    2014-01-01

    Full Text Available Aims and Objectives. To review the experience of a nurse-led colorectal cancer follow-up clinic in a tertiary referral colorectal cancer centre. Methodology. Data from the nurse-led colorectal cancer follow-up clinic in our unit was prospectively maintained in a colorectal cancer database. Data was analysed from January 1, 2006 until the December 31, 2011. Results. 1125 patients were diagnosed with colorectal cancer, and referred to our unit as a tertiary centre for specialised colorectal cancer. Nine hundred and four patients had surgical resection of their colorectal cancer. Four hundred and seven patients were referred to the nurse-led colorectal cancer clinic for surveillance. The mean age of the patient cohort was 67 years (range 32–88 and 56% of patients were male. One hundred and seventeen patients were discharged to their general practitioner having been disease free after 5 years of followup. Fifty-four patients were diagnosed with either local or distant recurrence. Conclusion. A nurse-led colorectal cancer follow-up clinic is running according to strict follow-up protocols. This type of clinic significantly reduces the number of routine follow-up patients that have to be seen by the colorectal surgical consultant.

  15. Six-year experience of a nurse-led colorectal cancer follow-up clinic.

    Science.gov (United States)

    Al Chalabi, Hasan; O'Riordan, James M; Richardson, Alex; Flannery, Delia; O'Connor, Katrina; Stuart, Charlotte; Larkin, John; McCormick, Paul; Mehigan, Brian

    2014-01-01

    Aims and Objectives. To review the experience of a nurse-led colorectal cancer follow-up clinic in a tertiary referral colorectal cancer centre. Methodology. Data from the nurse-led colorectal cancer follow-up clinic in our unit was prospectively maintained in a colorectal cancer database. Data was analysed from January 1, 2006 until the December 31, 2011. Results. 1125 patients were diagnosed with colorectal cancer, and referred to our unit as a tertiary centre for specialised colorectal cancer. Nine hundred and four patients had surgical resection of their colorectal cancer. Four hundred and seven patients were referred to the nurse-led colorectal cancer clinic for surveillance. The mean age of the patient cohort was 67 years (range 32-88) and 56% of patients were male. One hundred and seventeen patients were discharged to their general practitioner having been disease free after 5 years of followup. Fifty-four patients were diagnosed with either local or distant recurrence. Conclusion. A nurse-led colorectal cancer follow-up clinic is running according to strict follow-up protocols. This type of clinic significantly reduces the number of routine follow-up patients that have to be seen by the colorectal surgical consultant.

  16. Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up.

    Science.gov (United States)

    Eddy, Kamryn T; Tabri, Nassim; Thomas, Jennifer J; Murray, Helen B; Keshaviah, Aparna; Hastings, Elizabeth; Edkins, Katherine; Krishna, Meera; Herzog, David B; Keel, Pamela K; Franko, Debra L

    2017-02-01

    The course of eating disorders is often protracted, with fewer than half of adults achieving recovery from anorexia nervosa or bulimia nervosa. Some argue for palliative management when duration exceeds a decade, yet outcomes beyond 20 years are rarely described. This study investigates early and long-term recovery in the Massachusetts General Hospital Longitudinal Study of Anorexia and Bulimia Nervosa. Females with DSM-III-R/DSM-IV anorexia nervosa or bulimia nervosa were assessed at 9 and at 20 to 25 years of follow-up (mean [SD] = 22.10 [1.10] years; study initiated in 1987, last follow-up conducted in 2013) via structured clinical interview (Longitudinal Interval Follow-Up Evaluation of Eating Disorders [LIFE-EAT-II]). Seventy-seven percent of the original cohort was re-interviewed, and multiple imputation was used to include all surviving participants from the original cohort (N = 228). Kaplan-Meier curves estimated recovery by 9-year follow-up, and McNemar test examined concordance between recovery at 9-year and 22-year follow-up. At 22-year follow-up, 62.8% of participants with anorexia nervosa and 68.2% of participants with bulimia nervosa recovered, compared to 31.4% of participants with anorexia nervosa and 68.2% of participants with bulimia nervosa by 9-year follow-up. Approximately half of those with anorexia nervosa who had not recovered by 9 years progressed to recovery at 22 years. Early recovery was associated with increased likelihood of long-term recovery in anorexia nervosa (odds ratio [OR] = 10.5; 95% CI, 3.77-29.28; McNemar χ²₁ = 31.39; P bulimia nervosa (OR = 1.0; 95% CI, 0.49-2.05; McNemar χ²₁ = 0; P = 1.0). At 22 years, approximately two-thirds of females with anorexia nervosa and bulimia nervosa were recovered. Recovery from bulimia nervosa happened earlier, but recovery from anorexia nervosa continued over the long term, arguing against the implementation of palliative care for most individuals with eating disorders.

  17. Complications of Aortic Stenting in Patients below 20 Years Old: Immediate and Intermediate Follow-Up

    Directory of Open Access Journals (Sweden)

    Akbar Molaei

    2011-12-01

    Full Text Available Background: Optimal timing and mode of treatment for patients with coarctation of the aorta (COA remain controversial, particularly in children. Surgery, balloon dilatation, and stent implantation have all proven effective in the treatment of moderate or severe obstruction. The aim of this study was to investigate the complications of COA stenting angioplasty in pediatric patients. Methods: This retrospective, descriptive study was conducted on patients less than 20 years of age who underwent aortic stenting angioplasty because of congenital COA in the pediatric catheterization laboratory of Rajaie cardiovascular, medical and research Center, Tehran between 2005 and 2010. Results: A total of 26 patients (18 [65.4%] males and 9 [34.6%] females with congenital COA who had undergone aortic stenting angioplasty were recruited. Nineteen (73.1% of these patients had native COA and 7 (26.9% had recurrent COA. Most of the early complications were minor and temporary; only one patient developed early major complications. During the follow-up, whereas none of the native group patients developed late complications, in the re-COA group 28.57% of the patients had re-stenosis and 14.28% had chronic systemic hypertension, requiring drug therapy. Conclusion: Our investigation into post-stenting complications in patients with native COA and re-COA showed that endovascular stenting could be an effective and safe method, even in young patients with native COA.

  18. [Poor results in 183 threaded acetabular cups at a mean 7 years follow-up].

    Science.gov (United States)

    Lecestre, P; Poilbout, P; Dambreville, A; Vial, D

    1995-12-01

    We reviewed 183 threaded rings at a mean 7 years follow-up. Poor résults are frequent: 34 % had been revised and 50 % have radiographic migration, essentially with proximal migration of the cup. Generally, we reoperated with other cememtless implants. The type of threaded cup does not matter (spheric or conic). Only the duration of follow up seems significant. We think that biomecanical strains, rather than physiology, explain these numerous migrations. We have therefore abandoned threaded cups in favour of porous-coated impacted cups.

  19. Clinical treatment of a ruptured temporomandibular joint disc: morphological changes at 5-year follow-up.

    Science.gov (United States)

    Cardinal, Lucas; Porto, Felipe; Agarwal, Sachin; Grossman, Eduardo

    2014-01-01

    Osteoarthrosis is a disease that affects the temporomandibular joint (TMJ). This case report chronicles the diagnosis and treatment of a patient for whom this pathological condition was accompanied by a rupture of the articular disc. The patient presented with loud sounds in the left TMJ and an irregular mandibular occlusal plane due to condylar intrusion in the glenoid fossa on the ipsilateral side. A noninvasive treatment was selected. A 4-month follow-up revealed remission of the articular sounds, and tissue regeneration was noted. These improvements remained visible at 5-year follow-up.

  20. Reactive attachment disorder in maltreated twins follow-up: from 18 months to 8 years.

    Science.gov (United States)

    Heller, Sherryl Scott; Boris, Neil W; Fuselier, Sarah-Hinshaw; Page, Timothy; Koren-Karie, Nina; Miron, Devi

    2006-03-01

    The best means for the diagnosis and treatment of reactive attachment disorder of infancy and early childhood have not been established. Though some longitudinal data on institutionalized children is available, reports of maltreated young children who are followed over time and assessed with measures of attachment are lacking. This paper presents the clinical course of a set of maltreated fraternal twins who were assessed and treated from 19 months to 30 months of age and then seen in follow-up at 3 and 8 years of age. A summary of the early assessment and course is provided and findings from follow-up assessments of the cognitive, behavioral, and interpersonal functioning of each child is analysed. Follow-up measures, chosen to capture social-cognitive processing of these children from an attachment perspective, are highlighted. Finally, findings from the case are discussed from nosological and theoretical perspectives.

  1. Process skill rather than motor skill seems to be a predictor of costs for rehabilitation after a stroke in working age; a longitudinal study with a 1 year follow up post discharge

    Directory of Open Access Journals (Sweden)

    Björkdahl Ann

    2007-12-01

    Full Text Available Abstract Background In recent years a number of costs of stroke studies have been conducted based on incidence or prevalence and estimating costs at a given time. As there still is a need for a deeper understanding of factors influencing these costs the aim of this study was to calculate the direct and indirect costs in a younger ( Methods Fifty-eight patients included in a study of home rehabilitation and followed for 1 year after discharge from the rehabilitation unit, were interviewed about their use of health care services, assistance, medications and assistive devices. Costs (defined as the cost for society were calculated. A linear regression of cost and variables of functioning, ability, community integration and health-related quality of life was done. Results Inpatient care contributed substantially to the direct cost with a mean length of stay of 92 days. Rehabilitation during the first year constituted of an average of 28 days in day clinics, 38 physiotherapy sessions and 20 occupational therapy sessions. The total direct mean cost was 80 020 € and the indirect cost 35 129 €. The direct costs were influenced by the process skill (the ability to plan and perform a given task and to adapt when needed and presence of aphasia. Indirect costs for informal care giving increased for patients with a lower health-related quality of life as well as a low score on home integration. Conclusion Costs are high in this group of young (

  2. A Four-Year Follow-Up Study of Underachieving College Freshmen

    Science.gov (United States)

    Valine, Warren J.

    1976-01-01

    A four-year follow-up study of underachieving college freshmen measured changes in the self-concept of those still in college and those who had dropped out. Significant differences generally favored college seniors. Findings also indicate that dropping out of college may be a positive experience. (Author)

  3. Loneliness, Social Networks, and Mortality: 18 Years of Follow-up

    Science.gov (United States)

    Iecovich, Esther; Jacobs, Jeremy M.; Stessman, Jochanan

    2011-01-01

    We examined the influence of changes in loneliness and social support networks upon mortality during 18 years of follow-up among an elderly cohort and determined the gender-specific nature of this relationship. The study is based on data collected from the Jerusalem Longitudinal Study (1990-2008), which has followed a representative sample of 605…

  4. Psychiatric severity and mortality in substance abusers. A 15 year follow-up

    DEFF Research Database (Denmark)

    Fridell, Mats; Hesse, Morten

    2006-01-01

    on the Symptom Checklist 90 [SCL-90] Global Severity Index, lower meaningfulness on the Sense of Coherence scale, and lower Global Assessment of Functioning [GAF] scores at 5-year follow-up. By contrast, there were no associations between baseline drug use and antisocial personality disorder diagnoses...

  5. Intranasal LH-RH treatment of cryptorchidism. A clinical trial and 5 years follow-up

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Mauritzen, K; Skakkebaek, N E

    1987-01-01

    The effect of intranasal LH-RH on cryptorchidism was investigated in 45 prepubertal boys with 68 undescended testes. A daily dose of 1.2 mg LH-RH was given for 4 weeks. A total of 16 testes (24%) descended. Follow-up examination 5 years later showed that relapse had occurred in two cases. Fifty-t...

  6. Subjective quality of life in first-episode psychosis. A ten year follow-up study

    DEFF Research Database (Denmark)

    Gardsjord, Erlend Strand; Romm, Kristin Lie; Friis, Svein;

    2016-01-01

    patients with a first episode psychotic disorder was included from 1997 through 2000. At 10year follow-up 186 patients participated. QoL was measured by the Lehman's Quality of Life Interview. Linear mixed model analyses were performed to investigate longitudinal effects of baseline psychiatric symptoms...

  7. Fifteen-Year Follow-Up of Thyroid Status in Adults with Down Syndrome

    Science.gov (United States)

    Prasher, V.; Ninan, S.; Haque, S.

    2011-01-01

    Background: The natural history of thyroid function in adults with Down syndrome is relatively unknown with limited long-term follow-up data. Method: This study investigated annual thyroid function tests in 200 adults with Down syndrome over a 15-year period. Results: For healthy adults with Down syndrome there is a gradual increase in thyroxine…

  8. Fifteen-Year Follow-Up of Thyroid Status in Adults with Down Syndrome

    Science.gov (United States)

    Prasher, V.; Ninan, S.; Haque, S.

    2011-01-01

    Background: The natural history of thyroid function in adults with Down syndrome is relatively unknown with limited long-term follow-up data. Method: This study investigated annual thyroid function tests in 200 adults with Down syndrome over a 15-year period. Results: For healthy adults with Down syndrome there is a gradual increase in thyroxine…

  9. Discontinuation of long-term benzodiazepine use : 10-year follow-up

    NARCIS (Netherlands)

    de Gier, N. A. H.; Gorgels, W. J. M. J.; Lucassen, P. L. B. J.; Voshaar, R. Oude; Mulder, J.; Zitman, F.

    2011-01-01

    Background. Several interventions aiming at discontinuation of long-term benzodiazepine use have been proven effective in the short term. However, data on the persistence of discontinuation are lacking. Objectives. To assess 10-year follow-up status in patients who succeeded in stopping benzodiazepi

  10. Dynamic hyperinflation after metronome-paced hyperventilation in COPD--a 2 year follow-up.

    NARCIS (Netherlands)

    Hannink, J.D.C.; Lahaije, A.; Bischoff, E.W.M.A.; Helvoort, H.A.C. van; Dekhuijzen, R.; Schermer, T.R.J.; Heijdra, Y.F.

    2010-01-01

    In contrast to the decline in FEV(1), the behavior of dynamic hyperinflation (DH) over time is unknown in patients with COPD. Metronome-paced hyperventilation (MPH) is a simple applicable surrogate for exercise to detect DH. OBJECTIVE: To evaluate changes in MPH-induced DH during two years follow-up

  11. NOCTURNAL ENURESIS AND MINOR NEUROLOGICAL DYSFUNCTION AT 12 YEARS - A FOLLOW-UP-STUDY

    NARCIS (Netherlands)

    Lunsing, R J; Hadders-Algra, M; Touwen, B C; Huisjes, H J

    On follow-up at 12 years to assess the relationship between minor neurological dysfunction (MND) and primary nocturnal enuresis (NE), the frequency of NE was found to be significantly higher in children with MND (N = 167) than in those who were neurologically normal (N = 174). There was no

  12. The oral rehabilitation and 5 years follow up of a patient with prepubertal periodontitis- one case

    Directory of Open Access Journals (Sweden)

    Zelal Seyfioglu Polat

    2003-03-01

    Full Text Available Ethiologic, pathogenetic and host factors definition and classifications ofperiodontal diseases are done in many studies till nowadays. To regard these studiesprepubertal periodontitis is defined as early onset periodontitis.In our study it is aimed to present the treatment results of of apatient who isdiagnosed with prepubertal periodontitis, treated and followed up for five years.

  13. Six years of following up a glomus jugulare tumor - a case report

    Directory of Open Access Journals (Sweden)

    Ivanka Štenc Bradvica

    2012-02-01

    Full Text Available This case report followed up a patient for six years after she had been successfully treated by embolization and gamma knife surgery, while a complete surgical resection was contraindicated because of the high risk of possible mortality outcome. A development of internal hydrocephalus in a subacute postoperative period as a probable postoperative complication related to gamma knife surgery was noted.

  14. Nocturnal enuresis and minor neurological dysfunction at 12 years : a follow-up study

    NARCIS (Netherlands)

    Lunsing, R J; Hadders-Algra, M; Touwen, B C; Huisjes, H J

    1991-01-01

    On follow-up at 12 years to assess the relationship between minor neurological dysfunction (MND) and primary nocturnal enuresis (NE), the frequency of NE was found to be significantly higher in children with MND (N = 167) than in those who were neurologically normal (N = 174). There was no relations

  15. NOCTURNAL ENURESIS AND MINOR NEUROLOGICAL DYSFUNCTION AT 12 YEARS - A FOLLOW-UP-STUDY

    NARCIS (Netherlands)

    Lunsing, R J; Hadders-Algra, M; Touwen, B C; Huisjes, H J

    1991-01-01

    On follow-up at 12 years to assess the relationship between minor neurological dysfunction (MND) and primary nocturnal enuresis (NE), the frequency of NE was found to be significantly higher in children with MND (N = 167) than in those who were neurologically normal (N = 174). There was no relations

  16. Evolution of Costs of Inflammatory Bowel Disease over Two Years of Follow-Up

    NARCIS (Netherlands)

    van der Valk, Mirthe E; Mangen, Marie-Josée J; Severs, Mirjam; van der Have, Mike; Dijkstra, Gerard; van Bodegraven, Ad A; Fidder, Herma H; de Jong, Dirk J; van der Woude, C Janneke; Romberg-Camps, Mariëlle J L; Clemens, Cees H M; Jansen, Jeroen M; van de Meeberg, Paul C; Mahmmod, Nofel; van der Meulen-de Jong, Andrea E; Ponsioen, Cyriel Y; Bolwerk, Clemens; Vermeijden, J Reinoud; Siersema, Peter D; Leenders, Max; Oldenburg, Bas

    2016-01-01

    BACKGROUND: With the increasing use of anti-TNF therapy in inflammatory bowel disease (IBD), a shift of costs has been observed with medication costs replacing hospitalization and surgery as major cost driver. We aimed to explore the evolution of IBD-related costs over two years of follow-up. METHOD

  17. Sex differences in stroke survival: 10-year follow-up of the Copenhagen stroke study cohort

    DEFF Research Database (Denmark)

    Andersen, Morten Nonboe; Andersen, Klaus Kaae; Kammersgaard, Lars Peter

    2005-01-01

    the Scandinavian Stroke Scale (0-58); computed tomography determined stroke type. A risk factor profile was obtained for all including ischemic heart disease, hypertension, diabetes mellitus, atrial fibrillation, previous stroke, smoking, and alcohol consumption. Date of death was obtained within a 10-year follow-up...

  18. Sex Differences in Stroke Survival: 10-Year Follow-up of the Copenhagen Stroke Study Cohort

    DEFF Research Database (Denmark)

    Andersen, Morten Nonboe; Andersen, Klaus Kaae; Kammersgaard, Lars Peter

    2005-01-01

    the Scandinavian Stroke Scale (0-58); computed tomography determined stroke type. A risk factor profile was obtained for all including ischemic heart disease, hypertension, diabetes mellitus, atrial fibrillation, previous stroke, smoking, and alcohol consumption. Date of death was obtained within a 10-year follow-up...

  19. Cervical involvement in SAPHO syndrome: imaging findings with a 10-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Tohme-Noun, C.; Krainik, A.; Menu, Y. [Department of Radiology, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de medecine Bichat-Beaujon, Paris (France); Feydy, A. [Department of Radiology, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de medecine Bichat-Beaujon, Paris (France); Department of Radiology, Hopital Beaujon, 100 avenue du General Leclerc, 92118, Clichy (France); Belmatoug, N.; Fantin, B. [Department of Internal Medicine, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de medecine Bichat-Beaujon, Paris (France)

    2003-02-01

    Osteoarticular manifestations of SAPHO syndrome include vertebral lesions, typically in the thoracic segment. Chronic inflammatory changes are well depicted by MRI. We report the imaging findings with a 10-year follow-up in a case of SAPHO syndrome with marked cervical lesions. (orig.)

  20. Thalamic Deep Brain Stimulation for Neuropathic Pain: Efficacy at Three Years' Follow-Up.

    Science.gov (United States)

    Abreu, Vasco; Vaz, Rui; Rebelo, Virgínia; Rosas, Maria José; Chamadoira, Clara; Gillies, Martin J; Aziz, Tipu Z; Pereira, Erlick A C

    2017-07-01

    Chronic neuropathic pain is estimated to affect 3-4.5% of the worldwide population, posing a serious burden to society. Deep Brain Stimulation (DBS) is already established for movement disorders and also used to treat some "off-label" conditions. However, DBS for the treatment of chronic, drug refractory, neuropathic pain, has shown variable outcomes with few studies performed in the last decade. Thus, this procedure has consensus approval in parts of Europe but not the USA. This study prospectively evaluated the efficacy at three years of DBS for neuropathic pain. Sixteen consecutive patients received 36 months post-surgical follow-up in a single-center. Six had phantom limb pain after amputation and ten deafferentation pain after brachial plexus injury, all due to traumas. To evaluate the efficacy of DBS, patient-reported outcome measures were collated before and after surgery, using a visual analog scale (VAS) score, University of Washington Neuropathic Pain Score (UWNPS), Brief Pain Inventory (BPI), and 36-Item Short-Form Health Survey (SF-36). Contralateral, ventroposterolateral sensory thalamic DBS was performed in sixteen patients with chronic neuropathic pain over 29 months. A postoperative trial of externalized DBS failed in one patient with brachial plexus injury. Fifteen patients proceeded to implantation but one patient with phantom limb pain after amputation was lost for follow-up after 12 months. No surgical complications or stimulation side effects were noted. After 36 months, mean pain relief was sustained, and the median (and interquartile range) of the improvement of VAS score was 52.8% (45.4%) (p = 0.00021), UWNPS was 30.7% (49.2%) (p = 0.0590), BPI was 55.0% (32.0%) (p = 0.00737), and SF-36 was 16.3% (30.3%) (p = 0.4754). DBS demonstrated efficacy at three years for chronic neuropathic pain after traumatic amputation and brachial plexus injury, with benefits sustained across all pain outcomes measures and slightly greater

  1. A post-earthquake psychopathological investigation in Armenia: methodology, summary of findings, and follow-up.

    Science.gov (United States)

    Khachadourian, Vahe; Armenian, Haroutune; Demirchyan, Anahit; Melkonian, Arthur; Hovanesian, Ashot

    2016-07-01

    The post-earthquake psychopathological investigation (PEPSI) was designed to probe the short-and long-term effects of the earthquake in northern Armenia on 7 December 1988 on survivors' mental and physical health. Four phases of this study have been conducted to date, and, overall, more than 80 per cent of a sub-sample of 1,773 drawn from an initial cohort of 32,743 was successfully followed during 2012. This paper describes the methodology employed in the evaluation, summarises previous findings, details the current objectives, and examines the general characteristics of the sample based on the most recent follow-up phase outcomes. Despite a significant decrease in psychopathology rates between 1990 and 2012, prevalence rates of post-traumatic stress disorder and depression among study participants in 2012 were greater than 15 and 26 per cent, respectively. The paper also notes the strengths and limitations of the study vis-à-vis future research and highlights the importance and potential practical implications of similar assessments and their outcomes.

  2. The Birmingham hip resurfacing prosthesis: an independent single surgeon's experience at 7-year follow-up.

    Science.gov (United States)

    Madhu, Tiruveedhula S; Akula, Mahesh R; Raman, Raghu N; Sharma, Hemant K; Johnson, Verne G

    2011-01-01

    An independent single surgeon's 7-year experience with Birmingham hip resurfacing is presented. The study also involved investigation of the significance of pedestal sign in patients requiring revision. A consecutive 117 hips in 101 patients (59 male and 42 female patients) operated on by the senior author (VGJ) were assessed at a mean follow-up of 7 years (range, 5-9.4 years). Mean age at surgery was 54 years (range, 20-74 years). Seventy-three hips had a preoperative diagnosis of primary osteoarthritis, and secondary osteoarthritis was seen in 44 hips. Failure was defined as revision for any reason. Revision of the femoral component alone was undertaken in 8 hips (6.8%): 5 within first year for periprosthetic fracture neck of femur and in 3 hips after 5 years of follow-up. In 2 patients who were known to have osteonecrosis of the femoral head preoperatively, the femoral component progressively collapsed into varus after 5 years of follow-up. Pedestal sign was the earliest radiologic sign noted in these 2 patients and progressed rapidly within 1 year on serial radiographs well before the onset of clinical symptoms. Kaplan-Meier survival with revision as end point at 7 years was 91.5% (95% confidence interval, 97.6%-85.4%). Copyright © 2011 Elsevier Inc. All rights reserved.

  3. New psycho-pedagogic approach to obesity treatment: a 5-year follow-up.

    Science.gov (United States)

    Buclin-Thiébaud, Sévrine; Pataky, Zoltan; Bruchez, Vanessa; Golay, Alain

    2010-06-01

    The aim of the present study was to evaluate the body weight evolution in obese patients admitted for a 2-week residential program and followed-up on ambulatory basis, as well as to evaluate factors having impact on weight evolution after 5 years. Thirty-nine obese patients participated in a 2-week structured interdisciplinary weight loss program, involving individual and group therapies, and including physical activity, nutritional education and standard cognitive-behavioral techniques. Patients were then followed-up regularly by their general practitioners for 5 years. After 5 years, 33 subjects completed the study. Seventy percent of the patients lost weight or maintained their weight loss. Total score for dietary structure, eating behavior disorders, dietary surveillance and weight management strategies, as evaluated by a validated questionnaire, was significantly lower in the weight loss group (22.4+/-4.3) as compared to maintenance group (24.4+/-6.1, pactivity (p<0.05) that the regain group. The present study demonstrated that an initial multidimensional and multidisciplinary in-hospital program with a consecutive long-term ambulatory follow-up may lead to a significant weight loss (55%) and/or weight maintenance (15%). A multidisciplinary and well-designed initial treatment and long-term follow-up program is mandatory for obesity management. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  4. Developing COPD: a 25 year follow up study of the general population

    DEFF Research Database (Denmark)

    Løkke, Anders; Lange, Peter; Scharling, H;

    2006-01-01

    population. METHODS: As part of the Copenhagen City Heart Study, 8045 men and women aged 30-60 years with normal lung function at baseline were followed for 25 years. Lung function measurements were collected and mortality from COPD during the 25 year observation period was analysed. RESULTS: The percentage......BACKGROUND: Smokers are more prone to develop chronic obstructive pulmonary disease (COPD) than non-smokers, but this finding comes from studies spanning 10 years or less. The aim of this study was to determine the 25 year absolute risk of developing COPD in men and women from the general...... cessation, especially early in the follow up period, decreased the risk of developing COPD substantially compared with continuous smoking. During the follow up period there were 2912 deaths, 109 of which were from COPD. 92% of the COPD deaths occurred in subjects who were current smokers at the beginning...

  5. A prospective ten-year follow-up of patients with chronic urticaria.

    Science.gov (United States)

    Dionigi, P C L; Menezes, M C S; Forte, W C N

    2016-01-01

    Chronic urticaria can be the initial clinical presentation of a number of different diseases. The objective of the present study was to report the associated diseases during a ten-year clinical-laboratory follow-up in patients with an initial diagnosis of chronic spontaneous urticaria (CSU) of unknown cause. A prospective, longitudinal cohort study with a ten-year clinical-laboratory follow-up was conducted. Patients with a history of urticarial plaques of over six weeks presenting as the only clinical symptom were selected. Individuals with other clinical conditions, urticaria of known causes or chronic physical urticaria were excluded. The following tests were initially performed: haemogram, urine type I, stool parasite exam and sedimentation rate. The following exams were ordered during follow-up: PPD; urine culture; serology tests; antithyroid and antinuclear antibodies, rheumatoid factor, lupus anticoagulant; thyroid hormones; serum immunoglobulin; paranasal sinus and thorax radiographs; testing for BK and Helicobacter pylori; and prick tests. Infections were diagnosed in 29% of patients (syphilis, parasitosis, H. pylori, urinary infection, tuberculosis, hepatitis B and C); autoimmune diseases in 21% (thyroiditis, rheumatoid arthritis and antiphospholipid antibody syndrome); primary immunodeficiencies in 4% (IgA and IgG2 deficiencies); and chronic myeloid leukaemia in 1%. At ten-years of follow-up, the urticaria diagnosis was CSU of unknown cause in 45% of the cases. This ten-year clinical-laboratory follow-up of 100 individuals with chronic urticaria as the initial diagnosis revealed the presence of associated diseases in over half of the cases. The most prevalent diseases were infections and autoimmune diseases besides primary immunodeficiencies and blood diseases. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  6. Effects of a Randomized Reading Intervention Study Aimed at 9-Year-Olds: A 5-Year Follow-up.

    Science.gov (United States)

    Wolff, Ulrika

    2016-05-01

    The present paper reports on a 5-year follow-up of a randomized reading intervention in grade 3 in Sweden. An intervention group (n = 57) received daily training for 12 weeks in phoneme/grapheme mapping, reading comprehension and reading speed, whereas a control group (n = 55) participated in ordinary classroom activities. The main aim was to investigate if there were remaining effects of the intervention on reading-related skills. Previous analyses showed that the intervention group performed significantly better than the control group on spelling, reading speed, reading comprehension and phoneme awareness at the immediate post-test with sustained effects 1 year later. Results from the 5-year follow-up show that the only significant difference between the intervention (n = 47) and the control group (n = 37) was on word decoding. There was also a significant interaction effect of group assignment and initial word decoding, in the way that the lowest-performing students benefitted the most from the intervention. Another aim was to examine if the children identified in a screening (n = 2212) as poor readers in grade 2 still performed worse than typical readers. The analyses showed that the typically developing students (n = 66) outperformed the students identified as poor readers in grade 2 on working memory, spelling, reading comprehension and word decoding. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Follow-up of a Case of Vitelliform Macular Dystrophy Over an 8-year Period

    Institute of Scientific and Technical Information of China (English)

    Shizhou Huang; Lezheng Wu; Feng Wen; Guangwei Luo; Futian Jiang

    2014-01-01

    Purpose: To show the follow-up of a case of vitelliform mac-ular dystrophy with morphological and visual functional tests over an 8-year period. Methods:.Retrospective review of medical records..The mor-phological examination included color photography,.fluores-cein angiography, and ocular coherence tomography (OCT). The visual functional tests included visual acuity, electro-ocu-logram (EOG) and multifocal electroretinography (mfERG). The patient was observed for 8 years, from 2003 to 2011. Results:.During the follow-up,.the improvement of sensory retinal detachment and reduction of yellow-white deposit were observed with color photography and fluorescein angiography. OCT revealed a decrease in sensory retinal detachment and subretinal hyper-reflective deposits; both of these morphologi-cal changes were correspondent. Visual acuity was maintained throughout the follow-up..The Arden ratio of EOG was de-creased. The amplitudes of mfERG were decreased but slightly increased during the follow-up. Conclusion:.The retinal morphological changes and visual function slightly improved in this case of vitelliform macu-lopathy. The prognosis is good. (Eye Science 2014; 29:165-169)

  8. Evolution of adolescent idiopathic scoliosis: results of a multicenter study at 20 years' follow-up.

    Science.gov (United States)

    Pesenti, S; Jouve, J-L; Morin, C; Wolff, S; Sales de Gauzy, J; Chalopin, A; Ibnoulkhatib, A; Polirsztok, E; Walter, A; Schuller, S; Abelin-Genevois, K; Leroux, J; Lechevallier, J; Kabaj, R; Mary, P; Fuentes, S; Parent, H; Garin, C; Bin, K; Peltier, E; Blondel, B; Chopin, D

    2015-09-01

    To date there is no consensus on therapeutic indications in adolescent idiopathic scoliosis (AIS) with curvature between 30° and 60° at the end of growth. The objective of this study was to assess outcome in patients with moderate AIS. A multicenter retrospective study was conducted. Inclusion criteria were: Cobb angle, 30-60° at end of growth; and follow-up > 20 years. The data collected were angular values in adolescence and at last follow-up, and quality of life scores at follow-up. A total of 258 patients were enrolled: 100 operated on in adolescence, 116 never operated on, and 42 operated on in adulthood. Mean follow-up was 27.8 years. Cobb angle progression significantly differed between the 3 groups: 3.2° versus 8.8° versus 23.6°, respectively; P scoliosis, the risk of progression to ≥ 20° was significantly higher for initial Cobb angle > 35° (OR=4.278, P=0.002). There were no significant differences in quality of life scores. Patients operated on in adolescence showed little radiological progression, demonstrating the efficacy of surgical treatment for curvature greater than 50°. Curvature greater than 40° was progressive and may require surgery in adulthood. Lumbar scoliosis showed greater potential progression than thoracic scoliosis in adulthood, requiring fusion as of 35° angulation. IV, retrospective study. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Japanese encephalitis (JE) part II: 14 years' follow-up of survivors.

    Science.gov (United States)

    Sarkari, N B S; Thacker, A K; Barthwal, S P; Mishra, V K; Prapann, Shiv; Srivastava, Deepak; Sarkari, M

    2012-01-01

    Japanese encephalitis, the commonest Arbovirus encephalitis, has been endemic in many parts of Asia, the Pacific Islands, and India; also, there have been many epidemics. Most of the post JE cases have been associated with neurological and neuropsychiatric deficits but have not been properly classified and followed. Practically all the previous studies were in children or young adults. The aim of this study, involving only adult cases, the largest ever being reported, has been to follow the 688/1,199 survivors of JE patients out of 1,282 of acute cases admitted during four epidemics for a period of 14 years after properly classifying the sequelae. This prospective study was conducted in B.R.D. Medical College Gorakhpur (India), involving 665/688 post JE cases with neuropsychiatric deficits from four epidemics of 1978, 1980, 1988 and 1989 which were properly classified in nine groups. While the first epidemic of 1978 was being studied, more disastrous episodes flared up and the patients were subsequently added. Hence, the total duration of this prospective study was from November 1978 to December 2003. There were 14 defaulted initially from 688 followed (23/688 without sequelae and 665/688 with neuropsychiatric deficits), and later 130 were lost from time to time at various stages of follow up. Four out of 23/688 discharged without any deficit had to be readmitted for bizarre movements, assaultative behaviour and euphoria without fever and altered sensorium. All of them improved by symptomatic treatment. Progressive improvement occurred in all the parameters consisting of psychological disturbances, higher cerebral dysfunction, speech disorders (dysphonia, dysarthria, dysphasias, apraxia and agnosia), extra pyramidal, pyramidal features, and hypothalamic disturbances, cranial nerves including pupils and fundi and seizures. Maximum cases improved between 6 months (55%) to 1 year (78%). Only some features improved between 5 to 14 years. Four patients of hemiplegia

  10. Eight-year follow-up of a girl with McCune-Albright syndrome.

    Science.gov (United States)

    Aycan, Zehra; Önder, Aşan; Çetinkaya, Semra

    2011-01-01

    McCune-Albright syndrome (MAS) is characterized by the triad of fibrous dysplasia (FD), cafe-au-lait spots and precocious puberty (PP). We report a 14-year-old girl with MAS who has been followed-up for 8 years. She was referred for multiple fractures and vaginal bleeding at age 5.9 years. She had peripheral PP, FD, and osteoporosis and was diagnosed as MAS. The patient was treated with aromatase inhibitors and bisphosphonates. She had no menses during aromatase inhibitor treatment. Her growth rate and bone maturation were in normal ranges while on treatment. She had one new fracture on the seventh year of follow- up in spite of bisphosphonate treatment.

  11. Metabolically healthy obesity and depressive symptoms: 16-year follow-up of the Gazel cohort study.

    Science.gov (United States)

    Hinnouho, Guy-Marino; Singh-Manoux, Archana; Gueguen, Alice; Matta, Joane; Lemogne, Cedric; Goldberg, Marcel; Zins, Marie; Czernichow, Sébastien

    2017-01-01

    The health correlates of the metabolically healthy obese (MHO) phenotype, particularly in relation to depressive symptoms remains unclear. Accordingly, we examined the risk of depressive symptoms in this phenotype using a 16-year follow-up prospective study. A sample of 14 475 participants (75% men), aged 44-59 years in 1996, was drawn from the Gazel cohort. Obesity was defined as body mass index (BMI) ≥ 30 kg/m2 and metabolic health as having none of the self-reported following cardiovascular risk factors: hypertension, type 2 diabetes and dyslipidemia. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression (CES-D) scale in 1996, 1999, 2002, 2005, 2008 and 2012. Generalized Estimating Equations (GEE) were used to estimate the risk of depressive symptoms during a follow-up of 16 years. In multivariate analyses, metabolically unhealthy normal weight [Odds Ratio (OR) = 1.37; 95% Confidence Interval (CI): 1.25-1.51], overweight [1.44 (1.31-1.59)] and obese [1.30 (1.10-1.54)] but not MHO participants [1.04 (0.81-1.32)] had higher risk of depressive symptoms at the start of follow-up compared to metabolically healthy normal weight individuals. Depressive symptoms decreased over time in metabolically healthy normal weight individuals [0.52 (0.50-0.55)], this decrease was less marked only in metabolically unhealthy obese participants [1.22 (1.07-1.40)]. Compared to MHO participants, metabolically unhealthy obese individuals were at increased risk of depression at the start of follow-up, but with a similar reduction of this risk over time. Poor metabolic health, irrespective of BMI was associated with greater depressive symptoms at the start of follow-up, whereas a poorer course of depressive symptoms over time was observed only in those with both obesity and poor metabolic health.

  12. Development of hypertension and uraemia after pyelonephritis in childhood: 27 year follow up.

    OpenAIRE

    1989-01-01

    OBJECTIVE--Determination of the long term incidence of uraemia, hypertension, and toxaemia in pregnancy associated with non-obstructive focal renal scarring after pyelonephritis in childhood 25-35 years earlier. DESIGN--27 Year follow up of patients with non-obstructive focal scarring identified from a retrospective review of intravenous urograms performed in childhood between 1951 and 1967. SETTING--Paediatric primary referral centre and urological clinic in tertiary referral centre. PATIENT...

  13. Aortico-left ventricular tunnel in adulthood: twenty-two year follow up.

    Science.gov (United States)

    Norman, Rose; Kafka, Henryk

    2009-05-01

    Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac defect that is usually managed by surgical or catheter intervention. This case documents the 22 year follow up of a 44 year old man who has been managed medically through a programme of close clinical and echocardiographic monitoring. This report illustrates that conservative management of Type I ALVT can be undertaken without adverse clinical consequences.

  14. Pyridoxine-dependent seizures: 10-year follow-up of eight cases.

    Science.gov (United States)

    Koul, Roshan

    2009-01-01

    Eight children with pyridoxine-dependent seizures (PDS) were seen over a period of 10 years. Of those children, 6 are on regular follow-up. Four of the children were seen in one family. All the patients presented with refractory seizures, mainly neonatal status epilepticus. Though PDS is a rare condition, it must be considered in all cases with refractory seizures, particularly in children younger than 3 years. When confirming a diagnosis, oral pyridoxine is as effective as intravenous pyridoxine.

  15. Pyridoxine-dependent seizures: 10-year follow-up of eight cases

    OpenAIRE

    2009-01-01

    Eight children with pyridoxine-dependent seizures (PDS) were seen over a period of 10 years. Of those children, 6 are on regular follow-up. Four of the children were seen in one family. All the patients presented with refractory seizures, mainly neonatal status epilepticus. Though PDS is a rare condition, it must be considered in all cases with refractory seizures, particularly in childrens younger than 3 years. When confirming a diagnosis, oral pyridoxine is as effective as intravenous pyrid...

  16. Recurrent unicystic mural type ameloblastoma in a 9-year-old boy, 8 years follow-up

    Directory of Open Access Journals (Sweden)

    Burcu Sengüven

    2013-01-01

    Full Text Available Unicystic ameloblastoma is not a rare odontogenic tumor in the pediatric population. A significant care should be given to unicystic ameloblastoma if it has mural invasions due to its local aggressiveness, high recurrence rates and radical management options as in conventional ameloblastoma. Fine needle aspiration (FNA cytology is a rapid, non-traumatic diagnostic method that provides a required attention prior to surgery. We present an excisionsl biopsy proved FNA diagnosed mural type unicystic ameloblastoma in a 9-year-old child recurred as a solid ameloblastoma after 8 years. When distinctive features of ameloblastoma are known, an accurate diagnosis can be made by FNA cytology, in combination with clinicoradiological findings. This method gives benefit to the patients especially the younger ones both for the pre-operative surgical planning and the post-operative follow-up.

  17. Ten-year follow up after laparoscopic suture rectopexy for full-thickness rectal prolapse.

    Science.gov (United States)

    Foppa, C; Martinek, L; Arnaud, J P; Bergamaschi, R

    2014-10-01

    Studies have shown that recurrence rates of full-thickness rectal prolapse (FTRP) 5 years after surgery can quadruple at 10 years. This study aimed to evaluate the impact of laparoscopic suture rectopexy for FTRP on recurrence rates and functional outcome at a median follow up of 10 years. Prospectively collected data for patients who underwent laparoscopic suture rectopexy for FTRP between 1993 and 2006 were analysed. Laparoscopic rectopexy consisted of circumferential mobilization of the rectum down to the levator followed by suture suspension to promontory. Patients with preexisting constipation or who were unfit for general anaesthesia were not included. Incontinence, quality of life and constipation were assessed by validated scores. Recurrence-free curves were generated using the Kaplan-Meier method. One hundred and seventy-nine patients with a median age of 62 (15-93) years including 174 women and five men underwent laparoscopic suture rectopexy. There was no mortality. The 30-day complication rate was 4% (partial transection of the left ureter, pneumonia, urinary tract infection, urinary retention, superficial surgical site infection). Data on 172 patients (96%) were available at follow up. There were 10 recurrences of FTRP at 5-year follow up giving a crude recurrence rate of 6%. The actuarial 10-year recurrence rate was 20% (95% CI, 10.8-20.1). Follow-up continence (P < 0.0001) and quality of life were better than preoperatively: lifestyle (P < 0.001), coping (P < 0.001), self-perception (P < 0.005), embarrassment (P < 0.06). Constipation was unchanged. Laparoscopic suture rectopexy led to few complications, a recurrence rate of 20%, improved continence and quality of life with no worsening of constipation at 10 years. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  18. The Tripler LE3AN Program: a two-year follow-up report.

    Science.gov (United States)

    James, L C; Folen, R A; Page, H; Noce, M; Brown, J; Britton, C

    1999-06-01

    This paper provides a review of 2-year follow-up data on the Tripler Army Medical Center LE3AN Program. The LE3AN Program (emphasizing healthy Lifestyles, reasonable Exercise, realistic Expectations, Emotions, and Attitudes, and Nutrition) provides active duty service members a treatment strategy that involves a reasonable low-intensity exercise regimen, behavior modification, intensive nutritional counseling healthy meal planing, relapse prevention strategies, cognitive coping strategies, and healthy lifestyle principals to lose weight and maintain weight loss. Based on the 2-year data and additional clinical findings, we expand upon earlier preliminary reports. The 2-year follow-up data suggest that the program is a safe and efficacious treatment program.

  19. Association between subjective memory complaints and health care utilisation: a three-year follow up

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Siersma, Volkert; Waldemar, Gunhild

    2009-01-01

    BACKGROUND: Subjective memory complaints (SMC) are common among elderly patients and little is know about the association between SMC and health care utilisation. Thus, the aim of this study was to investigate health care utilisation during a three-year follow-up among elderly patients consulting...... their general practitioner and reporting subjective memory complaints (SMC). METHODS: This study was conducted as a prospective cohort survey in general practice with three-year follow-up. Selected health care utilisation or costs relative to SMC adjusted for potential confounders were analyzed in a two...... aged 65 years and older consulted their GP in October and November 2002 and participated in the present study. The adjusted probability of nursing home placement was significantly increased in subjects with SMC relative to subjects without SMC (RR = 2.3). More generally, SMC was associated...

  20. Primary and repeated stapled hemorrhoidopexy for prolapsing hemorrhoids: Follow-up to five years

    DEFF Research Database (Denmark)

    Raahave, D.; Pedersen, I.K.; Jepsen, Lars Vedel

    2008-01-01

    was designed to assess initial results, analyze complications and failures, and document both the need for repeated procedures and the outcomes of follow-up to five years. Methods: From 1998 to 2004, 258 patients underwent modified stapled hemorrhoidopexy. The appearance of the anus was scored preoperatively......, immediately after the procedure, at three months, and at one to five years postoperatively. The anatomy score ranged from 1 (normal anus) to 7 (worst prolapse). We also evaluated operation time, analgesia, staple line position, postoperative pain score, technical failures, postoperative complications, need...... of 258 patients (7 percent). The median anatomy score decreased from 6 (range, 3-7) preoperatively to 1 (range, 1-6) at last follow-up, irrespective of one or a repeated stapled hemorrhoidopexy, surgical excision, or technical failure. The risk of reintervention was greatest during the first year after...

  1. Five-Year Follow-Up of Supportive Psychodynamic Psychotherapy in First-Episode Psychosis

    DEFF Research Database (Denmark)

    Harder, Susanne; Køster, Anne; Valbak, Kristian

    2014-01-01

    -term outcome of SPP in a prospective, longitudinal, comparative, multicenter investigation of successively referred patients diagnosed with first-episode schizophrenia spectrum disorder. METHOD: Manualized SPP for up to 3 years as a supplement to standard treatment (ST) were compared to ST alone and followed...... up for 5 years (N = 269). The SPP targeted interpersonal relationships, emotion regulation, social cognition, and self-coherence. RESULTS: Significant between-group effects in favor of SPP+ST on social functioning, overall symptoms, and positive psychotic symptoms were found during the period...... of active SPP intervention. These differential effects, however, were not sustained after end of additional SPP at 5-year follow-up. CONCLUSION: The findings are in line with results from other approaches targeting social functioning in schizophrenia and support SPP as a valuable treatment. Further research...

  2. Birmingham Hip Resurfacing: A Single Surgeon Series Reported at a Minimum of 10 Years Follow-Up.

    Science.gov (United States)

    Mehra, Akshay; Berryman, Fiona; Matharu, Gulraj S; Pynsent, Paul B; Isbister, Eric S

    2015-07-01

    We report outcomes on 120 Birmingham Hip Resurfacings (BHRs) (mean age 50 years) at a minimum of ten-years follow-up. Cases were performed by one surgeon and included his learning curve. Six hips were revised, with no revisions for infection, dislocation, or adverse reaction to metal debris. Ten-year survival was 94.2% (95% confidence interval (CI) 88.8%-98.7%) for all revisions and 96.1% (95% CI 91.5%-99.8%) for revisions for aseptic loosening. Gender (P = 0.463) and head size (P = 0.114) did not affect revision risk. Mean post-operative Harris hip score was 84.0. Contrary to previous independent reports, good outcomes into the second decade were achieved with the BHR in both men and women. Longer term follow-up will confirm whether these promising outcomes in women continue.

  3. RADICAL RETROPUBIC PROSTATECTOMY: THE FIRST RUSSIAN EXPERIENCE OF 15-YEAR FOLLOW-UP AFTER SURGERY

    Directory of Open Access Journals (Sweden)

    E. I. Veliev

    2014-07-01

    Full Text Available The results of the maximum of more than 15 years of follow-up of Russia’s first large series of patients after radical retropubic prostatectomy (RPE were traced. The data of 1367 patients who had undergone RPE at the Clinic of Urology, S.P. Kirov Military Medical Academy, in 1997 to 2003 and at the Clinic of Urology, Russian Medical Academy of Postgraduate Education, in 2001 to 2010 were retrospectively studied. After excluding 626 patients who had an incomplete set of preoperative/postoperative characteristics, a postoperative follow-up of < 6 months, neoadjuvant hormonal or radiation therapy, the trial included 741 patients. Their median age at surgery was 64 years (interquartile range (IQR: 59-68; median prostatespecific antigen (PSA, 8.7 ng/ml (IQR: 6.2-14; median follow-up, 65 months (IQR: 50-87; the maximum follow-up period, 189 months. Out of the 741 patients, 30.2, 28.3, and 41.5% were referred to as D’Amico classification low-, moderate-, and high-risk groups, respectively. Five-, 10-, and 15-year relapse-free survival rates were 80.3, 74.7, and 66.7%; 5-, 10-, and 15-year cancer-specific survival rates were 98.3, 95.9, and 85.7%; and 5-, 10-, and 15-year overall survival rates were 92.5, 81.4, and 64.3%, respectively. The significant predictors of biochemical recurrence were a preoperative PSA level of 10.1–20 ng/ml (p = 0.041, > 20 ng/ml (p = 0.003; pathological stage pT3b–4N0 (p = 0.006 and any stage pT N1 (p = 0.003. Further investigations are needed to identify groups of patients who will have the most benefit from surgery.

  4. RADICAL RETROPUBIC PROSTATECTOMY: THE FIRST RUSSIAN EXPERIENCE OF 15-YEAR FOLLOW-UP AFTER SURGERY

    Directory of Open Access Journals (Sweden)

    E. I. Veliev

    2013-01-01

    Full Text Available The results of the maximum of more than 15 years of follow-up of Russia’s first large series of patients after radical retropubic prostatectomy (RPE were traced. The data of 1367 patients who had undergone RPE at the Clinic of Urology, S.P. Kirov Military Medical Academy, in 1997 to 2003 and at the Clinic of Urology, Russian Medical Academy of Postgraduate Education, in 2001 to 2010 were retrospectively studied. After excluding 626 patients who had an incomplete set of preoperative/postoperative characteristics, a postoperative follow-up of < 6 months, neoadjuvant hormonal or radiation therapy, the trial included 741 patients. Their median age at surgery was 64 years (interquartile range (IQR: 59-68; median prostatespecific antigen (PSA, 8.7 ng/ml (IQR: 6.2-14; median follow-up, 65 months (IQR: 50-87; the maximum follow-up period, 189 months. Out of the 741 patients, 30.2, 28.3, and 41.5% were referred to as D’Amico classification low-, moderate-, and high-risk groups, respectively. Five-, 10-, and 15-year relapse-free survival rates were 80.3, 74.7, and 66.7%; 5-, 10-, and 15-year cancer-specific survival rates were 98.3, 95.9, and 85.7%; and 5-, 10-, and 15-year overall survival rates were 92.5, 81.4, and 64.3%, respectively. The significant predictors of biochemical recurrence were a preoperative PSA level of 10.1–20 ng/ml (p = 0.041, > 20 ng/ml (p = 0.003; pathological stage pT3b–4N0 (p = 0.006 and any stage pT N1 (p = 0.003. Further investigations are needed to identify groups of patients who will have the most benefit from surgery.

  5. Making sense of post-treatment surveillance in head and neck cancer: when and what of follow-up.

    Science.gov (United States)

    Manikantan, Kapila; Khode, Shailesh; Dwivedi, Raghav C; Palav, Rajan; Nutting, Chris M; Rhys-Evans, Peter; Harrington, Kevin J; Kazi, Rehan

    2009-12-01

    Follow-up in patients treated for head and neck cancer (HNC) is aimed at early detection of recurrence, metastases and second primary tumours. Various modalities for the routine follow-up of patients with HNC have been proposed and studied in the literature. Consequently, practising head and neck surgeons and oncologists all over the world use different guidelines and protocols to follow-up their patients. These guidelines involve follow-up intervals of varying intensity and schedule an assortment of investigations that may be neither logical nor practical. This follow-up process may be difficult to administrate, cause unnecessary discomfort and morbidity to the patient and can have serious cost-implications to the healthcare system. This review summarises strategies for follow-up, imaging modalities and key investigations in the literature published between 1980 and 2009. In this structured review, we have assessed studies in the literature that have addressed follow-up intervals, imaging tests, tumour markers, endoscopy and thyroid function tests as a part of the routine post-treatment surveillance in HNC patients. Studies analysing the cost benefit of such surveillance have also been addressed. Based on the evidence presented, we have compiled definitive recommendations for effective surveillance/post-treatment follow-up in patients with HNC.

  6. Bone marrow edema syndrome of the foot: one year follow-up with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez-Canton, Guillermo; Casado, Oscar; Capelastegui, Ana; Astigarraga, Elena; Larena, Jose Alejandro; Merino, Amaya [OSATEK, Unidades de Resonancia Magnetica, Dr. Areilza 12-16, 48011, Bilbao, Basque Country (Spain)

    2003-05-01

    To describe the MR findings of bone marrow edema syndrome (BMES) of the foot and its evolution at 1 year follow-up.Design and patients Twenty-five of 32 patients with disabling foot and ankle pain unrelated to trauma diagnosed as BMES when MR imaging demonstrated a bone marrow edema pattern in one or more bones without any radiological or underlying clinical cause, were re-evaluated by MR imaging 1 year later. On the initial MR examinations an average of 4.7 individual bones were involved by bone marrow edema. Soft tissue edema was present in every patient and joint effusion in 10 patients. MR imaging at 1 year showed resolution of bone edema in 18 patients (72%), partial improvement in five (20%) and no improvement in two (8%). Six patients (24%) developed similar symptoms in the other foot during follow-up. Ten of 17 available plain radiographs showed some loss of radiodensity. Further bone marrow edema developed in bones of the same foot that were initially normal, or in uninvolved distant bone marrow areas in the same affected bone, in six of seven patients on follow-up MR imaging. The evolution of the MR findings of BMES of the foot is to complete resolution or partial improvement at 1 year in the majority of cases. Migration to the other foot occurs in up to a quarter of patients. (orig.)

  7. Cognitive behavioural therapy for obesity: one-year follow-up in a clinical setting.

    Science.gov (United States)

    Melchionda, N; Besteghi, L; Di Domizio, S; Pasqui, F; Nuccitelli, C; Migliorini, S; Baraldi, L; Natale, S; Manini, R; Bellini, M; Belsito, C; Forlani, G; Marchesini, G

    2003-09-01

    Cognitive behavioural therapy (CBT) is the most comprehensive means of medically treating obesity, but only few data have so far been published concerning its long-term effectiveness. We here report our experience of 1068 consecutive patients (868 females) treated with CBT at a university-based obesity centre. The patients were enrolled into three different programmes: a 14-week LEARN programme (672 patients), a 16-week MOB programme for the morbidly obese (259 patients), or a 20-week BINGE programme for subjects affected by binge eating (137 patients). Eighty-five percent of the subjects completed the weekly programmes. The percentage of patients attending the scheduled control visits during the 1-year follow-up gradually decreased, being very low in the BINGE group (10%). The percentage weight loss was an average of 6% during the weekly courses, being higher in the MOB programme; by the end of the weekly sessions, it exceeded 10% of initial body weight in 22% of cases and increased to 36% during the follow-up. The cumulative probability of follow-up was higher among the patients undergoing the MOB and LEARN programmes than among the BINGE patients (p obesity. Female gender and a weight loss of > 10% i.b.w. increased compliance to follow-up. The study further demonstrates the difficulty of achieving compliance to chronic management of obesity and the critical role of binge eating disorder in the medium-term treatment of obesity. Strategies are needed to improve adherence to a follow-up protocol.

  8. Maturogenesis of Two Maxillary Central Incisors: A Case Report with 10 Years of Follow Up

    Directory of Open Access Journals (Sweden)

    Abdollah Ghorbanzadeh

    2015-10-01

    Full Text Available This case report describes the treatment of two immature maxillary central incisors in a 7- year-old female patient. She suffered complicated crown fracture because of trauma, and the root formation was incomplete. White mineral trioxide aggregate (MTA was selected as the pulp-capping material after cervical pulpotomy to preserve the pulp tissue vitality and achieve maturogenesis. Follow-up evaluations showed successful treatment in terms of preservation of pulp vitality and demonstrated marked continuous physiological root devel- opment. During 10 years of follow-up, both teeth were clinically asymptomatic, and radio- graphic evaluations showed apparent root regeneration with apical root-end closure without pulp or periapical pathosis.

  9. Nine-year follow-up of children with atopic dermatitis by general practitioners.

    Science.gov (United States)

    Misery, Laurent; Ansolabehere, Xavier; Grandfils, Nathalie; Georgescu, Victor; Taieb, Charles

    2014-01-01

    The frequency of associated comorbidity and the cost of treatments in patients with atopic dermatitis (AD) followed up in primary care settings are poorly known. We carried out a retrospective cohort study on a longitudinal electronic medical records database of patients consulting a panel of general practitioners in France. All subjects with AD diagnosed during the first year of life were selected and matched with infants without the disease according to sex (1,163 vs. 1,163). Subjects were followed up for 9 years. Associated diseases, drug consumptions and available medical costs were detailed. Comparisons between subjects and controls were carried out. Subjects with AD had more comorbidities than others, especially in respiratory and ophthalmic system organs. The number of prescribed treatments in the field of skin diseases as well as overall medical costs (general practitioner consultations and prescribed drugs) were higher among atopic subjects, but differences were attenuated with age.

  10. One-year follow-Up in stroke patients discharged from rehabilitation hospital.

    Science.gov (United States)

    Paolucci, S; Grasso, M G; Antonucci, G; Troisi, E; Morelli, D; Coiro, P; Bragoni, M

    2000-01-01

    This study was designed to evaluate functional status at a 1-year follow-up in consecutive first-stroke patients after discharge from rehabilitation hospital and to identify reliable prognostic factors associated with changes in their abilities. Functional evaluation was made of consecutive patients 1 year after discharge to their own homes. Two multiple logistic regressions (forward stepwise) were performed using both improvement and worsening of the Barthel Index score between discharge and follow-up as dependent variables. Independent variables were medical, demographic and social factors. The final sample included 157 out of 172 patients. During the follow-up, 10 patients (5.81%) died because of a new cerebrovascular event, 1 patient died of myocardial infarction, 2 patients had new strokes and 2 fractured their paretic legs. Functionally, 43.3% of the patients maintained the level they achieved during inpatient rehabilitation treatment, 23.6% improved and the remaining 33.1% worsened. Patients with hemineglect and aged >/=65 years had a higher probability of functional worsening (odds ratio, OR = 3.77, 95% confidence interval, CI = 1.42- 10.0 and OR = 3.93, 95% CI = 1. 72-8.95, respectively). Postdischarge rehabilitation (performed for 46.5% of the final sample) was significantly and positively associated with functional improvement (OR = 7.23, 95% CI = 2.89-18. 05), and its absence with functional worsening (OR = 12.32, 95% CI = 4.47-37.01). In conclusion, in nearly half of the cases, functional status was still not stabilized at the time of discharge from the rehabilitation hospital. Postdischarge outpatient treatment was useful for preventing worsening of the functional ability achived during inpatient treatment and increased the possibility of further functional improvement. Age >/=65 years and hemineglect were predictors of functional worsening at follow-up.

  11. Back posture education in elementary schoolchildren: a 2-year follow-up study

    OpenAIRE

    Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

    2006-01-01

    Within the scope of primary prevention regarding back functioning in children, research on the stability of intervention effects is indispensable. Along this line, the transition from childhood to adolescence is an important phase to evaluate the potential stability of intervention effects because of the typically mechanical and psychological demands related to adolescence. The main aim of the current study was to investigate the effects of a back education program at 2-year follow-up, in you...

  12. Mindfulness intervention for child abuse survivors: A 2.5-year follow-up

    OpenAIRE

    Earley, MD; Chesney, MA; Frye, J.; Greene, PA; Berman, B; Kimbrough, E

    2014-01-01

    © 2014 Wiley Periodicals, Inc. Objective: The present study reports on the long-term effects of a mindfulness-based stress reduction (MBSR) program for adult survivors of childhood sexual abuse. Method: Of the study participants, 73% returned to the clinic for a single-session follow-up assessment of depression, posttraumatic stress disorder (PTSD), anxiety, and mindfulness at 2.5 years. Results: Repeated measures mixed regression analyses revealed significant long-term improvements in depres...

  13. Five-year follow-up of people diagnosed with compulsive shopping disorder.

    Science.gov (United States)

    Black, Donald W; Shaw, Martha; Allen, Jeff

    2016-07-01

    The authors assessed clinical symptoms and self-reported shopping and spending behavior in people diagnosed with compulsive shopping (CS) at a 5-year follow-up interview. All met the criteria of McElroy et al. for lifetime CS and had the disorder for >1year. Structured and semistructured instruments and self-report questionnaires were used to collect data. Of the original 26 subjects, 17 (65%) were interviewed and are the focus of this report. At follow-up, their ages ranged from 23 to 67years (mean=44years). Lifetime psychiatric comorbidity was common, but few had current psychiatric disorders at follow-up. Interest in shopping and spending decreased for eight (47%), stayed the same for five (29%), and increased for four (24%) subjects. Eleven subjects (65%) reported having attempted to quit their CS and three (18%) reported successfully doing so. Triggers for returning to CS included feelings of pressure/excitement/tension to shop; boredom; negative feelings such as sadness, depression, frustration, or anger; and the desire for positive feelings like happiness, power, or elation. Mean scores on the Compulsive Buying Scale (CBS) and the shopping version of the Yale-Brown Obsessive-Compulsive Scale showed overall improvement in CS symptoms (d=1.16 and d=-1.19, respectively); subjects were also less impulsive (d=-0.48). At baseline and follow-up, those with a lifetime mood disorder tended to have greater CS severity. While the subjects showed overall improvement, most had ongoing symptoms of CS. The implications of the findings are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Asian-Specific total knee system: 5-14 year follow-up study

    Directory of Open Access Journals (Sweden)

    Hosaka Kunihiro

    2011-11-01

    Full Text Available Abstract Background Knee size and body size differ in Asians compared with Caucasians. Nevertheless, many total knee arthroplasty (TKA prostheses used worldwide are made for Western Caucasian subjects. As a result, an Asian's knee might not fit these prostheses. We studied the Flexible Nichidai Knee (FNK system, a new model of TKA for Asian patients. The purpose of this report is to investigate the outcomes of this prosthesis retrospectively. Methods We investigated 1055 primary TKAs in 595 patients who underwent FNK for osteoarthritis (OA in Japan and were followed for > 5 years. The knee score and function score were used for clinical evaluation. We examined the range of motion (ROM preoperatively and at final follow-up and radiographic assessments. In addition, postoperative complications were investigated. A survivorship analysis was also conducted using two endpoints: revision for any reason and aseptic failure. Results 890 knees in 502 patients were available for study (follow-up rate of 96.0%. The mean follow-up term was 8.3 years (range, 5.0-14.1 years. The knee and function score significantly improved from 41.3 to 90.3 and from 39.1 to 76.2 points, respectively (p Conclusion The FNK prosthesis for Asians achieved excellent mid- to long-term survivorship and clinical results.

  15. Early juvenile arthritis – results of two-year follow up

    Directory of Open Access Journals (Sweden)

    S O Salugina

    2009-01-01

    Full Text Available Objective. To study clinical and laboratory manifestations of different variants of juvenile arthritis (JA at the disease onset and during prospective two-year follow up. Material and methods. The study was performed as a part of Institute of Rheumatology early arthritis examination program RADIKAL. 130 pts with early JA (60,7% - girls with disease duration from 2 weeks to 6 months (mean 2,9±1,6 months aged 1,5- 16 years (mean 7,9±5,0 years were included. 13 (10% pts had systemic, 45 (34,6% – polyarticular and 72 (55,4% – olygoarticular variant of JA. General state, joint status, systemic and organ manifestation as well as immunological parameters (ANF, RF, disease activity, functional class (by Steinbrocker and CHAQ were assessed at baseline, and after 6, 12, 24 months of follow up. Results. Oligoarticular variant prevailed at onset and after 2 years (57,6%-55,6%. Systemic features were noted in reduced form as single manifestations. Morning stiffness was absent in half of children and lasted more than 1 hour in 16,4% of pts. After 2 years number of pts with morning stiffness significantly decreased and its duration diminished. Rheumatoid nodules appeared in 1 pt after 1 year. Uveitis developed in 7 children (5,3% and to the end of follow up it appeared in 2 more pts. Most of pts had minimal or moderate functional disability (FK 1,2 and CHAQ 0,1-1,5 during follow up. Disease activity at onset did not exceed 1 or 2 stage (80,2% and after 2 years the disease was not active in half of pts. To the end of follow up remission was achieved in 59% of pts, more often in those who received disease modifying anti-rheumatic drugs. In 23,2% of pts mostly in those with polyarthritis JA continued to recur independently on treatment. Conclusion. Timely administered complex therapy hampered disease progression, induced remission and improved quality of life in most children with JA. Pts with olygoarthritis had most favorable course of the disease. Pts

  16. Mean fourteen-year, 100% follow-up of laparoscopic adjustable gastric banding for morbid obesity.

    Science.gov (United States)

    Victorzon, Mikael; Tolonen, Pekka

    2013-01-01

    Many studies of short-term to mid-term outcomes after laparoscopic adjustable gastric banding (LAGB) have been published, but reliable long-term outcome reports with a minimum follow up ≥ 10 years in a sufficient number of included patients are still scarce. The objective of this study was to evaluate the long-term results after LAGB. Sixty consecutive patients (44 women, 16 men) were treated for morbid obesity by LAGB between 1996 and 1999. Median age of the patients at the time of operation was 45 years (range 21-64). Median preoperative body mass index (BMI, kg/m(2)) was 45 (range 35-55). All patients were asked to adhere to a strict follow-up program. Patients' BMI and percentage excess weight loss (%EWL) were calculated in the hospital's database for bariatric patients, and excess weight was taken as the weight in kilograms above the weight at BMI of 25 kg/m(2). Complete data on all 60 patients could be assessed; thus, the overall rate of follow-up was 100%. After a median (range) follow-up of 14.1 years (13.2-16.8 years), the mean BMI (SD) dropped from 45 (5) to 36 (6) kg/m(2), with a mean (SD) EWL of 49% (29). At 15 years of follow-up, 29 (48%) bands have been removed, and 38 (63%) reoperations have been performed in 29 (48%) patients. Almost 70% received further treatment for their morbid obesity after band removal. Of those patients with the band still in place at 14 years, 40% had more than 50% EWL and 20% had less than 25% EWL. There was no mortality related to the primary or revisional operations, but 2 patients died of unrelated causes. Mean %EWL after LAGB after more than 14 years was fairly good-49%. However, a reoperation rate of more than 60% in 48% of the patients and a band removal rate of almost 50% may indicate that LAGB cannot be recommended as a primary procedure to the general morbidly obese population. © 2013 American Society for Metabolic and Bariatric Surgery. All rights reserved.

  17. 15-year follow-up of the Second Nordic Mantle Cell Lymphoma trial (MCL2)

    DEFF Research Database (Denmark)

    Eskelund, Christian W.; Kolstad, Arne; Jerkeman, Mats;

    2016-01-01

    , developed by the Nordic Lymphoma Group. We here present the 15-year updated results of the Nordic MCL2 study after a median follow-up of 11·4 years: For all patients on an intent-to-treat basis, the median overall and progression-free survival was 12·7 and 8·5 years, respectively. The MCL International......In recent decades, the prognosis of Mantle Cell Lymphoma (MCL) has been significantly improved by intensified first-line regimens containing cytarabine, rituximab and consolidation with high-dose-therapy and autologous stem cell transplantation. One such strategy is the Nordic MCL2 regimen...

  18. Use of mobile phones to improve post-hospitalisation follow-up of ...

    African Journals Online (AJOL)

    ... suggest that a substantial proportion of re-admissions are preventable through effective discharge planning and close patient follow up. ... Design: A cross sectional study. Setting: Siaya County Health facilities, in Nyanza province, Kenya.

  19. Dentinogenesis imperfect a type II: A case report with 17 years of follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Gama, Francisco Jose Reis; Correa, Isabella Sousa; Valerio, Claudia Scigliano; Fatima Ferreira, Emanuelle; Manzi, Flavio Ricardo [Pontifical Catholic University of Minas Gerais, Belo Horizonte (Brazil)

    2017-06-15

    Dentinogenesis imperfect a is a dominant autosomal hereditary disorder of dentin formation that affects the deciduous and permanent teeth. Its etiology is characterized by inadequate cell differentiation during odontogenesis. The clinical characteristics of dentinogenesis imperfect a are discolored teeth with a translucency that varies from gray to brown or amber. Radiographically, the teeth exhibit pulp obliteration, thin and short roots, bell-shaped crowns, and periapical bone rarefaction. The aim of this report was to present a case of dentinogenesis imperfect a type II that was followed up over a 17-year period. This report also presents scanning electron microscopy images of the enamel and dentin, showing that both were altered in the affected teeth. The disease characteristics and the treatments that were administered are reported in this study to guide dentists with respect to the need for early diagnosis and adequate follow-up to avoid major sequelae.

  20. The GSB III elbow prosthesis in rheumatoid arthritis: a 2- to 9-year follow-up

    DEFF Research Database (Denmark)

    Jensen, Claus Hjorth; Jacobsen, Steffen; Ratchke, Martin

    2006-01-01

    BACKGROUND: The optimal design of an elbow prosthesis for badly damaged elbows is unkown. We evaluated 23 GSB III semi-constrained (sloppy-hinged) total elbow arthroplasties in 16 consecutive patients with rheumatoid arthritis. PATIENTS AND METHODS: After a mean follow-up period of 5 (2-9) years...... and radiographic study. All patients had endstage rheumatoid arthritis (RA) of the elbow joint. RESULTS: In 2 patients, humeral components were revised due to malorientation. 1 arthroplasty was revised due to aseptic loosening of the humeral component. There were 4 cases of intraoperative fracture which healed....../supination increased by 31 degrees (0-130). There were no cases of infection or ulnar nerve dysfunction. At the latest follow-up, the HSS elbow score was 84 (40-100) points. 11 of 20 elbows were rated as excellent, 4 elbows were rated as good, 2 elbows were rated as fair, and 3 elbows were rated as poor. 14 of 16...

  1. Dentinogenesis imperfecta type II: A case report with 17 years of follow-up.

    Science.gov (United States)

    Gama, Francisco José Reis; Corrêa, Isabella Sousa; Valerio, Claudia Scigliano; Ferreira, Emanuelle de Fátima; Manzi, Flávio Ricardo

    2017-06-01

    Dentinogenesis imperfecta is a dominant autosomal hereditary disorder of dentin formation that affects the deciduous and permanent teeth. Its etiology is characterized by inadequate cell differentiation during odontogenesis. The clinical characteristics of dentinogenesis imperfecta are discolored teeth with a translucency that varies from gray to brown or amber. Radiographically, the teeth exhibit pulp obliteration, thin and short roots, bell-shaped crowns, and periapical bone rarefaction. The aim of this report was to present a case of dentinogenesis imperfecta type II that was followed up over a 17-year period. This report also presents scanning electron microscopy images of the enamel and dentin, showing that both were altered in the affected teeth. The disease characteristics and the treatments that were administered are reported in this study to guide dentists with respect to the need for early diagnosis and adequate follow-up to avoid major sequelae.

  2. The GSB III elbow prosthesis in rheumatoid arthritis: a 2- to 9-year follow-up

    DEFF Research Database (Denmark)

    Jensen, Claus Hjorth; Jacobsen, Steffen; Ratchke, Martin

    2006-01-01

    BACKGROUND: The optimal design of an elbow prosthesis for badly damaged elbows is unkown. We evaluated 23 GSB III semi-constrained (sloppy-hinged) total elbow arthroplasties in 16 consecutive patients with rheumatoid arthritis. PATIENTS AND METHODS: After a mean follow-up period of 5 (2-9) years...... patients were satisfied with the result and the 2 patients who were not satisfied had persistent pain. INTERPRETATION: Despite the inherent problems of cementing in small-calibre medullary cavities, the clinical outcome of the GSB III arthroplasty was encouraging for patients with-end stage RA. The rate......, we assessed quality of the cementing technique, signs of aseptic loosening, patient satisfaction, range of movement, and determined the Hospital for Special Surgery (HSS) elbow score. 3 patients had died before follow-up; thus, 20 replacements in 16 patients were available for clinical...

  3. Diagnosis and 10-year follow-up of a community-based hepatitis C cohort.

    Science.gov (United States)

    Yawn, Barbara P; Wollan, Peter; Gazzuola, Liliana; Kim, W Ray

    2002-02-01

    To determine the health care follow-up and treatment associated with physician-diagnosed hepatitis C (HCV) in a community-based population. We conducted a retrospective medical record review using records from all providers in Olmsted County, Minnesota. The study incorporated all Olmsted County residents with physician-diagnosed hepatitis C from 1990 through 1999. We assessed demographic and health status information as well as health services use in subjects with physician-diagnosed HCV. Physicians diagnosed hepatitis C in 355 subjects (219 men [62%], 136 women [38%]), mean age 43 years, in the 10-year period studied. About half of diagnoses (45%, n = 159) were confirmed with polymerase chain reaction or liver biopsies. Identified risk factors included IV drug use (50%), multiple sex partners (36%), and blood transfusion (30%). Follow-up assessment with aspartate aminotransferase/amino alanine transferase (AST/ALT) tests occurred in about half (49%) of subjects, while 202 subjects (60%) were referred for gastrointestinal (GI) specialist evaluation and 49 patients (14% of all, 25% of those referred to a GI specialist) had specific treatment for hepatitis C. Although well over half of patients (60%) had possible contraindications to HCV treatment, including heavy alcohol use, few were referred for chemical dependency therapy. In this community, follow-up and treatment related to HCV were limited. Attention to prevention of disease-accelerating co- infections was only modest. Referral or documented recommendations for treatment of alcoholism or heavy chronic alcohol ingestion were minimal.

  4. A four-year follow-up study in fibromyalgia. Relationship to chronic fatigue syndrome

    DEFF Research Database (Denmark)

    Nørregaard, J; Bülow, P M; Prescott, E

    1993-01-01

    The primary objectives of this study were to examine to what extent fibromyalgia patients later on developed presumpted causative somatic diseases and to examine symptoms and muscle strength some years after the diagnosis of fibromyalgia was established. A secondary objective was to describe...... the overlap between fibromyalgia and chronic fatigue syndrome. Only in two of 91 the muscle pain was found to be caused by another somatic disease during the median 4 year follow-up period. In one of the 83 attending subjects a somatic disease associated with muscle symptoms was established at the follow...

  5. Ten-digit replantation with seven years follow-up: A case report.

    Science.gov (United States)

    Cong, Haibo; Sui, Haiming; Wang, Chenlin; Wang, Zhumin; Yang, Qingmin; Wang, Buxing

    2010-07-01

    In this report, we present a case of successful replantation of 10-digit complete amputation and results of postoperative rehabilitation in 7 years follow-up. The rehabilitation program included psychotherapy, physical therapy, sensory re-education, and measurements. At the 7 years postoperatively, the static two-point discriminations of replanted digits ranged from 4 to 11 mm. Grasping powers ranged from 69 to 81 lb, and pinching powers ranged from 13 to 19 lb. The patient returned to the previous employment. Our experience has demonstrated that systemic postoperative rehabilitation and measurements could achieve satisfactory recovery of the sensory and motor functions of multiple-digit replantation.

  6. Pyridoxine-dependent seizures: 10-year follow-up of eight cases

    Directory of Open Access Journals (Sweden)

    Koul Roshan

    2009-01-01

    Full Text Available Eight children with pyridoxine-dependent seizures (PDS were seen over a period of 10 years. Of those children, 6 are on regular follow-up. Four of the children were seen in one family. All the patients presented with refractory seizures, mainly neonatal status epilepticus. Though PDS is a rare condition, it must be considered in all cases with refractory seizures, particularly in childrens younger than 3 years. When confirming a diagnosis, oral pyridoxine is as effective as intravenous pyridoxine.

  7. Traumatic Habit causing Gingival Recession in a child: 3-Year Follow Up

    Directory of Open Access Journals (Sweden)

    Adilis Alexandria

    2015-02-01

    Full Text Available Introduction: The purpose of this report was to present a successful treatment approach in an unusual gingival recession as a result of finger sucking traumatic habit associated with high labial frenum. Case Report: A 10-year-old girl presented moderate pain, recession in the mandibular right incisor and finger sucking habit. The performed treatment was: oral hygiene instruction, use of palatal appliance, psychological support and frenectomy. After three years follow up, significant increases in the width of keratinized gingival, root coverage and profits in clinical attachment levels were observed. Conclusion: This case report showed great results in recovery of the periodontal health in a child.

  8. Crescendo response to rituximab in oral pemphigus vulgaris: a case with 7-year follow-up.

    Science.gov (United States)

    Greenblatt, D T; Benton, E C; Groves, R W; Setterfield, J F

    2016-07-01

    Pemphigus vulgaris (PV) is an autoimmune blistering disease affecting the skin and mucous membranes. Rituximab, a CD20 chimeric monoclonal antibody, has efficacy in PV management. We report a case of severe oral PV that showed a progressive response to repeated courses of rituximab, culminating in a rapid response within 4 weeks following severe relapse 4 years after initial therapy. It demonstrates the progressively shorter time to achieve partial or complete remission following rituximab infusions, combined with minimal adjuvant therapy over a 7-year follow-up period.

  9. Pyridoxine neuropathy. A four-year electrophysiological and clinical follow-up of a severe case.

    Science.gov (United States)

    Santoro, L; Ragno, M; Nucciotti, R; Barbieri, F; Caruso, G

    1991-02-01

    In a 54-year-old male a severe sensory neuropathy was observed during treatment for pulmonary tuberculosis with isoniazid (400 mg/day) and pyridoxine (600 mg/day). Eight months after withdrawal from isoniazid the sensory symptomatology was still progressing, although muscle strength was never reduced. A sural nerve biopsy revealed marked loss of large myelinated fibres. Only when pyridoxine treatment was interrupted did a slow improvement begin. A clinical and electrophysiologic follow-up showed a very slow and still incomplete recovery after four years. The possibility of an unusual individual susceptibility to toxic effects of pyridoxine is considered.

  10. Attempted suicide in Denmark. IV. A five-year follow-up

    DEFF Research Database (Denmark)

    Wang, A G; Brille-Brahe, U; Nielsen, B

    1990-01-01

    behaviour and to try to identify relevant factors for evaluation of future suicide risk. During the follow-up period 11.6% of the attempters committed suicide, the majority within the first year after the index attempt. Seventy-five percent of the suicides were committed less than 6 months after the last......From October 1, 1980 to April 20, 1981, 207 patients were admitted to the Department of Psychiatry, Odense University Hospital, after attempting suicide. Information on physical, mental and social conditions was collected. The patients were then followed for 5 years, to register subsequent suicidal...

  11. Prognostic significance of transient myocardial ischaemia after first acute myocardial infarction: five year follow up study

    DEFF Research Database (Denmark)

    Mickley, H; Nielsen, J R; Berning, J

    1995-01-01

    OBJECTIVE: To assess the five year prognostic significance of transient myocardial ischaemia on ambulatory monitoring after a first acute myocardial infarction, and to compare the diagnostic and long term prognostic value of ambulatory ST segment monitoring, maximal exercise testing...... episodes of transient ST segment depression, of which 98% were silent. Over a mean of 5 (range 4 to 6) years of follow up, patients with ambulatory ischaemia were no more likely to have objective end points than patients without ischaemic episodes. If, however, subjective events were included...

  12. Surgical treatment of gingival overgrowth with 10 years of follow-up

    Directory of Open Access Journals (Sweden)

    Ballini Andrea

    2010-08-01

    Full Text Available Abstract Background In some pathological conditions, gingivitis caused by plaque accumulation can be more severe, with the result of an overgrowth. Nevertheless, the overgrowth involves the gingival margin with extension to the inter-dental papilla. The lesion may involve the inter-proximal spaces, and become so extensive that the teeth are displaced and their crowns covered. Severe overgrowth may lead to impairment in aesthetic and masticatory functions, requiring surgical excision of the excessive tissue. Aim of this study is to describe an operative protocol for the surgical treatment of localized gingival overgrowth analyzing the surgical technique, times and follow-up. Methods A total of 20 patients were enrolled and underwent initial, non surgical, periodontal treatment and training sessions on home oral hygiene training. The treatment plan involved radical exeresis of the mass followed by positioning of an autograft of connective tissue and keratinized gingiva. Results During 10 years of follow-up, all the grafts appeared well vascularized, aesthetically satisfactory, and without relapse. Conclusions Periodontal examinations, surgical procedures, and dental hygiene with follow-up are an essential part of the treatment protocol. However, additional effort is needed from the patient. Hopefully, the final treatment result makes it all worthwhile.

  13. Fifteen-year follow-up of quality of life in type 1 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Peter; R; van; Dijk; Susan; JJ; Logtenberg; Klaas; H; Groenier; Joost; C; Keers; Henk; JG; Bilo; Nanne; Kleefstra

    2014-01-01

    AIM:To evaluate metabolic control and health-related quality of life(HRQOL)in a type 1 diabetes mellitus(T1DM)population.METHODS:As part of a prospective cohort study,283T1DM patients treated with various insulin treatment modalities including multiple daily injections(MDI)and continuous subcutaneous insulin infusion(CSII)were examined annually.HRQOL was measured using the SF-36 and EuroQol questionnaires.Data regarding HRQOL,glycaemic and metabolic control from baseline and follow-up measures in 2002 and 2010 were analysed.Linear mixed models were used to calculate estimated values and differences between the three moments in time and the three treatment modalities.RESULTS:Significant changes[meanΔ(95%CI)]in body mass index[2.4 kg/m2(1.0,3.8)],systolic blood pressure[-6.4 mmHg(-11.4,-1.3)]and EuroQol-VAS[-7.3(-11.4,-3.3)]were observed over time.In 2010,168 patients were lost to follow-up.Regarding mode of therapy,52 patients remained on MDI,28 remained on CSII,and 33 patients switched from MDI to CSII during follow-up.Among patients on MDI,HRQOL decreased significantly over time:mental component summary[-9.8(-16.3,-3.2)],physical component summary[-8.6(-15.3,-1.8)]and EuroQol-VAS[-8.1(-14.0,-2.3)],P<0.05 for all.For patients using CSII,the EuroQol-VAS decreased[-9.6(-17.5,-1.7)].None of the changes over time in HRQOL differed significantly with the changes over time within the other treatment groups.CONCLUSION:No differences with respect to metabolic and HRQOL parameters between the various insulin treatment modalities were observed after 15 years of follow-up in T1DM patients.

  14. Schizophrenia and quality of life: a one-year follow-up in four EU countries

    Directory of Open Access Journals (Sweden)

    Lacalmontie Elisabeth

    2006-09-01

    Full Text Available Abstract Background This article systematically monitors the quality of life (QOL of patients with schizophrenia from seven different sites across four European countries: France, Ireland, Portugal and Spain. Methods A one-year prospective cohort study was carried out. Inclusion criteria for patients were: a clinical lifetime diagnosis of schizophrenia according to ICD-10 (F20 diagnostic criteria for research, age between 18 and 65 years and at least one contact with mental health services in 1993. Data concerning QOL were recorded in seven sites from four countries: France, Portugal, Ireland and Spain, and were obtained using the Baker and Intagliata scale. At baseline, 339 patients answered the QOL questionnaire. At one-year follow-up, Spain could not participate, so only 263 patients were contacted and 219 agreed to take part. QOL was compared across centres by areas and according to a global index. QOL was correlated with presence of clinical and social problems, needs for care and interventions provided during the one-year follow-up. Results We did not find any link between gender and QOL. There were some significant differences between centres concerning many items. What is more, these differences were relative: in Lisbon where the lowest level of satisfaction was recorded, people were satisfied with food but highly dissatisfied with finances, whereas in St Etienne, where the highest level of satisfaction was recorded, people were less satisfied with food when they were more satisfied with finances. The evolution in one year among those respondents who took part in the follow-up (excluding the subjects from Granada showed different patterns depending on the items. Conclusion The four countries have different resources and patients live in rather different conditions. However, the main differences as far as their QOL is concerned very much depend on extra-psychiatric variables, principally marital status and income.

  15. Sacral-Alar-Iliac Fixation in Children with Neuromuscular Scoliosis: Minimum 5-Year Follow-Up.

    Science.gov (United States)

    Jain, Amit; Sullivan, Brian T; Kuwabara, Anne; Kebaish, Khaled; Sponseller, Paul D

    2017-09-05

    The aim of our study was to investigate the 5-year outcomes of children with neuromuscular scoliosis treated with sacral-alar-iliac screws. We reviewed clinical and radiographic records of patients ≤18 years old treated by 1 pediatric orthopaedic surgeon for neuromuscular scoliosis with spinal fusion using sacral-alar-iliac pelvic anchors. Thirty-eight patients, with a minimum 5-year radiographic follow-up (6.0 ± 1.2 years), were studied. Mean patient age was 13 ± 2.0 years and 47% were female. The mean number of levels fused was 18 ± 0.7. The diagnosis was cerebral palsy in 66% of patients. Between the preoperative period and final follow-up there was a mean 79% correction of the major coronal curve (85° to 18°) and 57% correction of the pelvic obliquity (16° to 7°). Patients maintained correction of mean pelvic obliquity from the early postoperative period (6°) to final follow-up (7°). Preoperatively, 76% of patients had pelvic obliquity of >10°compared with 26% after surgery. There were no cases of neurologic or vascular complications or pseudarthrosis. Radiographs revealed bilateral sacral-alar-iliac screw lucency in 8 patients; 4 of these patients had deep wound infections, and the other 4 were asymptomatic. Unilateral screw fracture was found in 1 patient with an 8-mm screw diameter (1.3%, 1 of 76 screws); the patient was observed and remained asymptomatic. There were no cases of set screw displacement, screw back-out, or rod dislodgement. Sacral-alar-iliac screws are safe and effective pelvic anchors for use in children with neuromuscular scoliosis. Copyright © 2017. Published by Elsevier Inc.

  16. Schizophrenia and quality of life: a one-year follow-up in four EU countries.

    LENUS (Irish Health Repository)

    2006-01-01

    BACKGROUND: This article systematically monitors the quality of life (QOL) of patients with schizophrenia from seven different sites across four European countries: France, Ireland, Portugal and Spain. METHODS: A one-year prospective cohort study was carried out. Inclusion criteria for patients were: a clinical lifetime diagnosis of schizophrenia according to ICD-10 (F20) diagnostic criteria for research, age between 18 and 65 years and at least one contact with mental health services in 1993. Data concerning QOL were recorded in seven sites from four countries: France, Portugal, Ireland and Spain, and were obtained using the Baker and Intagliata scale. At baseline, 339 patients answered the QOL questionnaire. At one-year follow-up, Spain could not participate, so only 263 patients were contacted and 219 agreed to take part. QOL was compared across centres by areas and according to a global index. QOL was correlated with presence of clinical and social problems, needs for care and interventions provided during the one-year follow-up. RESULTS: We did not find any link between gender and QOL. There were some significant differences between centres concerning many items. What is more, these differences were relative: in Lisbon where the lowest level of satisfaction was recorded, people were satisfied with food but highly dissatisfied with finances, whereas in St Etienne, where the highest level of satisfaction was recorded, people were less satisfied with food when they were more satisfied with finances. The evolution in one year among those respondents who took part in the follow-up (excluding the subjects from Granada) showed different patterns depending on the items. CONCLUSION: The four countries have different resources and patients live in rather different conditions. However, the main differences as far as their QOL is concerned very much depend on extra-psychiatric variables, principally marital status and income.

  17. The 35 years followed up study of 72 patients with transient ischemic attacks

    Institute of Scientific and Technical Information of China (English)

    Wang Xinde; Gong Tao

    2000-01-01

    Objective Seventy-two TIA patients were followed up for 35 years. The recurrence of TIA, thc ocurrence of complete stroke and myocardial infarction, the fatality rate and the causes of death, the survival rate in every year and its 95% confidence interval, and limitation of neurovascular surgical indication were observed. Methods We followed up 72 patients with TIA for 35 years and analyzed those conditions mentioned above with the methods ofcochort study, life table and other medical epidemiological statistics. Results The recurrent rate of TIA was 27.9%, the occurrence rate of complete stroke 65.7%, that of myocardial infarction 8.4%. The fatality rate was 72.7%. The main cause of death was complete stroke, accounting for 59.6%. The first cause of death in non-elderly patients was cerebral hemorrhage and in the elderly patiems was cerebral infarction. There were two patients with fatal myocardial infarction, accounting for 2. 8% The survival rate of 29 years was 24.5% and its 95% confidence interval was 5.0-44.0%. The 19 cases had the indication of neurovascular surgical operation, accounting for 26.6%. Conclusion In the long term followed-up study the prognosis of patients with TIA was better than that of those witt cerebral infarction. About one thud of patients had the recurrence of TIA. The occurrence rate of complete stroke was obviously higher than that of myocardial infarction. Estimably, the effect on preventing the occurrence of complete stroke in patients with TIA by neurovascular surgical operation was limited

  18. Post-traumatic stress symptoms among former child soldiers in Sierra Leone: follow-up study.

    Science.gov (United States)

    Betancourt, Theresa S; Newnham, Elizabeth A; McBain, Ryan; Brennan, Robert T

    2013-09-01

    Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined. The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated. Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed. Self-reported rates of possible PTSD using standard cut-off points declined from 32% to 16% 4 years later (Pchild soldiers despite limited access to care. Family and community support played a vital part in promoting psychological adjustment.

  19. A 3-year follow-up of sun behavior in patients with cutaneous malignant melanoma.

    Science.gov (United States)

    Idorn, Luise Winkel; Datta, Pameli; Heydenreich, Jakob; Philipsen, Peter Alshede; Wulf, Hans Christian

    2014-02-01

    IMPORTANCE UV radiation (UVR) exposure is the primary environmental risk factor for developing cutaneous malignant melanoma (CMM). OBJECTIVE To measure changes in sun behavior from the first until the third summer after the diagnosis of CMM using matched controls as a reference. DESIGN, SETTING, AND PARTICIPANTS Three-year follow-up, observational, case-control study performed from May 7 to September 22, 2009, April 17 to September 15, 2010, and May 6 to July 31, 2011, at a university hospital in Denmark of 21 patients with CMM and 21 controls matched to patients by sex, age, occupation, and constitutive skin type participated in the study. Exposure to UVR was assessed the first and second summers (n=20) and the first and third summers (n=22) after diagnosis. Data from 40 participants were analyzed. MAIN OUTCOMES AND MEASURES Exposure to UVR was assessed by personal electronic UVR dosimeters that measured time-related UVR in standard erythema dose (SED) and corresponding sun diaries (mean, 74 days per participant each participation year). RESULTS Patients' daily UVR dose and UVR dose in connection with various behaviors increased during follow-up (quantified as an increase in daily UVR dose each year; all days: mean, 0.3 SED; 95% CI, 0.05-0.5 SED; days with body exposure: mean, 0.6 SED; 95% CI, 0.07-1.2 SED; holidays: mean, 1.2 SED; 95% CI, 0.3-2.1 SED; days abroad: 1.9 SED; 95% CI, 0.4-3.4 SED; and holidays with body exposure: mean, 2.3 SED; 95% CI, 1.1-3.4 SED). After the second year of follow-up, patients' UVR dose was higher than that of controls, who maintained a stable UVR dose. No difference was found between groups in the number of days with body exposure or the number of days using sunscreen in the second and third years of follow-up. CONCLUSIONS AND RELEVANCE Our findings suggest that patients with CMM do not maintain a cautious sun behavior in connection with an increase in UVR exposure, especially on days with body exposure, when abroad, and on holidays.

  20. Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

    DEFF Research Database (Denmark)

    Roug, Stine; Madsen, Lone Galmstrup

    2012-01-01

    To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure of eradicat......To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure...

  1. Cost of acute hospitalization and post-discharge follow-up care for meningococcal disease in the US.

    Science.gov (United States)

    Davis, Keith L; Misurski, Derek; Miller, Jacqueline M; Bell, Timothy J; Bapat, Bela

    2011-01-01

    The combined costs of acute hospitalization and post-discharge follow-up care in patients with meningococcal disease have not been widely documented. In this study, data were retrospectively analyzed from three large databases of hospital discharge records and commercial insurance claims in the US. Cases of meningococcal disease were defined as admissions with an ICD-9-CM diagnosis code in the range of 036.x. From the 2005 HCUP Nationwide Inpatient Sample, 349 (weighted N=1,710) meningococcal-related hospitalizations were identified with a mean facility cost (in 2009 dollars) of $19,526 per admission. Similar estimates ($18,119 and $20,066, respectively) were obtained from 268 admissions identified in the LifeLink (formerly PharMetrics) database during 1999-2007 and from 1,058 hospitalizations in the Perspective Comparative Database (PCD) during 2000-2007. Using insurance claims from LifeLink, we estimated that payers incur an additional $26,178 in non-facility (professional and other ancillary) costs during the course of a meningococcal admission, as well as $22,230 in additional medical and pharmacy expenses for post-discharge care during the ensuing year. The majority of follow-up costs ($14,637) were attributed to repeat hospitalizations. Mean length of stay for meningococcal disease was consistently estimated across databases at 8 to 9 days. Data from the PCD further suggested that meningococcal disease carries, on average, nearly 2 days of intensive care unit utilization. In conclusion, hospital admissions for meningococcal disease are costly to payers. These costs are heightened when non-facility services and post-discharge care are also considered. Awareness of the full cost burden of meningococcal disease is needed when evaluating vaccination programs targeting the disease.

  2. Three-Year Follow-up of Conservative Treatments of Shoulder Osteoarthritis in Older Patients.

    Science.gov (United States)

    Guo, Jiong Jiong; Wu, Kailun; Guan, Huaqing; Zhang, Lei; Ji, Cheng; Yang, Huilin; Tang, Tiansi

    2016-07-01

    Little is known about the mid-term results of nonsurgical treatment for shoulder osteoarthritis (OA), especially in a Chinese population. This study sought to determine the efficacy of nonsurgical management in older patients with shoulder OA. A total of 129 conservatively treated unilateral shoulder OA patients who were older than 65 years were evaluated prospectively at the initial office visit and then subsequently at 3, 6, 12, 18, 24, and 36 months later. During the 36-month follow-up period, all patients could receive conventional therapy, such as nonsteroidal anti-inflammatory medication, corticosteroid injection, sodium hyaluronate, and education, at the discretion of treating physicians. Some patients received physiotherapy, rehabilitation training, and a shoulder strap to improve the range of motion and muscular strength training from a physical therapist. Parameters measured included comparative effectiveness of each therapeutic method, visual analog scale (VAS), Simple Shoulder Test (SST), and Short Form (36) Health Survey (SF-36) scores. At 3-year follow-up, most patients had a significant increase from their pretreatment values in pain, self-assessed shoulder function, mental health, and 5 of 8 SF-36 domains. The study showed a decline in SST and VAS at 6 and 12 months after an initial ascent at 3 months, and then it was rescued and continued at 3-year follow-up. Combined therapy could improve symptoms significantly. This study suggests that a conservative approach may be more appropriate and can produce satisfactory mid-term outcomes in selected cases. The findings of this study suggest that conservative treatments should be extended for longer than 12 months before the decision regarding shoulder arthroplasty is made. [Orthopedics. 2016; 39(4):e634-e641.].

  3. Australian Aboriginal Birth Cohort study: follow-up processes at 20 years

    Directory of Open Access Journals (Sweden)

    Davison Belinda

    2009-09-01

    Full Text Available Abstract Background In 1987, a prospective study of an Australian Aboriginal Birth Cohort was established focusing on the relationships of fetal and childhood growth with the risk of chronic adult disease. However as the study is being conducted in a highly marginalized population it is also an important resource for cross-sectional descriptive and analytical studies. The aim of this paper is to describe the processes of the third follow up which was conducted 20 years after recruitment at birth. Methods Progressive steps in a multiphase protocol were used for tracing, with modifications for the expected rural or urban location of the participants. Results Of the original 686 cohort participants recruited 68 were untraced and 27 were known to have died. Of the 591 available for examination 122 were not examined; 11 of these were refusals and the remainder were not seen for logistical reasons relating to inclement weather, mobility of participants and single participants living in very remote locations. Conclusion The high retention rate of this follow-up 20 years after birth recruitment is a testament to the development of successful multiphase protocols aimed at overcoming the challenges of tracing a cohort over a widespread remote area and also to the perseverance of the study personnel. We also interpret the high retention rate as a reflection of the good will of the wider Aboriginal community towards this study and that researchers interactions with the community were positive. The continued follow-up of this life course study now seems feasible and there are plans to trace and reexamine the cohort at age 25 years.

  4. Obesity paradox disappears in coronary artery bypass graft patients during 20-year follow-up.

    Science.gov (United States)

    Hällberg, Ville; Kataja, Matti; Lahtela, Jorma; Tarkka, Matti; Inamaa, Tapio; Palomäki, Ari

    2016-02-24

    Although obesity is a risk factor for coronary heart disease (CHD), it might be associated with a favourable prognosis in patients with CHD. The aim of the study was to evaluate this so called 'obesity paradox' during a follow-up period of 20 years in patients who had undergone coronary artery bypass grafting (CABG). The study population consisted of 922 CHD patients who had undergone CABG between 1993 and 1994. Pre and perioperative data was collected from patient records and supplemented with patient questionnaires, telephone contacts and data from national archives. The 10-year postoperative prognosis of normal-weight patients (body mass index (BMI) 18.5-24.9 kg/m(2)) was inferior to that of overweight (BMI 25.0-29.9 kg/m(2)) and obese patients (BMI⩾30.0 kg/m(2)) and to the background population. Beyond 10 years the prognosis of obese patients deteriorated when compared with the overweight group. At the end of the 20-year follow-up, survival of the normal weight group was 0.68 (95% confidence interval (CI), 0.49-0.87; pparadox seems to disappear due to progression of cardiometabolic disease in patients who have undergone CABG. © The European Society of Cardiology 2016.

  5. Primary localized conjunctival amyloidosis: A case report with a ten-year follow-up period

    Directory of Open Access Journals (Sweden)

    Juan Carlos Mesa-Gutiérrez

    2008-10-01

    Full Text Available Juan Carlos Mesa-Gutiérrez, Tomás Martí Huguet, Noemí Barnils Garcia, Jorge Arruga GinebredaDepartment of Ophthalmology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, SpainAbstract: A 57-year-old woman consulted our department about a plaque that had been present in her left eye for one year. Ophthalmological examination revealed a solid mass in the left conjunctival semilunar fold. An excitional biopsy was peformed, revealing an amyloid deposition. The patient was referred to the Internal Medicine Department for systemic study. All studies were negative for systemic amyloidosis. Throughout ten years of follow-up study, the patient has shown neither conjunctival recurrence nor any evidence of systemic amylodosis. Despite the fact that several authors have described ocular amyloidosis as an ophthalmologic manifestation of systemic amyloidosis, conjunctival location of amyloidosis is a very rare condition. Amyloid characterization in ocular structures should not be considered a final diagnosis since involvement of systemic underlying diseases must be ruled out. We report a case of localized conjunctival amyloidosis with a ten-year follow-up period that excluded ocular or systemic diseases.Keywords: conjuctival amyloidosis, ocular amyloidosis, hyaline protein

  6. Kenny-Caffey Syndrome: oral findings and 4-year follow-up of overlay denture therapy.

    Science.gov (United States)

    Demir, Tahsin; Kecik, Defne; Cehreli, Zafer C

    2007-01-01

    Kenny-Caffey Syndrome (KCS) is an extremely rare osteosclerotic bone dysplasia associated with hypocalcemia and ocular abnormalities. Although the condition is well reported in the medical literature, dental manifestations have not been discussed in great detail. The purpose of this report is to present specific oral features and prosthetic management in a KCS patient. Overlay dentures were utilized in the management of low vertical dimension of occlusion, congenital absence of several permanent teeth, and problems associated with function and esthetics. Results of the 4-year follow-up overlay denture therapy are presented.

  7. Neonatal, severe primary hyperparathyroidism: a 7-year clinical and radiological follow-up of one patient

    Energy Technology Data Exchange (ETDEWEB)

    Doria, Andrea S.; Daneman, Alan [Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario (Canada); Huang, Carol; Makitie, Outi; Kooh, Sang W.; Sochett, Etienne [Department of Endocrinology, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8 (Canada); Thorner, Paul [Department of Laboratory Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario (Canada)

    2002-09-01

    Neonatal primary hyperparathyroidism is a rare entity characterized by marked hypercalcemia, diffuse parathyroid hyperplasia, and skeletal demineralization. It is often lethal unless total parathyroidectomy is performed. Long-term outcome of treated patients is poorly documented. We report the clinical and radiographic outcome of this disease in a 7-year-old boy who underwent a total parathyroidectomy and autotransplantation of a fragment of one parathyroid gland to his thigh in the neonatal period. This paper demonstrates the importance of prompt diagnosis and management in neonatal hyperparathyroidism and the role of various imaging modalities in its diagnosis and follow-up. (orig.)

  8. Treatment of Odontogenic Myxoma: A Multidisciplinary Approach—6-Year Follow-Up Case

    Directory of Open Access Journals (Sweden)

    João Gustavo Oliveira de Souza

    2014-01-01

    Full Text Available The most aggressive diseases that affect the oral environment are considered tumors of the jaw. The surgical treatment is preferably done by surgical resection of the lesion, resulting in a great loss of tissue and esthetics. Multidisciplinary planning is required for the rehabilitation of these cases. Autogenous grafting techniques or vascularized flaps allow ridge reconstruction for implant placement, restoring function, and esthetics. This paper reports a 6-year follow-up case of an odontogenic myxoma treated with wide resection and mandibular bone reconstruction for posterior rehabilitation with dental implants.

  9. Physical Activity Programs with Post-Intervention Follow-Up in Children: A Comprehensive Review According to Categories of Intervention.

    Science.gov (United States)

    Nguyen, Sally; Häcker, Anna-Luisa; Henderson, Melanie; Barnett, Tracie; Mathieu, Marie-Eve; Pagani, Linda; Bigras, Jean-Luc

    2016-06-30

    Only 9% of Canadian children meet the National Guidelines of 60 min of daily moderate-to-vigorous intensity physical activity. The aim of this review is to assess the mid- and long-term effectiveness of physical activity interventions and their impact on cardiovascular risk factors in children. We assessed the success of interventions within three different categories: those using a behavioural and social approach, an informational approach or an environmental approach. The average number of children included in these studies was 860 (range of 30-5106); the age range was from 2 to 18 years; and the mean intervention duration was 1607 min (range of 12-8160 min). The length of follow-up post-intervention averaged 13 months (ranging from 0.25 to 96 months). A positive impact on physical activity was found in 74% and on any measured outcomes in 90% of the studies reviewed. However, the benefits of physical activity interventions decreased with longer follow-up. Regardless of the approaches, physical activity interventions improved cardiovascular risk factors. However, the challenge of any program is to maintain beneficial effects once the intervention is completed. These findings will inform the development of future intervention programs in order to optimize sustained cardiovascular benefits.

  10. Physical Activity Programs with Post-Intervention Follow-Up in Children: A Comprehensive Review According to Categories of Intervention

    Directory of Open Access Journals (Sweden)

    Sally Nguyen

    2016-06-01

    Full Text Available Only 9% of Canadian children meet the National Guidelines of 60 min of daily moderate-to-vigorous intensity physical activity. The aim of this review is to assess the mid- and long-term effectiveness of physical activity interventions and their impact on cardiovascular risk factors in children. We assessed the success of interventions within three different categories: those using a behavioural and social approach, an informational approach or an environmental approach. The average number of children included in these studies was 860 (range of 30–5106; the age range was from 2 to 18 years; and the mean intervention duration was 1607 min (range of 12–8160 min. The length of follow-up post-intervention averaged 13 months (ranging from 0.25 to 96 months. A positive impact on physical activity was found in 74% and on any measured outcomes in 90% of the studies reviewed. However, the benefits of physical activity interventions decreased with longer follow-up. Regardless of the approaches, physical activity interventions improved cardiovascular risk factors. However, the challenge of any program is to maintain beneficial effects once the intervention is completed. These findings will inform the development of future intervention programs in order to optimize sustained cardiovascular benefits.

  11. Incidence of Alzheimer′s disease in India: A 10 years follow-up study

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    P S Mathuranath

    2012-01-01

    Full Text Available Objective: To determine overall and age-specific incidence rates of Alzheimer′s disease (AD in a southern Indian province, Kerala. Materials and Methods: A 10-year (2001-2011 prospective epidemiologic study of community residing subjects aged ≥55 years at enrollment. The catchment area included four urban and semi-urban regions of Trivandrum city in Kerala, India, was selected to provide a range of demographic and socioeconomic representation. Cognitive and functional ability screening were done at baseline and 24-month follow-up assessments. Consensus diagnostic procedures were done using the Diagnostic and Statistical Manual of Mental Disorders, 4 th edition (DSM-IV, and the National Institute of Neurological and Communicative Disorders and Stroke - Alzheimer′s Disease and Related Disorders Association (NINDS-ADRDA criteria for the diagnosis of dementia and AD. Results: Among the 1066 eligible participants who were cognitively normal at baseline, 104 developed dementia (98 with AD over a follow-up period of 8.1 years. The incidence rates per 1000 person-years for AD was 11.67 (95% CI: 10.9-12.4 for those aged ≥55 years and higher for those aged ≥65 years (15.54, 95% CI: 14.6-16.5. In those aged ≥65 years, the world age standardized incidence rate was 21.61 per 100,000, and standardized against the age distribution for the year 2000 U.S. Census, the age-adjusted incidence rate was 9.19 (95% CI: 9.03-9.35 per 1000 person-years. Incidence rate of AD increased significantly and proportionately with increasing age. Conclusion: These are the first AD incidence rates to be reported from southern India. The incidence rates appear to be much higher than that reported from rural north India, comparable with that reported from China, and marginally lower than that reported from the western world.

  12. Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

    DEFF Research Database (Denmark)

    Roug, Stine; Madsen, Lone Galmstrup

    2012-01-01

    To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure...

  13. Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

    DEFF Research Database (Denmark)

    Roug, Stine; Madsen, Lone Galmstrup

    2012-01-01

    To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure...

  14. One-year MR imaging follow-up of patients with multiple sclerosis under cortisone therapy

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    Uhlenbrock, D.; Herbe, E.; Seidel, D.; Gehlen, W.

    1989-03-01

    Twenty patients with relapsing/remitting course of MS were studied four times with MR imaging over the course of one year. First MR was undertaken during the acute relapse, afterwards patients were given cortisone therapy for four to six weeks. The second MR study followed 4-6 weeks after the first, the patients at this time being in remission. The third MR study was carried out 4 months after the first, the last scan one year after the first. The total number of lesions varied, though not greatly, over the whole follow-up, but there was an influence of the clinical course of MS on the pattern of lesions in MR imaging, mostly in respect to the number of confluences and the size of the lesions. Follow-up over one year showed that the inflammatory process produced an increase in the number of plaques, independent of the fact that most patients stayed in remission. A delayed effect of the cortisone therapy on the size, number, and confluence of plaques is suggested whilst clinical signs improved in most cases immediately after the beginning of drug therapy. Independent of the clinical course of the disease in some cases plaques previously seen vanished and others appeared in one and the same examination.

  15. Induction of maturogenesis by partial pulpotomy: 1 year follow-up.

    Science.gov (United States)

    Bacaksiz, A; Alaçam, A

    2013-01-01

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

  16. Arthroscopic arthrodesis of the shoulder: Fourteen-year follow-up

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    Antonio Jiménez-Martín

    2011-01-01

    Full Text Available Shoulder arthrodesis is indicated in infections, brachial paralysis, irreparable rotator cuff tears, osteoarthritis without indication of prosthesis, rescue after arthroplasty, or after surgery for cancer. Arthroscopic arthrodesis is exceptional. Our aim is presenting our result after 14 years of follow-up of one patient. We present a case report of a 17-year-old male patient. He suffered fracture of left scapula (type V, Ideberg, fracture of left clavicle (type I, Craig, and fracture of left distal ulna. We realized osteosynthesis of clavicle (plate and screws with the aim of treating this floating shoulder. Electromyography showed partial axonotmesis of axilar nerve. After 7 months of follow-up, axonotmesis was still present. We realized arthroscopic shoulder arthrodesis (three cannulated screws. Fourteen years later, shoulder movement was as follows: Flexion, 0-90°; maximum abduction, 40° with shoulder atrophy; Constant, 47 points; and UCLA, 17 points, without pain. Arthrodesis with screws reaches a subjective benefit in 82% of patients. Percentage of pseudarthrosis is less than in patients treated with plates, although the risks of infections, fractures, and material removal are greater than in patients treated with plates. Shoulder arthroscopic arthrodesis is exceptional, but it allows minimal surgical aggression.

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

    Directory of Open Access Journals (Sweden)

    A. Bacaksiz

    2013-01-01

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

  18. One-year follow-up study of psychotic patients treated with blonanserin: a case series.

    Science.gov (United States)

    Takahashi, Sakae; Suzuki, Masahiro; Uchiyama, Makoto

    2013-09-01

    Blonanserin is a relatively new atypical antipsychotic drug, and has been used in Korea and Japan for 1 and 3 years, respectively. Therefore, the clinical characteristics of blonanserin remain unclear. In this study, to clarify the features of blonanserin, we performed prospective and long-term comparative investigations of patients treated with blonanserin. We followed 10 psychiatric patients who were switched to blonanserin from other antipsychotics for 1 year (schizophrenia: 8; mental retardation: 2). In the light of quality of life, we focused on adverse effects of patients during the follow-up. In the long-term follow-up, (i) hyperprolactinemia is more frequently in risperidone than in blonanserin; however, it is more often in blonanserin than in olanzapine; and (ii) weight gain is more common in olanzapine than in blonanserin. We switched to blonanserin from other antipsychotic drugs within the same case, and then followed the case for 1 year. We consider that long-term observations within the same case lead to obvious comparisons among drugs. On the basis of our findings, we conclude that blonanserin may be useful for the maintenance treatment of schizophrenia without inducing hyperprolactinemia and weight gain. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

  19. The arthroscopic latarjet procedure for anterior shoulder instability: 5-year minimum follow-up.

    Science.gov (United States)

    Dumont, Guillaume D; Fogerty, Simon; Rosso, Claudio; Lafosse, Laurent

    2014-11-01

    The arthroscopic Latarjet procedure combines the benefits of arthroscopic surgery with the low rate of recurrent instability associated with the Latarjet procedure. Only short-term outcomes after arthroscopic Latarjet procedure have been reported. To evaluate the rate of recurrent instability and patient outcomes a minimum of 5 years after stabilization performed with the arthroscopic Latarjet procedure. Case series; Level of evidence, 4. Patients who underwent the arthroscopic Latarjet procedure before June 2008 completed a questionnaire to determine whether they had experienced a dislocation, subluxation, or further surgery. The patients also completed the Western Ontario Shoulder Instability Index (WOSI). A total of 62 of 87 patients (64/89 shoulders) were contacted for follow-up. Mean follow-up time was 76.4 months (range, 61.2-100.7 months). No patients had reported a dislocation since their surgery. One patient reported having subluxations since the surgery. Thus, 1 patient (1.59%) had recurrent instability after the procedure. The mean ± standard deviation aggregate WOSI score was 90.6% ± 9.4%. Mean WOSI domain scores were as follows: Physical Symptoms, 90.1% ± 8.7%; Sports/Recreation/Work, 90.3% ± 12.9%; Lifestyle, 93.7% ± 9.8%; and Emotions, 88.7% ± 17.3%. The rate of recurrent instability after arthroscopic Latarjet procedure is low in this series of patients with a minimum 5-year follow-up. Patient outcomes as measured by the WOSI are good. © 2014 The Author(s).

  20. Lifestyle and weight predictors of a healthy overweight profile over a 20-year follow-up.

    Science.gov (United States)

    Fung, Michael D T; Canning, Karissa L; Mirdamadi, Paul; Ardern, Chris I; Kuk, Jennifer L

    2015-06-01

    To examine whether changes in modifiable risk factors [physical activity, cardiorespiratory fitness (CRF), body weight, and diet composition] are associated with the transition to metabolically healthy overweight/obese (MHOW) versus metabolically abnormal overweight/obese. Analysis included 1,358 adults [aged 25.0 (3.5) years] from the CARDIA study who were healthy at baseline and had overweight/obesity at follow-up. Participants with zero or one of the following six risk factors were classified as MHOW: elevated triglycerides, LDL, blood pressure, fasting glucose, and HOMA-insulin resistance and low HDL. Over the 20-year follow-up, the sample gained weight (BMI 24.5 to 31.1 kg/m(2) ), and the prevalence of MHOW was 47% at follow-up. After adjusting for changes in CRF, diet, and weight change, physical activity and macronutrient intake were not independently associated with MHOW (P > 0.05), while changes in CRF [fit-unfit: RR (95%) = 0.58, 0.52-0.66; unfit-unfit: RR = 0.67, 0.58-0.76, versus fit-fit] and weight [gain: RR (95%) = 0.54, 0.43-0.67; cycle: RR = 0.74, 0.57-0.94, versus stable] were independently associated with MHOW. Focusing on high CRF and strategies to limit weight gain may be important for individuals with overweight and obesity in early to mid-adulthood to maintain a metabolically healthy profile. © 2015 The Obesity Society.

  1. Risk Factors for Mortality in Hemodialysis Patients: Two-Year Follow-Up Study

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    Maria do Sameiro-Faria

    2013-01-01

    Full Text Available Background. End-stage renal disease (ESRD patients under hemodialysis (HD have high mortality rate. Inflammation, dyslipidemia, disturbances in erythropoiesis, iron metabolism, endothelial function, and nutritional status have been reported in these patients. Our aim was to identify any significant association of death with these disturbances, by performing a two-year follow-up study. Methods and Results. A large set of data was obtained from 189 HD patients (55.0% male; 66.4 ± 13.9 years old, including hematological data, lipid profile, iron metabolism, nutritional, inflammatory, and endothelial (dysfunction markers, and dialysis adequacy. Results. 35 patients (18.5% died along the follow-up period. Our data showed that the type of vascular access, C-reactive protein (CRP, and triglycerides (TG are significant predictors of death. The risk of death was higher in patients using central venous catheter (CVC (Hazard ratio [HR] =3.03, 95% CI = 1.49–6.13, with higher CRP levels (fourth quartile, compared with those with lower levels (first quartile (HR = 17.3, 95% CI = 2.40–124.9. Patients with higher TG levels (fourth quartile presented a lower risk of death, compared with those with the lower TG levels (first quartile (HR = 0.18, 95% CI = 0.05–0.58. Conclusions. The use of CVC, high CRP, and low TG values seem to be independent risk factors for mortality in HD patients.

  2. Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report

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    Fabrizio Bassi

    2015-01-01

    Full Text Available The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors’ attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period.

  3. An evaluation of survival of space maintainers: a six-year follow-up study.

    Science.gov (United States)

    Tulunoglu, Ozlem; Ulusu, Tezer; Genç, Yasemin

    2005-02-15

    The aim of this study was to evaluate the median survival time of fixed and removable space maintainers related to age groups, gender, and their distribution in upper and lower dental arches. The adherence of patients to a periodic recall program and the success rate of different types of space maintainers related to different arches were also evaluated. This study included 663 patients aged between 4-15 years old that were treated between the years of 1997 and 2002. The patients were categorized into four main groups: lost to follow-up, failed, successful, and censored at the end of study. Three hundred forty-five space maintainers were considered lost to follow-up, 83 were considered failed, 206 successful, and 20 censored-at-end. The overall median survival time of the appliances was 6.51 months. Median survival time was 7.25 months in the 4-6 age group, 6.35 months in the 7-12 age group, and 7.0 months in the 13+ age groups. Median survival time was 5.76 months in girls and 7.11 months in boys. Median survival time of space maintainers was 7.17 months for maxilla and 6.69 months in the mandible. Median survival time was 5.25 months for space maintainers fabricated in both arches.

  4. Optic neuritis in Hong Kong: a 1-year follow-up study.

    Science.gov (United States)

    Lau, Patrick P K; Yau, Gordon S K; Lee, Jacky W Y; Wong, Winnie W Y; Tam, Victor T Y; Chan, Eric Y T; Tse, Doris M W; Yuen, Can Y F

    2015-06-01

    To investigate the etiology and prevalence of optic neuritis in a Chinese population. This was a single centre prospective cohort study. Consecutive patients with either a first or recurrent attack of optic neuritis from November 2010 to December 2011 were recruited from a district hospital in Hong Kong Special Administrative Region, China. All patients underwent serology testing for NMO (neuromyelitis optica) IgG; oligoclonal bands from lumbar puncture; computer tomography and contrast magnetic resonance imaging (MRI) of the brain and orbit as well as visual field; and optical coherence tomography testing. Patients were followed up for 1 year after the initial attack. 30 optic neuritis subjects were recruited. 73.3 % (22/30) remain as clinical isolated syndrome (CIS) after 1-year follow-up. 10 % (3/30) patients developed multiple sclerosis. 10 % (3/30) were diagnosed with NMO and 6.7 % (2/30) with NMO-spectrum disorder. The majority of acute unilateral optic neuritis in Chinese was CIS in origin although a fraction does progress to develop MS or NMO-related disorders. Clinicians should be aware of the associations and offer appropriate systemic workups.

  5. [The Octabaix study. Baseline assessment and 5 years of follow-up].

    Science.gov (United States)

    Ferrer, Assumpta; Formiga, Francesc; Padrós, Gloria; Badia, Teresa; Almeda, Jesús; Octabaix, Grupo Estudio

    This is a review of a prospective, community-based study with a follow-up period of 5years. It is a study of 328 participants aged 85 at baseline, of which 62% were female, 53% widows, and a third of them living alone. High blood pressure was observed in 75.9%, dyslipidaemia in 51.2%, and diabetes in 17.7%. At baseline the median Barthel Index was 95, the Spanish version of the Mini-Mental State Examination was 28, the Charlson index 1, the Mini Nutritional Assessment 25, the Gijón test 10, the visual analogue scale of the Quality of Life Test was 60, and with a mean of 6.1 prescription drugs. A lower quality of life was also associated with female gender, a phenotype of frailty, heart failure, and a high level of social risk. At 5years of follow-up, the mortality rate was high, with 138 (42.1%) of the population sample dying at the end of the period. It represents an annual mortality rate of 8.4%. Thus, a common denominator of this review has been the high importance of functionality and overall comorbidity factors associated with mortality in this very old age group, compared to other more traditional factors in younger populations. Several studies of frailty have also been assessed in this group, as well as falls, nutritional risk, diabetes and successful aging, including important aspects to better understand this population group.

  6. Management of hereditary gingival fibromatosis: A 2 years follow-up case report

    Science.gov (United States)

    Tripathi, Amitandra Kumar; Dete, Gopal; Saimbi, Charanjeet Singh; Kumar, Vivek

    2015-01-01

    Hereditary gingival fibromatosis (HGF) is a rare hereditary condition characterized by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva due to increase in sub-mucosal connective tissue component. This paper presents a case report of an 18-year-old female suffering from HGF with positive family history. Her 42-year-old mother also have enlargement of the gums. After through clinical examination of both the patients, routine blood investigation was advised. All the investigations were within normal physiological limits of both the patients. Surgical excision of enlarged gingival tissue was planned after meticulous scaling and root planing. Patients were recalled 1 week after surgery. Postoperative healing were good and desired crown lengthening was achieved with significant improvement in speech and masticatory problems in both the patients. There was no recurrence of the disease even after 2 years follow-up. PMID:26229281

  7. Characteristics of DUI recidivists: a 12-year follow-up study of first time DUI offenders.

    Science.gov (United States)

    Cavaiola, Alan A; Strohmetz, David B; Abreo, Sandra D

    2007-04-01

    77 individuals convicted of a drinking and driving (DUI) offense were screened for recidivism approximately 12 years following their first offense. At the time of the initial DUI conviction, participants were administered the MAST and the MMPI-2. Participants' drinking history and driving history and arrest at the time of screening and at a 12-year follow-up were also reviewed. The results indicate that, among DUI recidivists, on average 6 years elapsed between their first and second DUI offenses. Driving history prior to the first DUI offense was predictive of later recidivism. The only significant finding from the MAST and MMPI results was that repeat offenders tended to have higher scores on the L and K validity scales of the MMPI. These results are discussed in the context of Jessor's Problem-Behavior Theory and as well their clinical implications for screening and treatment decisions involving first time DUI offenders.

  8. Management of hereditary gingival fibromatosis: A 2 years follow-up case report.

    Science.gov (United States)

    Tripathi, Amitandra Kumar; Dete, Gopal; Saimbi, Charanjeet Singh; Kumar, Vivek

    2015-01-01

    Hereditary gingival fibromatosis (HGF) is a rare hereditary condition characterized by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva due to increase in sub-mucosal connective tissue component. This paper presents a case report of an 18-year-old female suffering from HGF with positive family history. Her 42-year-old mother also have enlargement of the gums. After through clinical examination of both the patients, routine blood investigation was advised. All the investigations were within normal physiological limits of both the patients. Surgical excision of enlarged gingival tissue was planned after meticulous scaling and root planing. Patients were recalled 1 week after surgery. Postoperative healing were good and desired crown lengthening was achieved with significant improvement in speech and masticatory problems in both the patients. There was no recurrence of the disease even after 2 years follow-up.

  9. Management of hereditary gingival fibromatosis: A 2 years follow-up case report

    Directory of Open Access Journals (Sweden)

    Amitandra Kumar Tripathi

    2015-01-01

    Full Text Available Hereditary gingival fibromatosis (HGF is a rare hereditary condition characterized by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva due to increase in sub-mucosal connective tissue component. This paper presents a case report of an 18-year-old female suffering from HGF with positive family history. Her 42-year-old mother also have enlargement of the gums. After through clinical examination of both the patients, routine blood investigation was advised. All the investigations were within normal physiological limits of both the patients. Surgical excision of enlarged gingival tissue was planned after meticulous scaling and root planing. Patients were recalled 1 week after surgery. Postoperative healing were good and desired crown lengthening was achieved with significant improvement in speech and masticatory problems in both the patients. There was no recurrence of the disease even after 2 years follow-up.

  10. Crown-root fracture with pulp exposure: a case report with 16-year follow-up.

    Science.gov (United States)

    Moura, Lucia Fatima Almeida de Deus; Leao, Valeria Leopoldino de Area; de Moura, Marcoeli Silva; de Moura, Carmem Dolores Vilarinho Soares; Goncalves, Alessandro Ribeiro; Lima, Cacilda Castelo Branco; de Lima, Marina de Deus Moura

    2015-01-01

    A 12-year-old boy presented for dental care 35 days after he fell from his bicycle. Clinical and radiographic examinations revealed a longitudinal crown-root fracture with pulp exposure in the maxillary left central incisor. The radiograph also suggested necrosis of the maxillary right central incisor. Urgent treatment of the left central incisor involved gingivectomy followed by autogenous bonding of the tooth fragment with self-curing composite resin. Immediately after bonding, coronal access was prepared, chemical and mechanical preparation was completed, and a calcium hydroxide intracanal dressing was placed. One week after the initial appointment, endodontic treatment was initiated in the right central incisor. The root canal of the maxillary left central incisor was maintained with calcium hydroxide paste (replaced at 45-day intervals) for 1 year and then definitively obturated. At the 16-year follow-up, satisfactory periodontal, esthetic, and clinical conditions were observed, and a radiograph revealed no resorption or periapical changes.

  11. The trabecular bypass stent in a pseudophakic glaucoma patient: A 1-year follow-up.

    Science.gov (United States)

    Fea, Antonio M; Dogliani, Monica; Machetta, Federica; Lale-Lacroix, Gabriella; Brogliatti, Beatrice; Grignolo, Federico M

    2008-12-01

    To describe the 1-year success of a trabecular stent implant in a pseudophakic glaucoma patient. The stent is implanted through a small corneal incision under gonioscopic control. Intraocular pressure control was reported in cultured human anterior segment. Observational case report. We report the case of a patient who was implanted and followed-up for 1 year at the Dipartimento di Fisiopatologia Clinica. The main outcome measures were intraocular pressure and visual field. The patient's intraocular pressure was controlled with topical beta-blockers for 6 months and without therapy for 6 months. Two diurnal curves demonstrated achievement of target pressure during the day. The 1-year visual field was unchanged. We are not aware of previous reports of trabecular stent implantation in pseudophakic patients. The trabecular stent had minimal peri-operative morbidity. Identification of the implantation site is challenging and reduction of efficacy over time may occur.

  12. Management of multiple intrusive luxative injuries: A case report with 7-year follow-up

    Directory of Open Access Journals (Sweden)

    Seema Thakur

    2014-01-01

    Full Text Available This report presents a case of severe intrusive luxation of multiple anterior teeth in an 11-year-old girl. The teeth were repositioned successfully by endodontic and orthodontic management. The case was monitored for 7 years. Depending on the severity of the injury, different clinical approaches for treatment of intrusive luxation may be used. Despite the variety of treatment modalities, rehabilitation of intruded teeth is always a challenge and a multidisciplinary approach is important to achieve a successful result. In this case, intruded teeth were endodontically treated with multiple calcium hydroxide dressings and repositioned orthodontically. The follow-up of such cases is very important as the repair process after intrusion is complex. After 7 years, no clinical or radiographic pathology was detected.

  13. A three-year follow-up of congenital adrenal hyperplasia newborn screening,

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    Isabela L. Pezzuti

    Full Text Available OBJECTIVE:congenital adrenal hyperplasia (CAH newborn screening can prevent neonatal mortality in children with the salt-wasting form of the disease and prevent incorrect gender assignments, which can occur in females. However, the occurrence of false-positive results in preterm or low-birth-weight newborns creates some diagnostic difficulties, with consequent therapeutic implications. This study aimed to report the results of a pilot project for neonatal CAH screening conducted in the state of Minas Gerais, Brazil from 09/2007 to 05/2008 with a three-year follow-up.METHODS:dried blood specimens were collected on filter paper cards three to seven days after birth of all newborns in the period. Samples were analyzed for 17-hydroxyprogesterone using an enzyme-linked immunosorbent assay (ELISA.RESULTS:a total of 159,415 children were screened. The apparent incidence of the classic variant of the disease was 1:9,963, based on initial diagnoses following newborn screening. During the follow-up period, eight of 16 children initially diagnosed with CAH were reclassified as unaffected, resulting in a revised incidence of 1:19,927. The false-positive rate was 0.31%, and the positive predictive value was 2.1%. Sensitivity and specificity were 100% and 99.7%, respectively.CONCLUSIONS:newborn screening is an important public health policy in developing countries such as Brazil, where CAH remains underdiagnosed. It has great potential to identify children with the disease who otherwise cannot be diagnosed earlier. Long-term follow-up and monitoring of all children with positive screening results are crucial to ensure a correct diagnosis and to calculate a reliable incidence ratio of the disease.

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

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    Anselmetti, Giovanni Carlo, E-mail: gc.anselmetti@fastwebnet.it [Villa Maria Hospital, Interventional Radiology Unit (Italy); Manca, Antonio, E-mail: anto.manca@gmail.com [Institute for Cancer Research and Treatment (IRCC), Interventional Radiology Unit (Italy); Marcia, Stefano, E-mail: stemarcia@gmail.com [Institute of Radiology, University of Cagliari (Italy); Chiara, Gabriele, E-mail: gabriele.chiara@ircc.it [Institute for Cancer Research and Treatment (IRCC), Interventional Radiology Unit (Italy); Marini, Stefano, E-mail: stemarini@gmail.com [Institute of Radiology, University of Cagliari (Italy); Baroud, Gamal, E-mail: gamalbaroud@gmail.com [University of Sherbrooke, Departement de Genie Mecanique (Canada); Regge, Daniele, E-mail: daniele.regge@ircc.it [Institute for Cancer Research and Treatment (IRCC), Radiology Unit (Italy); Montemurro, Filippo, E-mail: filippo.montemurro@ircc.it [Institute for Cancer Research and Treatment (IRCC), Internal Medicine Unit (Italy)

    2013-05-08

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

  15. Apathy in first episode psychosis patients: a ten year longitudinal follow-up study.

    Science.gov (United States)

    Evensen, Julie; Røssberg, Jan Ivar; Barder, Helene; Haahr, Ulrik; Hegelstad, Wenche ten Velden; Joa, Inge; Johannessen, Jan Olav; Larsen, T K; Melle, Ingrid; Opjordsmoen, Stein; Rund, Bjørn Rishovd; Simonsen, Erik; Sundet, Kjetil; Vaglum, Per; Friis, Svein; McGlashan, Thomas

    2012-04-01

    Apathy is a common symptom in first episode psychosis (FEP), and is associated with poor functioning. Prevalence and correlates of apathy 10 years after the first psychotic episode remain unexplored. The aims of the study were twofold: 1) to examine prevalence and predictors of apathy at 10 years, and 2) to examine the relationship between apathy at 10 years and concurrent symptoms, functioning and outcome, including subjective quality of life. Three-hundred-and-one patients with FEP were included at baseline, 186 participated in the 10 year follow-up. Of these, 178 patients completed the Apathy Evaluation Scale (AES-S-Apathy). Patients were classified as having apathy (AES-S-Apathy≥27) or not. The relationship between apathy and baseline variables (Demographics, Diagnosis, Duration of Untreated Psychosis), measures of symptomatology (Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia), functioning (Global Assessment of Functioning Scale, Strauss Carpenter Level of Functioning Scale) and subjective quality of life (Lehman's Quality of Life Interview) were estimated through correlation analyses and blockwise multiple hierarchical regression analysis. Nearly 30% of patients met the threshold for being apathetic at follow-up. No baseline variables predicted apathy significantly at 10 years. Apathy was found to contribute independently to functioning and subjective quality of life, even when controlling for other significant correlates. Apathy is a common symptom in a FEP cohort 10 years after illness debut, and its presence relates to impaired functioning and poorer subjective quality of life. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Lumbar total disc replacement. Seven to eleven-year follow-up.

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

    2005-03-01

    Symptomatic lumbar degenerative disc disease is a challenging entity to treat. The results of arthrodesis may be compromised in the short term by pseudarthrosis and in the long term by pain at the iliac-crest donor site and by junctional degeneration. Total disc replacement has the potential to provide long-lasting relief to these patients. The purpose of this study was to present the clinical and radiographic results assessed seven to eleven years following a Prodisc total lumbar disc replacement. Sixty-four patients had single or multiple-level implantation of a total lumbar disc replacement between 1990 and 1993. The mean duration of follow-up was 8.7 years. Clinical results were evaluated by assessing preoperative and postoperative lumbar pain, radiculopathy, disability, and modified Stauffer-Coventry scores. Preoperative and postoperative radiographs were evaluated as well. Subgroup analysis was performed to determine if gender, an age of less than forty-five years, previous surgery, or multilevel surgery had an effect on outcome. At an average of 8.7 years postoperatively, there were significant improvements in the back-pain, radiculopathy, disability, and modified Stauffer-Coventry scores. Thirty-three of the fifty-five patients with sufficient follow-up had an excellent result, eight had a good result, and fourteen had a poor result. Neither gender nor multilevel surgery affected outcome. An age of less than forty-five years and prior lumbar surgery had small but significant negative effects on outcome. Radiographs did not demonstrate loosening, migration, or mechanical failure in any patient. Five patients had approach-related complications. The Prodisc lumbar total disc replacement appears to be effective and safe for the treatment of symptomatic degenerative disc disease. Gender and multilevel surgery did not affect the outcomes, whereas prior lumbar surgery or an age of less than forty-five years was associated with slightly worse outcomes. Longer

  17. Ten Year Follow-Up of Gap Balanced, Rotating Platform Total Knee Arthroplasty in Patients Under 60 Years of Age.

    Science.gov (United States)

    Lee, Jason H; Barnett, Steven L; Patel, Jay J; Nassif, Nader A; Cummings, Dennis J; Gorab, Robert S

    2016-01-01

    68 patients (91 primary total knee arthroplasties) were evaluated at a mean 10-year, minimum 5 year follow up in patients younger than sixty years of age utilizing the gap balanced, rotating platform design. Follow up assessment included implant survivorship, adverse events, x-rays, Knee Society rating system and clinical evaluation. Three revisions were performed with only one for aseptic loosening at 45 months. Two manipulations were performed in the early postoperative period. Survivorship of the rotating platform, gap balanced knee was 96.7% using surgical revision for any reason and 98.9% using aseptic loosening as endpoints. The rotating platform design using the gap balancing technique in young patients had excellent survivorship at 10-year mean follow up.

  18. Musculoskeletal disorders among construction workers: a one-year follow-up study

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    Boschman Julitta S

    2012-10-01

    Full Text Available Abstract Background Work-related musculoskeletal disorders (MSDs are an important cause of functional impairments and disability among construction workers. An improved understanding of MSDs in different construction occupations is likely to be of value for selecting preventive measures. This study aimed to survey the prevalence of symptoms of MSDs, the work-relatedness of the symptoms and the problems experienced during work among two construction occupations: bricklayers and supervisors. Methods We randomly selected 750 bricklayers and 750 supervisors resident in the Netherlands in December 2009. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire one year later. The participants were asked about complaints of the musculoskeletal system during the last six months, the perceived work-relatedness of the symptoms, the problems that occurred during work and the occupational tasks that were perceived as causes or aggravating factors of the MSD. Results Baseline response rate was 37%, follow-up response was 80%. The prevalence of MSDs among 267 bricklayers and 232 supervisors was 67% and 57%, respectively. Complaints of the back, knee and shoulder/upper arm were the most prevalent among both occupations. Irrespective of the body region, most of the bricklayers and supervisors reported that their complaints were work-related. Complaints of the back and elbow were the most often reported among the bricklayers during work, whereas lower arm/wrist and upper leg complaints were the most often reported among the supervisors. In both occupations, a majority of the participants perceived several occupational physical tasks and activities as causes or aggravating factors for their MSD. Recurrent complaints at follow-up were reported by both bricklayers (47% of the complaints and supervisors (31% of the complaints. Participants in both occupations report that mainly back and knee complaints result in additional problems

  19. Cognitive evolution in hypertensive patients: a six-year follow-up

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    Vicario A

    2011-05-01

    Full Text Available Augusto Vicario1,2,3, Mildren A del Sueldo2,3, Judith M Zilberman2,3, Gustavo H Cerezo2,31Department of Internal Medicine, Cardiovascular Division, Hospital Español de Buenos Aires, Argentina; 2Argentine Federation of Cardiology, (AFC, Buenos Aires, Argentina; 3Research Group, Human Health Commission, CERTUS Foundation, Buenos Aires, Argentina Background: Several studies have examined the links between hypertension, vascular damage, and cognitive impairment. The functions most commonly involved seem to be those associated with memory and executive function.Aims: 1 to report the cognitive evolution in a cohort of hypertensive patients, 2 to identify the affected domains, and 3 to correlate the results obtained with blood pressure measurements.Materials and Methods: Observational 6-year follow-up cohort study including both males and females aged ≥65 and ≤80 years, and hypertensive patients under treatment. Patients with a history of any of the following conditions were excluded: stroke, transient ischemic attack, diabetes mellitus, atrial fibrillation, cardiac surgery, dementia, or depression. Four neurocognitive evaluations were performed (at baseline and every 2 years. The tests used evaluated memory and executive function domain. Blood pressure was measured on every cognitive evaluation.Results: Sixty patients were followed for 76.4 ± 2.8 months. The average age at baseline was 72.5 ± 4.2 and 77.9 ± 4.6 at 6 years (65% were women. Two patients were lost to follow up (3.3% and 8 patients died (13.3%.The density incidence for dementia was 0.6% patients per year (pt/y (n = 3 and for depression was 1.6% pt/y (n = 12. No changes were observed in either memory impairment or the Mini Mental State Examination (MMSE results (p = ns during follow-up. A progressive impairment of the executive function was shown regardless of the blood pressure measurements.Conclusion: 1 the incidence of dementia doubled to general population, 2 the initial memory

  20. Skype clinics after intestinal transplantation - follow-up beyond post codes.

    Science.gov (United States)

    Gerlach, Undine A; Vrakas, Georgios; Holdaway, Lydia; O'Connor, Marion; Macedo, Rubens; Reddy, Srikanth; Friend, Peter J; Giele, Henk; Vaidya, Anil

    2016-07-01

    The follow-up after intestinal transplantation (ITX) is complex and limited to specialized centers. ITX recipients often travel all over the country to be seen in the outpatient clinic of specialized centers which is costly and time-consuming. Videoconferences through Skype have been implemented to eliminate travel time, costs, and to improve patient compliance without jeopardizing safety. Eighteen of 19 patients followed up after ITX or modified multivisceral transplantation (MMVTX) in conventional outpatient clinics in Oxford agreed to attend additional Skype clinics. All patients who were followed up through Skype clinics after ITX/MMVTX received a questionnaire to measure their satisfaction with methods and technical aspects of videoconferencing as well as time/mode of traveling, travel expenses/costs, waiting time in outpatient clinic and patients' satisfaction. Mean travel distance to Oxford was 236 ± 168 miles, mean travel time was 277 ± 175 min, and mean travel cost was 200 ± 56 Great Britain Pounds. A total of 56% had to take time off work and/or find child/family care for the time spent in travel. These patients reported a satisfaction score of 4.38 ± 0.77 of 5 points as opposed to 2.88 ± 0.90 for attending the conventional outpatient clinic. Skype clinics have been proven successful and feasible in highly specialized fields like ITX in eligible patients.

  1. Four-year follow-up study of pharmacological treatment in pathological gamblers.

    Science.gov (United States)

    Rosenberg, Oded; Dinur, Limor Klein; Dannon, Pinhas N

    2013-01-01

    In the past decade, we have witnessed the emergence of pharmacological treatments for pathological gambling with some success but many question marks. We aimed to explore pharmacological treatments that have been previously explored with some success, with the intent of comparing their efficacy and pave the way to larger placebo-controlled trials. In this study, we allocated 78 patients to 4 different types of psychotropic medications: naltrexone, topiramate, bupropion, and escitalopram. We treated patients for more than 2 years, with additional 2-year follow-ups without medication. The sample was evaluated using the 21-item Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Global Assessment of Functioning, and the Visual Analog Scale to measure general well-being before enrollment as well as at 1 month, 6 months, 24 months, and 48 months after beginning medication treatment. During the first 2 years of treatment, 34 patients dropped out, with one more dropping out during the additional 2 years of follow-up. Significant improvement on all rating scales was seen in all groups after 2 years, except HAMD in the group that received topiramate. We found the naltrexone-treated group of patients to have a statistically significant lower dropout rate compared with other groups, statistically significant lower HAMD scores in comparison to the group treated with bupropion, statistically significant lower Hamilton Anxiety Rating Scale score compared to the groups treated with escitalopram and topiramate, and significantly higher Visual Analog Scale scores compared to the groups treated with bupropion and topiramate. Pathological gambling is essentially a biopsychological disorder that may be attenuated provided that patients adhere to medication. In our study, among 4 medications with different mechanisms of action, naltrexone was found to be the most effective. Placebo-controlled studies involving large numbers of subjects are required before

  2. Application of Regent mechanical valve in patients with small aortic annulus: 3-year follow-up

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    Zhao Dong

    2012-09-01

    Full Text Available Abstract Background Aortic valve replacement (AVR with a small aortic annulus is always challenging for the cardiac surgeon. In this study, we sought to evaluate the midterm performance of implantation with a 17-mm or 19-mm St. Jude Medical Regent (SJM Regent mechanical valve in retrospective consecutive cohort of patients with small aortic annulus (diameter ≤ 19 mm. Methods From January 2008 to April 2011, 40 patients (31 female, mean age = 47.2 ± 5.8 years with small aortic annulus (≤19 mm in diameter underwent aortic valve replacement with a 17-mm or 19-mm St. Jude Medical Regent (SJM Regent mechanical valve. Preoperative mean body surface area, New York Heart Association class, and mean aortic annulus were 1.61 ± 0.26 m2, 3.2 ± 0.4, and 18 ± 1.4 mm respectively. Patients were divided into two groups, according to the implantation of 17 mm SJM Regent mechanical valve (group 1, n = 18 or 19 mm SJM Regent valve (group 2, n = 22. All patients underwent echocardiography examination preoperatively and at one year post-operation. Results There were no early deaths in either group. Follow-up time averaged 36 ± 17.6 months. The mean postoperative New York Heart Association class was 1.3 ± 0.6 (p 2/m2 to 69.8 ± 9.3%, 41.4 ± 8.3%, and 0.92 ± 0.10 cm2/m2 respectively (P 2, 46.1 ± 8.5 mmHg to 86.7 ± 18.2 g/m2 , 13.7 ± 5.2 mmHg respectively. In group 2, the LVEF, LVFS and EOAI increased from 45.9% ± 9.7%, 30.7% ± 8.0%, and 0.81 ± 0.09 cm2/m2 to 77.4% ± 9.7%, 44.5% ± 9.6%, and 1.27 ± 0.11 cm2/m2 respectively, while the LVMI, and the aortic transvalvular pressure gradient decreased from 118.3 ± 27.6 g/m2, 44.0 ± 6.7 mmHg to 80.1 ± 19.7 g/m2, 10.8 ± 4.1 mmHg as well. The prevalence of PPM was documented in 2 patients in Group 1. Conclusions Patients with small aortic annulus and body surface

  3. Itolizumab provides sustained remission in plaque psoriasis: a 5-year follow-up experience.

    Science.gov (United States)

    Budamakuntla, L; Madaiah, M; Sarvajnamurthy, S; Kapanigowda, S

    2015-03-01

    There is an unmet need for psoriasis therapies that provide long-term remission. Itolizumab is a humanized recombinant anti-CD6 monoclonal antibody shown to be effective in psoriasis. We report a patient who received itolizumab in a phase 2 clinical trial, and experienced long-term remission. At baseline, the patient's Psoriasis Area and Severity Index (PASI) was 12.2, and Physician's Global Assessment (PGA) score was 3. After 8 weeks of treatment, the patient achieved 97% improvement in PASI. She continued to have ≥ 90% improvement, initially for 4 weeks (follow-up phase), and later for 20 weeks (follow-up extension phase). She continued to visit the hospital after the final study visit; her most recent visit was on 10 May 2013. PGA results during the visits revealed sustained response for 4 years and 5 months after stopping itolizumab. Itolizumab could be therefore an important treatment option for moderate to severe psoriasis, with potential to provide long-lasting remission.

  4. Atrial fibrillation ablation guided with electroanatomical mapping system: A one year follow up

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    Yoga Yuniadi

    2010-08-01

    Full Text Available Aim AF is the most common arrhythmia in clinical practice and associated with an increased long-term risk of stroke, heart failure, and all-cause mortality. Catheter ablation of AF is relatively new modality to convert AF to sinus rhythm. This study was aimed to elaborate efficacy of catheter ablation in mixed type of AF.Methods Thirty patients (age of 52 ± 8 yo comprised of 19 paroxysmal and 11 chronic AF underwent radiofrequency catheter ablation guided by electroanatomical CARTO™ mapping system. We used step wise ablation approach with circumferential pulmonary vein isolation (PVI as a cornerstone. Additional ablation comprised of roof line, mitral isthmus line, complex fractionated atrial electrogram (CFAE, septal line and coronary sinus ablation was done respectively if indicated. All patients were followed up to 1 year for AF recurrence.Results Circumferential PVI was successfully performed in all patients but one. Average follow up period was 11.5 months. More than 80% of all patients remain in sinus rhythm at the end of follow period which 62% of them were free from any anti-arrhythmic drug. No major complication in all patients series.Conclusion Radiofrequency ablation guided with electroanatomical mapping is effective and safe in mixed type of AF. (Med J Indones 2009;19:172-8Key words: Ablation, atrial fibrillation, electroanatomical, Indonesia

  5. Workplace bullying and sleep difficulties: a 2-year follow-up study.

    Science.gov (United States)

    Hansen, Ase Marie; Hogh, Annie; Garde, Anne Helene; Persson, Roger

    2014-04-01

    The aims of the present study were to investigate whether being subjected to bullying and witnessing bullying at the workplace was associated with concurrent sleep difficulties, whether frequently bullied/witnesses have more sleep difficulties than occasionally bullied/witnesses, and whether there were associations between being subjected to bullying or witnessing bullying at the workplace and subsequent sleep difficulties. A total of 3,382 respondents (67 % women and 33 % men) completed a baseline questionnaire about their psychosocial work environment and health. The overall response rate was 46 %. At follow-up 2 years later, 1671 of those responded to a second questionnaire (49 % of the 3,382 respondents at baseline). Sleep difficulties were measured in terms of disturbed sleep, awakening problems, and poor quality of sleep. Bullied persons and witnesses reported more sleep difficulties than those who were neither bullied nor witnesses to bullying at baseline. Frequently bullied/witnesses reported more sleep difficulties than respondents who were occasionally bullied or witnessing bullying at baseline. Further, odds ratios for subsequent sleep difficulties were increased among the occasionally bullied, but not among witnesses. However, the associations weakened when adjusting for sleep difficulties at baseline. Being subjected to occasional bullying at baseline was predictive of subsequent sleep difficulties. Witnessing bullying at baseline did not predict sleep difficulties at follow-up.

  6. One-year follow-up of the nutritional status of patients undergoing liver transplantation

    Directory of Open Access Journals (Sweden)

    Maria Eugênia Deutrich Aydos

    Full Text Available Background: Choosing the method of nutritional assessment is essential for proper follow-up of the nutritional status of patients undergoing liver transplantation. Objectives: Evaluate and compare the nutritional status of cirrhotic patients before and after liver transplantation over a year by different methods of nutritional assessment. Methods: Patients undergoing liver transplantation were assessed in five phases: pre-transplant, 1, 3, 6 and 12 months after transplantation at the hospital Santa Casa de Misericordia de Porto Alegre, RS, Brazil. The methods used for nutritional assessment were anthropometry, grip strength of the non-dominant hand (HGS by dynamometry, thickness of the adductor pollicis muscle (APM and phase angle (PA by bioelectrical impedance analysis (BIA. In all evaluations, the same measurements were taken. Results: Evaluations were performed in 22 patients. Methods that showed a higher prevalence of malnourished patients before transplantation were PA by BIA (25%, arm muscle circumference (AMC (21.9% and arm circumference (AC (18.8%. When comparing the nutritional status of patients during follow-up, there was a significant difference only in the evaluation methods AC, triceps skinfold thickness and PA by BIA. At the end, the methods of nutritional assessment were compared again. They showed a significant statistical difference, with HGS being the best method for detecting malnutrition. Conclusions: In conclusion, it is suggested that the method PA by BIA could be widely used with this population since the results are consistent with other findings in the literature and they are significant, reliable, and reproducible.

  7. Periodontal parameters of osseointegrated dental implants. A 4-year controlled follow-up study.

    Science.gov (United States)

    Nishimura, K; Itoh, T; Takaki, K; Hosokawa, R; Naito, T; Yokota, M

    1997-08-01

    The aim of this study was to evaluate the periodontal parameters of osseointegrated dental implants. The condition of the peri-implant mucosa was assessed using periodontal parameters, i.e., of plaque index, bleeding on probing, probing pocket depth, probing attachment level and Periotest scores as well as a radiographic parameter, over a 4-year follow-up period. 32 non-submerged ITI dental implants, all placed in the mandible, were studied in 12 patients who had good oral hygiene. All patients were regularly recalled at 6-month intervals. The overall implant success rate was 100%. None of the implants showed any signs of inflammation, radiographic bone loss or any detectable mobility during the follow-up period. Methods similar to those used to evaluate the natural dentition were effectively employed to assess the clinical status of the dental implants. The diagnostic value of these parameters could not, however, be determined from this study due to the absence of any peri-implant tissue complications. The results indicated that some periodontal parameters of healthy peri-implant mucosa might be slightly different from healthy periodontal tissue.

  8. Hereditary gingival fibromatosis and its management: 2-year follow-up

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    Amitandra Kumar Tripathi

    2014-01-01

    Full Text Available Hereditary gingival fibromatosis (HGF is a rare hereditary condition characterised by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva caused by increase in sub-mucosal connective tissue component. This paper presents a case report of a 14-year-old male suffering from HGF with positive family history. After through clinical examination, routine blood investigation was advised. All the parameters were within normal physiological limits. Surgical excision of enlarged gingival mass was planned after meticulous scaling and root planning. Patient was recalled 1-week after surgery. Postoperative healing was good and desired crown lengthening was achieved with significant improvement in speech and masticatory problems. There was no recurrence of the disease even after 2 years follow-up.

  9. Periodontal ligament distraction: esthetics and occlusal stability at the 2-year follow-up.

    Science.gov (United States)

    Allgayer, Susiane; Rosenbach, Gabriella; Tavares, Carlos Alberto Estevanell; Polido, Waldemar Daudt

    2013-04-01

    Dental distraction is an orthodontic tooth movement technique that allows closure of extraction spaces, usually of premolars, in periods from 1 to 3 weeks, by bodily retraction of the canine. This article reports on canine distalization by using a distractor device obtained from a conventional hyrax screw. The patient was an adolescent boy, aged 17 years 9 months, who came to the clinic with the chief complaint of tooth crowding. The clinical examination showed a convex profile, retroclined and protruded maxillary incisors, buccally tipped and protruded mandibular incisors, and a Class I malocclusion. The treatment comprised extractions and rapid canine distraction procedures. Pretreatment, posttreatment, and 2-year follow-up records are shown and demonstrate that dental distraction is a viable alternative of treatment. With this treatment strategy, satisfactory results were obtained without additional anchorage devices, achieving an attractive smile and optimal occlusion. The main considerations about the treatment alternatives and their clinical concerns are discussed.

  10. Lexical access changes in patients with multiple sclerosis: a two-year follow-up study.

    Science.gov (United States)

    Sepulcre, Jorge; Peraita, Herminia; Goni, Joaquin; Arrondo, Gonzalo; Martincorena, Inigo; Duque, Beatriz; Velez de Mendizabal, Nieves; Masdeu, Joseph C; Villoslada, Pablo

    2011-02-01

    The aim of the study was to analyze lexical access strategies in patients with multiple sclerosis (MS) and their changes over time. We studied lexical access strategies during semantic and phonemic verbal fluency tests and also confrontation naming in a 2-year prospective cohort of 45 MS patients and 20 healthy controls. At baseline, switching lexical access strategy (both in semantic and in phonemic verbal fluency tests) and confrontation naming were significantly impaired in MS patients compared with controls. After 2 years follow-up, switching score decreased, and cluster size increased over time in semantic verbal fluency tasks, suggesting a failure in the retrieval of lexical information rather than an impairment of the lexical pool. In conclusion, these findings underline the significant presence of lexical access problems in patients with MS and could point out their key role in the alterations of high-level communications abilities in MS.

  11. Parkin disease in a Brazilian kindred: Manifesting heterozygotes and clinical follow-up over 10 years.

    Science.gov (United States)

    Khan, Naheed L; Horta, Wagner; Eunson, Louise; Graham, Elizabeth; Johnson, Janel O; Chang, Shannon; Davis, Mary; Singleton, Andrew; Wood, Nicholas W; Lees, Andrew J

    2005-04-01

    We report on a large Brazilian kindred with young-onset parkinsonism due to either a homozygous or heterozygous mutation in parkin. A total of 6 members were affected: 5 were homozygous and 1 heterozygous for a deletion in exon 4. Two other heterozygotes also had extrapyramidal signs. All affected subjects showed characteristic features of parkin disease with foot dystonia and an excellent response to levodopa complicated by motor fluctuations and dyskinesia within 3 years of therapy. Careful clinical follow-up over 10 years showed the phenotype was similar in all the homozygotes with asymmetrical limb bradykinesia and early walking difficulties. Some acceleration of disability was observed in some of the cases as they entered the third decade of illness, but dementia was absent.

  12. Cohabitation and marital status as predictors of mortality--an eight year follow-up study

    DEFF Research Database (Denmark)

    Lund, Rikke; Due, Pernille; Modvig, Jens

    2002-01-01

    In a follow-up study of 1265 women and men aged 50, 60 and 70 years, we analysed how mortality was associated with cohabitation status (living alone/not living alone), living with/without a partner, and marital status respectively. Data originate from a longitudinal questionnaire study of a random...... sample of people born in 1920, 1930 and 1940 with baseline in 1990. Survival time for all individuals were established during the next 8 years until May 1998. Multivariate Cox analysis stratified by age and gender showed that individuals living alone experienced a significantly increased mortality...... on the association with mortality. Hereby, we found no evidence of an indirect effect of health behaviours on the association between living arrangements and mortality. In contrast to many previous studies, we found no significant gender and age differences in the association between living arrangement and mortality...

  13. Cohabitation and marital status as predictors of mortality - an eight year follow-up study

    DEFF Research Database (Denmark)

    Due, Pernille; Modvig, Jens Simon; Holstein, Bjørn Evald

    2002-01-01

    In a follow-up study of 1265 women and men aged 50, 60 and 70 years, we analysed how mortality was associated with cohabitation status (living alone/not living alone), living with/without a partner, and marital status respectively. Data originate from a longitudinal questionnaire study of a random...... sample of people born in 1920, 1930 and 1940 with baseline in 1990. Survival time for all individuals were established during the next 8 years until May 1998. Multivariate Cox analysis stratified by age and gender showed that individuals living alone experienced a significantly increased mortality...... on the association with mortality. Hereby, we found no evidence of an indirect effect of health behaviours on the association between living arrangements and mortality. In contrast to many previous studies, we found no significant gender and age differences in the association between living arrangement and mortality...

  14. Evolution of analogical reasoning in children: follow-up from six to eleven years old

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    Luis Fidel Abregú Tueros

    2009-10-01

    Full Text Available The aim of this study is to establish the time and period of development of Analogical Reasoning (AR and evaluate its independence and performance with respect to the age. We performed a longitudinal cohort study of two age groups and six annual follow-up phases from each one (2000-2005, 2001-2006 in six to eleven years-old children in the city of Huanuco (Peru with a sample of 167 children (first stage, and N=121 (sixth stage. The Raven’s progressive matrices test, coloured version, was applied individually without time limits. Results indicate that AR development occurs in a constant and late way from seven to eleven years-old children, and also that there is independence between the ability of AR and the children age. We discuss the importance of knowledge in the relationships between analogies topics, adjusted to the age, as a mediating factor in the development of AR.

  15. Indirect pulp treatment in a permanent molar: case reort of 4-year follow-up

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    Ticiane Cestari Fagundes

    2009-02-01

    Full Text Available This case report describes the Indirect Pulp Treatment (IPT of deep caries lesion in a permanent molar. A 16-year-old male patient reported discomfort associated with thermal stimulation on the permanent mandibular left first molar. The radiographs revealed a deep distal caries lesion, very close to the pulp, absence of radiolucencies in the periapical region, and absence of periodontal space thickening. Pulp sensitivity was confirmed by thermal pulp vitality tests. Based on the main complaint and the clinical and radiographic examinations, the treatment plan was established to preserve pulp vitality. Clinical procedures consisted of removing the infected dentin and lining the caries-affected dentin with calcium hydroxide paste. The tooth was provisionally sealed for approximately 60 days. After this period, tooth vitality was confirmed, the remaining carious dentin was removed, and the tooth was restored. At 4-year follow-up, no clinical or radiographic pathological findings were found.

  16. One-year follow-up period after transumbilical thoracic sympathectomy for hyperhidrosis: outcomes and consequences.

    Science.gov (United States)

    Zhu, Li-Huan; Du, Quan; Chen, Long; Yang, Shengsheng; Tu, Yuanrong; Chen, Shengping; Chen, Weisheng

    2014-01-01

    Thoracic sympathectomy is considered the most effective method to treat palmar hyperhidrosis. We developed a novel approach for thoracic sympathectomy in patients with palmar hyperhidrosis through the umbilicus, using an ultrathin gastroscope. The aim of this study was to evaluate the continuing efficacy and patient satisfaction of this innovative surgery. All procedures were performed under general anesthesia and the patients were intubated with a dual-lumen endotracheal tube. After a 5-mm umbilical incision, the muscular parts of the diaphragmatic dome were incised with a needle-knife and the nasal gastroscope was advanced into the thoracic cavity. The sympathetic chain was identified at the desired thoracic level and ablated with hot biopsy forceps. All patients were followed up for at least 1 year after the procedure through clinic visits or telephone/e-mail interviews. From April 2010 to August 2011, a total of 35 patients underwent a transumbilical thoracic sympathectomy. Fifty-seven percent were male patients, with a mean age of 21.2 years (range, 16-33 years). The success rate after 12 months was 97.1% (34 of 35) for isolated palmar hyperhidrosis and 72.2% (13 of 18) for axillary hyperhidrosis. Compensatory sweating was reported in 28.6% of patients at the 1-year follow-up evaluation. There was no mortality, no diaphragmatic hernia, and no Horner syndrome was observed. Quality of life related to hyperhidrosis improved substantially in 27 (77.1%) patients, and improved in 4 (11.4%) patients at 12 months after surgery. A total of 94.3% of patients were satisfied with the excellent cosmetic results of the surgical incision. Transumbilical thoracic sympathectomy is an efficacious alternative to the conventional approach. This technique avoided the chronic pain and chest wall paresthesia associated with the chest incision. In addition, this novel procedure afforded maximum cosmetic benefits. Copyright © 2014 The American Association for Thoracic Surgery

  17. Metabolic syndrome in Thai schizophrenic patients: a naturalistic one-year follow-up study

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    Charnsilp Chawanun

    2007-04-01

    Full Text Available Abstract Background Not only the prevalence, but also the progress of metabolic abnormalities in schizophrenic patients is of importance for treatment planning and policy making. However, there have been very few prospective studies of metabolic disturbance in schizophrenic patients. This study aimed to assess the progress of metabolic abnormalities in Thai individuals with schizophrenia by estimating their one-year incidence rate of metabolic syndrome (MetS. Methods We screened all schizophrenic patients who visited our psychiatric clinic. After the exclusion of participants with MetS at baseline, each subject was reassessed at 6 and 12 months to determine the occurrence of MetS. The definition of MetS, as proposed by the International Diabetes Federation (IDF, was applied. Results Fifty-seven participants (24 males and 33 females had a mean of age and duration of antipsychotic treatment of 37.5 years old and 8.4 years, respectively. At baseline, 13 subjects met the MetS definition. Of 44 subjects who had no MetS at baseline, 35 could be followed up. Seven of these 35 subjects (20.0% had developed MetS at the 6- or 12-month visit, after already having 2 MetS components at baseline. The demographic data and characteristics of those developing and not developing MetS were not different in any respect. Conclusion Thai schizophrenic patients are likely to develop MetS. Their metabolic abnormalities may progress rapidly and fulfill the MetS definition within a year of follow-up. These findings support the importance of assessing and monitoring metabolic syndrome in schizophrenic patients.

  18. Vertical scar versus the inverted-T scar reduction mammaplasty: a 10-year follow-up.

    Science.gov (United States)

    Bouwer, Lesley R; van der Biezen, Jan Jaap; Spronk, Cees A; van der Lei, Berend

    2012-10-01

    A retrospective study was undertaken to evaluate whether the initial outcome of two types of reduction mammaplasty techniques (vertical scar reduction mammaplasty vs. the inverted-T scar reduction mammaplasty) remains stable in the long term: Sixty-nine patients who had undergone breast reduction surgery in the period 1997-2000 at the Department of Reconstructive Plastic Surgery at the Medical Center of Leeuwarden were willing and able to participate in this study. A structured questionnaire was used to assess the degree of patient satisfaction. For subjective evaluation, the Strasser Grading System on photographs at the 3 months after surgery and after long-term follow-up (10 years) was used. The median general appreciation mark for the entire surgical procedure given by patients was 8 (1-10) on a scale from 1 to 10. Forty-six of the 69 patients could be scored according to Strasser: at 3 months in 17 patients (37%) the result was 'good', in 21 patients (46%) 'mediocre' and in eight patients (17%) 'poor'. After 10 years, in 37 of the patients (80%) the result was 'good', in six patients (13%) 'mediocre' and in three patients (7%) 'poor'. At 3 months, there was a higher incidence of bottoming out in the vertical scar group (one on two patients) as compared to the inverted-T scar group (one on 10 patients); however, at the 10-years follow-up bottoming out was 50% in the inverted-T scar group and 20% in the vertical scar group. Despite bottoming out, in both the vertical scar reduction mammaplasty technique and the inverted-T scar reduction mammaplasty technique, high patient satisfaction rates are achieved that remains for years.

  19. Surgical Treatment for Adult Spinal Deformity: Projected Cost Effectiveness at 5-Year Follow-Up

    Science.gov (United States)

    Terran, Jamie; McHugh, Brian J.; Fischer, Charla R.; Lonner, Baron; Warren, Daniel; Glassman, Steven; Bridwell, Keith; Schwab, Frank; Lafage, Virginie

    2014-01-01

    Background In the United States, expenditures related to spine care are estimated to account for $86 billion annually. Policy makers have set a cost-effectiveness benchmark of less than $100,000/quality adjusted life year (QALY), forcing surgeons to defend their choices economically. This study projects the cost/QALY for surgical treatment of adult spinal deformity at 5-year follow-up based on 2-year cost- and health-related quality-of-life (HRQOL) data. Methods In a review of 541 patients with adult spinal deformity, the patients who underwent revision or were likely to undergo revision were identified and cost of surgery was doubled to account for the second procedure; all other patients maintained the cost of the initial surgery. Oswestry Disability Index (ODI) was modeled by revision status based on literature findings. Total surgical cost was based on Medicare reimbursement. Chi square and student t tests were utilized to compare cost-effective and non–cost-effective patients. Results The average cost/QALY at 5-year follow-up was $120,311.73. A total of 40.7% of patients fell under the threshold of a cost/QALY <$100,000. Cost-effective patients had higher baseline ODI scores (45% vs 34% [P=0.001]), lower baseline total Scoliosis Research Society scores (2.89 vs 3.00 [P=0.04]), and shorter fusions (8.23 vs 9.87 [P=0.0001]). Conclusion We found 40.7% of patients to be below the threshold of cost effectiveness. Factors associated with reaching the threshold <$100,000/QALY were greater preoperative disability, diagnosis of idiopathic scoliosis, poor preoperative HRQOL scores, and fewer fusion levels. PMID:24688328

  20. Efficacy and safety of tacrolimus compared with cyclosporin A microemulsion in renal transplantation: 2 year follow-up results.

    Science.gov (United States)

    Krämer, Bernhard K; Montagnino, Giuseppe; Del Castillo, Domingo; Margreiter, Raimund; Sperschneider, Heide; Olbricht, Christoph J; Krüger, Bernd; Ortuño, Joaquín; Köhler, Hans; Kunzendorf, Ulrich; Stummvoll, Hans-Krister; Tabernero, Jose M; Mühlbacher, Ferdinand; Rivero, Manuel; Arias, Manuel

    2005-05-01

    Comparison studies of calcineurin inhibitors as cornerstone immunosuppressants in renal transplantation have demonstrated that tacrolimus consistently reduces acute rejection rates and, in some studies, also improves long-term renal outcome in comparison to cyclosporin A (CsA). The aim of the present 2 year follow-up of the European Tacrolimus vs Cyclosporin A Microemulsion Renal Transplantation Study was to investigate long-term clinical outcome in terms of rate of acute rejection, graft and patient survival and graft function. The European Tacrolimus vs Cyclosporin A Microemulsion Renal Transplantation Study was a randomized, comparative 6 month trial of the calcineurin inhibitors tacrolimus and CsA in combination with both azathioprine and steroids. The intent-to-treat population (ITT) consisted of 286 patients in the tacrolimus arm and 271 in the CsA microemulsion (CsA-ME) arm. Whereas whole blood level targets were 10-20 and 5-15 ng/ml for tacrolimus and 100-400 and 100-200 ng/ml for CsA during months 0-3 and 4-6, respectively, during the investigator-driven follow-up after termination of the main study (months 7-24) no specific calcineurin inhibitor target levels were required. Follow-up data were collected at 2 years post-transplantation from 237 (82.9% of the ITT population) patients who received tacrolimus and 222 (81.9% of the ITT population) patients who received CsA-ME. Calculated on ITT populations, mortality (2.0% vs 3.3%; PRenal function 2 years post-transplant, measured by serum creatinine concentrations, was significantly better in tacrolimus-based compared with CsA-ME-based immunosuppression (136.9 vs 161.6 micromol/l; Ptransplantation. Tacrolimus-based immunosuppression may induce long-term benefits with regard to graft function and graft survival. The overall side-effect profile is considered to be favourable.

  1. [Primary pulmonary artery sarcoma in 36-year-old women: 3-years follow-up after partial resection and radiotherapy].

    Science.gov (United States)

    Drożdż, Jarosław; Warchoł, Ewa; Fijuth, Jacek; Filipiak, Krzysztof; Spych, Michał; Maciejewski, Marek; Piestrzeniewicz, Katarzyna; Ludomir, Stafańczyk; Janaszek-Sitkowska, Hanna; Januszewicz, Andrzej; Zembala, Marian

    2013-01-01

    Intimal sarcoma of the heart and pulmonary artery is a very rare, malignant, primary tumour. The prognosis in patients with primary sarcoma of the pulmonary artery, including intimal sarcoma, is poor. We present the case and 3-years follow-up of 36-year-old woman who was successfully treated with surgical, partial resection of the tumour followed by radiotherapy.

  2. Motor complications in Parkinson's disease: ten year follow-up study.

    Science.gov (United States)

    López, Iria Cabo; Ruiz, Pedro J García; Del Pozo, Silvia Vázquez Fernández; Bernardos, Vicenta Sánchez

    2010-12-15

    Parkinson's disease (PD) can be symptomatically controlled with standard treatments; however, after a few years, this response typically declines and most patients develop motor complications. We carried out a prospective practice-based study to evaluate the evolution appearance and evolution of motor complications in 64 de novo PD patients over 5 years and in 38 PD patients over 10 years. We studied untreated patients from initial assessment at basal conditions and evaluated every 6 months thereafter with treatment (levodopa versus other drugs). The follow-up assessments were performed with the Unified Parkinson's Disease Rating Scale (UPDRS). At each assessment, patients were monitored regarding the development of dyskinesias, motor fluctuations, freezing, loss of postural reflexes, and cognitive impairment. We observed a significant improvement in UPDRS scores during the first year, then a progressive decline, more evident after the third year. Motor complications increased after the third year, and at the end of the survey (tenth year); drug-induced dyskinesias and motor fluctuations were experienced (71.1 and 94.7%, respectively). After the first decade, many complications arose from the non-levodopa-responsive features of the disease (cognitive impairment was present in 52.6% and gait freezing in 71.1%). Initial medication may influence medium-term complications but not long-term problems. Most long-term disabling problems of PD were related to non-levodopa-responsive features.

  3. Treatment of chronic hepatitis C among injecting drug users: A 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Ruzić Maja

    2013-01-01

    Full Text Available Background/Aim. Hepatitic C infection (HCV is a systemic, generalised disease with the prevalence of inflammation in the liver. The aim of this study was to determine the success of treatment for chronic hepatitis C with pegilated interferon alfa 2a and ribavirin in injecting drug users. Methods. This a 5-year follow-up study included 30 patients [63.3% men and 36.7% women, average age 30.2 years (SD 7.1 years] injecting drug users in one-year abstinence, with chronic hepatitis C, treated with the pegilated interferon α 2a and ribavirin. Complete history with possible route of infection, the standard biochemical tests, liver biopsy, quantification of the viral genome in sera and HCV genotyping and subtyping were done prior to the therapy initiation. Depending on the HCV genotype, the therapy was conducted over a period of 48 weeks for genotype 1 and 24 weeks for genotype non 1. Five years later all 30 patients were invited on control examination; 22 of them appeared at the check-up and quantification of the viral genome in their sera were analized. Results. The established degree of liver fibrosis was: F0 in 40%, F1 in 23.33%, F2 in 26.67%, F3 in 3.33% and F4 in 6.67% of the patients. Genotype 3a was dominant (50.0%, 1b was registered in 40.0%, 1a in 6.66% and 2b in 3.33% of the patients. Sustained virologic response (SVR was achieved in 86.7% of the patients, 10.0% of the patients were non-responders, while 3.33% of them revealed recurrence of HCV. Opiate abuse recurrence during antiviral therapy happened in 6.7% of the patients. Five years after the antiviral therapy 73.3% of the patients appeared at the check-up and all of them were in stable abstinence from opiate abuse. All of those, with a sustained viral response of five-year duration, had the negative PCR HCV RNA test (< 50 IU ml-1. In the patients showing unsatisfactory therapy response 5 years before, antiviral therapy was repeated by the same therapeutic regimen, but without adequate

  4. Five-year follow-up after transcatheter aortic valve implantation for symptomatic aortic stenosis.

    Science.gov (United States)

    Zahn, Ralf; Werner, Nicolas; Gerckens, Ulrich; Linke, Axel; Sievert, Horst; Kahlert, Philipp; Hambrecht, Rainer; Sack, Stefan; Abdel-Wahab, Mohamed; Hoffmann, Ellen; Zeymer, Uwe; Schneider, Steffen

    2017-07-06

    Transcatheter aortic valve implantation (TAVI) has been implemented into the care of elderly patients suffering from severe symptomatic aortic stenosis. However, data on long-term follow-up are sparse and predictors of long-term mortality need to be evaluated to better select patients. Therefore, we aimed to analyse predictors of 5-year mortality after TAVI. We analysed data from the German Transcatheter Aortic Valve Interventions-Registry. Each of the 27 participating hospitals agreed to include all consecutive TAVI patients at their institution. Out of 1444 patients treated with TAVI, 1378 patients had a follow-up of at least 4.5 years (completeness 95.4%). Endpoint for this analysis was 5-year survival. Cox regression analysis was used to determine risk factors associated with this endpoint. Patients who died were compared with survivors. The two groups showed multiple differences in patient characteristics, indications for interventions, preinterventional, as well as interventional characteristics and postinterventional events. Calculated 1-year mortality was 21.8% and 5-year mortality 59.1%. A higher logistic EuroScore was associated with a lower 5-year survival, being 45.5% in patients with a logistic EuroScore of 40%. Cox proportional hazard analysis revealed the following independent predictors of 5-year mortality: female gender (HR (HR)=0.66, 95% CI 0.56 to 0.77, pyear) (HR=1.02, 95% CI 1.01 to 1.03, p=0.006), prior myocardial infarction (HR=1.29, 95% CI 1.07 to 1.57, p=0.009), urgent TAVI (HR=1.25, 95% CI 1.04 to 51, p=0.020) and diabetes mellitus (HR=1.20, 95% CI 1.02 to 1.40, p=0.024). These data from the early TAVI experience show a 5-year mortality of 59.1%. Some of the predictors of 5-year mortality seem to be modifiable, such as residual aortic regurgitation, type of TAVI access route and concomitant mitral regurgitation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved

  5. Psychopathology and attrition in the Baltimore ECA 15-year follow-up 1981-1996.

    Science.gov (United States)

    Badawi, M A; Eaton, W W; Myllyluoma, J; Weimer, L G; Gallo, J

    1999-02-01

    Predictors of non-response were investigated in a 15-year follow-up (1981-1996) of 3,481 individuals in a probability sample from the household population of East Baltimore. Demographics (age, sex, race, education, marital status, and unemployment), household factors (living arrangements, household income, household size, and number of children), cultural variables (ancestral ethnicity and foreign language), social variables (social support and networks, committing felony, carrying a weapon, using an alias, and wandering), health factors (physical illness, health insurance, medical assistance, Medicare, receiving disability benefits, social security, and welfare), interviewer's observation, and psychopathologic variables (mental disorders, suicide behavior, comorbidity, and drug use) were collected at baseline in 1981 and in 1982, then linked to follow-up data between 1993 and 1996. A tracing process involving mail, phone, criss-cross directories, motor vehicle administration records, a commercial credit bureau, the state criminal justice system, hospital records, the US National Death Index, and field tracing were used to locate the original sample. A total of 3,066 respondents of the original sample (88.1%) were traced. Non-response was categorized into Sample Mortality (that part of the original sample that died during follow-up), Sample Loss (that part of the original sample that survived but could not be found) and Refusal (that part of the original sample that survived and was found but refused to participate). Stratified analysis and adjusted multiple logistic regression modeling found sample mortality and sample loss were strongly influenced by individual and household variables and by psychopathology. Sample mortality was influenced by specific mental disorders or conditions as mania, drug abuse/dependency, antisocial personality, cognitive impairment, alcohol abuse/dependency, phobia, drug use (except PCP), and comorbidity. Household factors protective

  6. A 3-Year Follow-up of Sun Behavior in Patients With Cutaneous Malignant Melanoma

    DEFF Research Database (Denmark)

    Idorn, Luise Winkel; Datta, Pameli; Heydenreich, Jakob

    2014-01-01

    IMPORTANCE UV radiation (UVR) exposure is the primary environmental risk factor for developing cutaneous malignant melanoma (CMM). OBJECTIVE To measure changes in sun behavior from the first until the third summer after the diagnosis of CMM using matched controls as a reference. DESIGN, SETTING...... that measured time-related UVR in standard erythema dose (SED) and corresponding sun diaries (mean, 74 days per participant each participation year). RESULTS Patients' daily UVR dose and UVR dose in connection with various behaviors increased during follow-up (quantified as an increase in daily UVR dose each...... suggest that patients with CMM do not maintain a cautious sun behavior in connection with an increase in UVR exposure, especially on days with body exposure, when abroad, and on holidays....

  7. Effect of pregnancy on the prognosis for multiple sclerosis. A 5-year follow up investigation

    DEFF Research Database (Denmark)

    Stenager, Egon; Stenager, E N; Jensen, Knud

    1994-01-01

    . The investigation was initiated in 1986 when handicap was evaluated by Kurtzke Disability Status Score (DSS). At a 5-year follow up 4 had died and 6 could not participate. There were 29 women in the investigation of whom 7 were childless, 10 had onset of MS at least 6 months after last childbirth, and 12 had onset......INTRODUCTION: The purpose of the study was to evaluate the effect of pregnancy and childbirth on the longterm prognosis for women with multiple sclerosis (MS). METHOD AND MATERIAL: A cohort of 39 women with definite MS were identified on 1.1.1986 using a reproducible selection method...... (p = 0.005). CONCLUSION: On the basis of this prospective investigation and the literature, it may be concluded that it is unlikely that pregnancy and childbirth have an influence on the longterm prognosis for MS. However, the conclusion must be interpreted with caution as the number of patients...

  8. Shock-wave therapy for tennis and golfer's elbow--1 year follow-up.

    Science.gov (United States)

    Krischek, O; Hopf, C; Nafe, B; Rompe, J D

    1999-01-01

    Thirty patients with chronic medial epicondylitis were treated with low-energy shock waves. They received 500 impulses of 0.08 mJ/mm2 three times at weekly intervals. At 1 year follow-up examinations were performed. According to the Verhaar criteria, only seven patients reached excellent or good results. In eight cases a fair outcome was recorded, and in 14 patients the outcome was poor. Only six patients were satisfied with the treatment. The average relief of pain was 32%. These data were significantly worse than for identically treated patients with chronic tennis elbow. Thus, the question arises as to whether extracorporal shock-wave therapy is indicated in medial epicondylitis.

  9. Rotational path partial denture design: a 10-year clinical follow-up--Part II.

    Science.gov (United States)

    Jacobson, T E

    1994-03-01

    A review of the rotational path removable partial denture design concept has been presented. The rigid direct retainers used in these designs satisfy the basic requirements of clasp designs. The reported results of a survey of the members of The Academy of Prosthodontics may provide insight into the reasons for reluctance on the part of some practitioners to use the concept more often when indicated. Possible reasons include the following: lack of sufficient understanding of the concept, difficulty in obtaining knowledgeable laboratory support, absence of documented evidence of long-term clinical success, and a general lack of confidence in the efficacy of the procedure as described in the literature. This article presents references that are available to improve the understanding of technicians and dentists with regard to the rotational path concept. In addition, several patients followed up for 10 or more years demonstrated long-term clinical success.

  10. Postoperative Mortality after Hip Fracture Surgery: A 3 Years Follow Up

    Science.gov (United States)

    Un, Canan; Sacan, Ozlem; Gamli, Mehmet; Baskan, Semih; Baydar, Mustafa

    2016-01-01

    Background and Aims To determine mortality rates and predisposing factors in patients operated for a hip fracture in a 3-year follow-up period. Methods The study included patients who underwent primary surgery for a hip fracture.The inclusion criteria were traumatic, non-traumatic, osteoporotic and pathological hip fractures requiring surgery in all age groups and both genders. Patients with periprosthetic fractures or previous contralateral hip fracture surgery and patients who could not be contacted by telephone were excluded. At 36 months after surgery, evaluation was made using a structured telephone interview and a detailed examination of the hospital medical records, especially the documents written during anesthesia by the anesthesiologists and the documents written at the time of follow-up visits by the orthopaedic surgeons. A total of 124 cases were analyzed and 4 patients were excluded due to exclusion criteria. The collected data included demographics, type of fracture, co-morbidities, American Society of Anesthesiologists (ASA) scores, anesthesia techniques, operation type (intramedullary nailing or arthroplasty; cemented-noncemented), peroperative complications, refracture during the follow-up period, survival period and mortality causes. Results The total 120 patients evaluated comprised 74 females(61.7%) and 46 males(38.3%) with a mean age of 76.9±12.8 years (range 23–95 years). The ASA scores were ASA I (0.8%), ASA II (21.7%), ASA III (53.3%) and ASA IV (24.2%). Mortality was seen in 44 patients (36.7%) and 76 patients (63.3%) survived during the 36-month follow-up period. Of the surviving patients, 59.1% were female and 40.9% were male.The survival period ranged between 1–1190 days. The cumulative mortality rate in the first, second and third years were 29.17%, 33.33% and 36.67% respectively. The factors associated with mortality were determined as increasing age, high ASA score, coronary artery disease, congestive heart failure, Alzheimer

  11. Wilson's disease in southern Brazil: a 40-year follow-up study

    Directory of Open Access Journals (Sweden)

    Ricardo Schmitt de Bem

    2011-01-01

    Full Text Available BACKGROUND: Long-term data on the clinical follow-up and the treatment effectiveness of Wilson's disease are limited because of the low disease frequency. This study evaluated a retrospective cohort of Wilson's disease patients from southern Brazil during a 40-year follow-up period. METHODS: Thirty-six Wilson's disease patients, diagnosed from 1971 to 2010, were retrospectively evaluated according to their clinical presentation, epidemiological and social features, response to therapy and outcome. RESULTS: Examining the patients' continental origins showed that 74.5% had a European ancestor. The mean age at the initial symptom presentation was 23.3 ± 9.3 years, with a delay of 27.5 ± 41.9 months until definitive diagnosis. At presentation, hepatic symptoms were predominant (38.9%, followed by mixed symptoms (hepatic and neuropsychiatric (30.6% and neuropsychiatric symptoms (25%. Kayser-Fleischer rings were identified in 55.6% of patients, with a higher frequency among those patients with neuropsychiatric symptoms (77.8%. Eighteen patients developed neuropsychiatric features, most commonly cerebellar syndrome. Neuroradiological imaging abnormalities were observed in 72.2% of these patients. Chronic liver disease was detected in 68% of the patients with hepatic symptoms. 94.2% of all the patients were treated with D-penicillamine for a mean time of 129.9 ± 108.3 months. Other treatments included zinc salts, combined therapy and liver transplantation. After initiating therapy, 78.8% of the patients had a stable or improved outcome, and the overall survival rate was 90.1%. CONCLUSION: This study is the first retrospective description of a population of Wilson's disease patients of mainly European continental origin who live in southern Brazil. Wilson's disease is treatable if correctly diagnosed, and an adequate quality of life can be achieved, resulting in a long overall survival.

  12. Endoscopic thoracic sympathectomy for primary hyperhidrosis: a 16-year follow up in a single UK centre.

    Science.gov (United States)

    Askari, Alan; Kordzadeh, Ali; Lee, Gui Han; Harvey, Michael

    2013-06-01

    Since the introduction of Endoscopic Thoracic Sympathectomy ( ETS ) by Kux in 1951, the procedure has been performed for treatment of primary hyperhidrosis (PH) of the upper limb. Despite its initial success and minimally invasive nature, the long-term results are yet to be established. The aim of this study is to evaluate the outcome of patients after ETS with particular emphasis on patient satisfaction and its effectiveness over a 16-year period. A patient survey of fifty-one (n = 51) patients who had ETS for PH of palms from 1995 to 2011 was conducted. The data on age, sex, site of the PH, family history, trigger, hospital stay, relief from symptoms, complications, refractory sweating and overall satisfaction with the procedure was analysed with SAS software version 9.1.3. The mean follow-up was 77 months (range, 6-189 months) with equal gender distribution (n = 24 males Vs n = 27 females) and mean age of 19 (range, 13-64 years). The hereditary prevalence was 55%. Forty-six patients (90.2%) reported an immediate (≤24 h) and four patients (7.8%) reported a delay (>24 h) in relief of symptoms. To the best of our knowledge this is longest duration of follow-up reported in the literature. Copyright © 2012 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  13. Pyridoxine-dependent convulsions among children with refractory seizures: A 3-year follow-up study

    Directory of Open Access Journals (Sweden)

    Sadanandavalli Retnaswami Chandra

    2016-01-01

    Full Text Available Introduction: Epilepsy accounts for 1% of the global disease burden and about 8–10 million epilepsy patients live in India. About 30–40% of these patients become drug-resistant and land up with palliative or disease-modifying surgeries. This is a situation causing great concern in view of the psychosocial and economic burden on the patient and the family apart from severe cognitive and motor consequences, especially in children. Therefore, it is mandatory to have an insight into the wide spectrum of causes with reference to refractoriness to antiepileptic medications in children with epilepsy. Patients and Methods: Children admitted under our team with refractory epilepsy as per the International League Against Epilepsy (ILAE criteria in the last 3 years were included in the study. Results: Refractory epilepsy constituted 13.3% of inpatients in the pediatric group. Males dominated with 68.9% of these patients. Nearly 34.4% of these patients were found to suffer from various neurometabolic diseases. Almost 3.5% were due to pyridoxine-dependent convulsions. This group of patients showed an excellent response to dietary manipulation, disease-modifying treatment for the metabolic disorder, and supportive small-dose anticonvulsants. During follow-up, they showed very good response with reference to global development and seizure control. Conclusion: Pyridoxine-dependent convulsions are relatively rare forming about 3.5% of refractory epilepsies in this series. With initiation of appropriate therapy, results with reference to seizure control as well as neurodevelopment became evident within 2 weeks, and at 1-year follow-up, complete independence for majority of the needed activities is achieved with minimum cost, almost zero side effects, and absolute elimination of the need for palliative surgery.

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

    Science.gov (United States)

    Patel, Vipul; Thaly, Rahul; Shah, Ketul

    2007-02-01

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

  15. Subjective quality of life in first-episode psychosis. A ten year follow-up study.

    Science.gov (United States)

    Gardsjord, Erlend Strand; Romm, Kristin Lie; Friis, Svein; Barder, Helene Eidsmo; Evensen, Julie; Haahr, Ulrik; ten Velden Hegelstad, Wenche; Joa, Inge; Johannessen, Jan Olav; Langeveld, Johannes; Larsen, Tor Ketil; Opjordsmoen, Stein; Rund, Bjørn Rishovd; Simonsen, Erik; Vaglum, Per; McGlashan, Thomas; Melle, Ingrid; Røssberg, Jan Ivar

    2016-04-01

    Subjective quality of life (S-QoL) is an important outcome measure in first episode psychosis (FEP). The aims of this study were to describe S-QoL-development the first 10-years in FEP patients and to identify predictors of this development. A representative sample of 272 patients with a first episode psychotic disorder was included from 1997 through 2000. At 10 year follow-up 186 patients participated. QoL was measured by the Lehman's Quality of Life Interview. Linear mixed model analyses were performed to investigate longitudinal effects of baseline psychiatric symptoms and socio-economic variables and the effects of changes in the same variables on S-QoL-development. S-QoL improved significantly over the follow-up period. More contact with family and a better financial situation at baseline had a positive and longstanding effect on S-QoL-development, but changes in these variables were not associated with S-QoL-development. Higher depressive symptoms and less daily activities at baseline both had a negative independent effect, but a positive interaction effect with time on S-QoL-development indicating that the independent negative effect diminished over time. In the change analysis, increased daily activities and a decrease in depressive symptoms were associated with a positive S-QoL-development. Treatment of depressive symptoms and measures aimed at increasing daily activities seem important to improve S-QoL in patients with psychosis. More contact with family and a better financial situation at baseline have a long-standing effect on S-QoL-development in FEP patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Changes observed in diabetic retinopathy: eight-year follow-up of a Spanish population

    Science.gov (United States)

    Romero-Aroca, Pedro; de la Riva-Fernandez, Sofia; Valls-Mateu, Aida; Sagarra-Alamo, Ramon; Moreno-Ribas, Antonio; Soler, Nuria

    2016-01-01

    Background/aims To determine the changes in the incidence of diabetic retinopathy (DR), diabetic macular oedema (DMO) and their risk factors in a population-based study of patients with diabetes mellitus (DM) referred to our 16 Primary Health Care Areas (HCAs). Methods Prospective population-based study of a total of 15 396 Caucasian patients with DM, who represent 86.53% of the total patients with DM in our HCAs, were studied over an 8-year follow-up period. All patients were screened with a mean follow-up of 3.18±1.11 times for each patient over the 8 years. Results The yearly mean value of any DR was 8.37±2.19% (8.09%–8.99%); of advanced DR yearly mean value of 0.46±0.22% (0.03–0.78); and of DMO a yearly mean value of 2.19±0.18% (2%–2.49%). A clear increase was observed in the last 3 years, any DR increased from 8.09% in 2007 to 8.99% in 2014, and DMO from 2% in 2007 to 2.49% in 2014. These increases were more evident in some age groups. For patients with any DR aged 41–50 and 51–60 and for patients with advanced DR aged 41–50, 51–60 and 61–70, the increase was more marked, related to an increase in HbA1c values or to patients treated with insulin. Conclusions An increase in the incidence of DR and DMO was observed, especially in the younger patients aged between 31 and 70 years. This is linked to bad metabolic control of DM. Our results suggest a greater number of ocular complications in the near future, such as neovascular glaucoma, if these current findings are not addressed. PMID:26769672

  17. The Prognosis of Primary Percutaneous Coronary Intervention after One Year Clinical Follow Up

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    Yahya Dadjoo

    2013-03-01

    Full Text Available Objectives: The aim of this study was to evaluate the clinical outcomes, one year after primary percutaneous coronary intervention(PCI. Patients and Methods: From September 2009 to March 2012, primary PCI was performed on 70 cases, and the data relating to their catheterization were recorded. Peri-interventional treatment data included PCI with drug-eluting or bare-metal stent or balloon angioplasty alone. Results: The mean age of the patients was 61.34+11.31 years, and 72.9% of them were males. The ratios of patients with diabetes, hypertension and, hyperlipidemia were 61.4%, 71.4%, and 52.9% respectively. In clinical follow-up, total incidence of death was 4.3%, with no death occurring during 30 days. However, 3 patients died after one-year, of which one patient (1.4% had cardiac problem and the other 2 (2.9% died because of non-cardiac reasons. Target vessel revascularization, reinfarction within 30 days, and mechanical complication or stroke were not found in any of the patients. Patients with hypertension (6% and those with LAD ST-elevation myocardial infarction (5% died after one year (P= 0.263 and P= 0.319 respectively. However, no mortality was reported in patients with RCA and LCX ST-elevation myocardial infarction. Of subjects with multivessel disease, 7% died after one-year (P= 0.161, but there was no reported mortality in those with single vessel disease.

  18. Dentin caries risk indicators in 1-year-olds. A two year follow-up study.

    Science.gov (United States)

    Hultquist, Ann Ingemansson; Bågesund, Mats

    2016-11-01

    Early childhood caries (ECC) risk factors are suspected to vary between regions with different caries prevalence. Identify ECC risk factors for 1-year-olds predicting dentin caries at 3 years of age in a region with low caries prevalence. Caries risk was assessed by dental hygienist or dental assistant in 779 one-year-olds. The oral mutans streptococci (MS) score was performed from a tooth surface or (in pre-dentate children) from oral mucosa. A parental questionnaire with questions regarding family factors (siblings with or without caries), general health, food habits (night meals, breastfeeding, other beverage than water), oral hygiene habits and emerged teeth were answered by parents of the 1-year-olds. Dentin caries was assessed when the children were 3-year-olds. Simple and multiple logistic regression analyses were used for identification of caries-associated factors. An increased caries risk was assessed in 4.4% of the 1-year-olds. Dentin caries was found in 2.6% of the 3-year-olds. Caries risk at 1 year was associated with caries at 3 years (OR = 6.5, p = .002). Multiple regression analysis found the variables Beverages other than water (OR = 7.1, p year-olds in a region with low caries experience.

  19. Therapeutic embolization of high-flow priapism 1 year follow up with color Doppler sonography

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    Zhao, Song, E-mail: zhaosong1984@QQ.com; Zhou, Jun, E-mail: 18740585@QQ.COM; Zhang, Yi-Fan, E-mail: XXXzyf2011@163.com; Zhang, Xiao-Long, E-mail: 87512377@QQ.COM; Long, Qing-Yun, E-mail: longqy2005@aliyun.com

    2013-12-01

    Objective: The aim of this study was to evaluate the use of color Doppler sonography (CDS) for the diagnosis of high-flow priapism and the treatment of cavernosal arterial fistula via super-selective arterial embolization. Methods and materials: We reviewed eight cases of high-flow priapism with cavernosal arterial fistula, from 2005 to 2011. All of the patients were diagnosed with a high-flow priapism and unilateral artery fistula via CDS. Conventional treatments for the eight cases were unsuccessful, and the patients were then treated through super-selective embolization. Diagnostic angiograms of the internal iliac artery showed a fistula on one side of the cavernosal artery, thus confirming the CDS images. We compared hemodynamic parameters including the peak systolic velocity, end diastolic velocity the resistance index of the pathological cavernosal artery and intracavernosal pressure in all patients before and after treatment using t-test. The efficacy of super-selective embolization and the erectile function of all patients were evaluated at a follow-up time of 12 months. Results: All patients were successfully treated and angiography showed that the fistulas disappeared after treatment. Additionally significant differences were found in the peak systolic velocity, the end diastolic velocity, the resistance index and intracavernosal pressure between pre-treatment and post-treatment (P < 0.05). At 5 days post-treatment, only one case relapses had occurred. Seven cases displayed restored erectile function and only one case exhibited erectile dysfunction. Conclusion: Color Doppler sonography is a highly sensitive method for the examination of high-flow priapism, and super-selective embolization is a safe and effective treatment for cavernosal arterial fistula.

  20. Midlife personality and risk of Alzheimer disease and distress: a 38-year follow-up.

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    Johansson, Lena; Guo, Xinxin; Duberstein, Paul R; Hällström, Tore; Waern, Margda; Ostling, Svante; Skoog, Ingmar

    2014-10-21

    To study the association between midlife neuroticism and extraversion and development of late-life dementia and long-standing distress in a sample of women followed for 38 years. A population-based sample of 800 women, aged 38 to 54 years, was examined in 1968, with subsequent examinations in 1974, 1980, 1992, 2000, and 2005. Neuroticism and extraversion were assessed using the Eysenck Personality Inventory at baseline. Distress was measured according to a standardized question at each study wave. Dementia was diagnosed according to DSM-III-R criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data. During the 38-year follow-up, 153 women developed dementia; Alzheimer disease (AD) dementia was diagnosed in 104 of these. A higher degree of neuroticism in midlife was associated with increased risk of AD dementia and long-standing distress over 38 years. The association between neuroticism and AD dementia diminished after adjusting for long-standing distress. Extraversion was associated with a lower degree of long-standing distress, but had no impact on AD dementia. When the 2 personality dimensions were combined, high neuroticism/low extraversion showed the highest risk of AD dementia. Our study suggests that midlife neuroticism is associated with increased risk of AD dementia, and that distress mediates this association. The results have clinical implications because a group of women at risk of AD dementia is identified. © 2014 American Academy of Neurology.

  1. Regular aquatic exercise for chronic kidney disease patients: a 10-year follow-up study.

    Science.gov (United States)

    Pechter, Ülle; Raag, Mait; Ots-Rosenberg, Mai

    2014-09-01

    Chronic kidney disease (CKD) patients not yet in dialysis can benefit from increased physical activity; however, the safety and outcomes of aquatic exercise have not been investigated in observational studies. The aim of this study was to analyze association of 10 years of regularly performed aquatic exercise with the study endpoint--that is, all-cause death or start of dialysis. Consecutive CKD patients were included in the study in January 2002. The exercise group (n=7) exercised regularly under the supervision of physiotherapist for 10 years; the control group (n=9), matched in terms of age and clinical parameters, remained sedentary. Low-intensity aerobic aquatic exercise was performed regularly twice a week; 32 weeks or more of exercise therapy sessions were conducted annually. None of the members of the aquatic exercise group reached dialysis or died in 10 years. In the sedentary control group, 55% reached the study endpoint--renal replacement therapy (n=2) or all-cause death (n=3). Occurrence of the study endpoint, compared using the exact multinomial test with unconditional margins, was statistically significantly different (P-value: 0.037) between the study groups. Regular supervised aquatic exercise arrested CKD progression. There was a statistically significant difference between the sedentary group and the exercise group in reaching renal replacement therapy or all-cause death in a follow-up time of 10 years.

  2. Two-year follow-up of a randomised trial with repeated antenatal betamethasone.

    Science.gov (United States)

    Peltoniemi, O M; Kari, M A; Lano, A; Yliherva, A; Puosi, R; Lehtonen, L; Tammela, O; Hallman, M

    2009-11-01

    Weekly repeated antenatal corticosteroid treatment improves respiratory outcome but decreases fetal growth and may impair neurodevelopmental outcome. We have previously reported that a single repeat betamethasone (BM) dose neither decreased fetal growth nor improved the outcome of preterm infants during the first hospitalisation. To study prospectively whether a single repeat dose of BM influences neurodevelopment and growth within 2 years. Women with imminent delivery before 34.0 gestational weeks were eligible if they remained undelivered for >7 days after a single course of antenatal BM. After stratification, a single repeat dose of BM (12 mg) or placebo was given. The children underwent neurological and psychometric examinations and a speech evaluation at a corrected age of 2 years. Prospective, blinded evaluation following the randomised multicentre trial. 259 (82%) surviving infants completed the 2-year follow-up, 120 in the BM group and 139 in the placebo group. The rate of survival without severe neurodevelopmental impairment was similar in both groups (BM 98%, placebo 99%). The risk of cerebral palsy (BM 2%, placebo 1%), growth or re-hospitalisation rates (BM 60%, placebo 50%) did not differ between the groups. A single repeat dose of antenatal BM tended not to influence physical growth or neurodevelopment at 2 years of age.

  3. Changes of systemic microinflammation after weight loss and regain - a five-year follow up study.

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    Olszanecka-Glinianowicz, Magdalena; Chudek, Jerzy; Szromek, Adam; Zahorska-Markiewicz, Barbara

    2012-01-01

    The aim of this study was to evaluate the influence of body mass changes on plasma concentrations of proinflammatory cytokines in obese women after the initially obtained weight reduction in a five-year follow-up period. Thirty out of 42 women with simple obesity (age 41.8 ± 11.9 years; BMI 36.5 ± 4.6 kg/m2) who achieved a greater than 5% weight loss at the end of a three-month weight loss programme were re-examined after five years. In addition to anthropometric and body composition measurements, plasma concentrations of TNF-alpha, sTNFRs and IL-6 were determined. The mean weight loss after the three-month weight loss programme was 7.9 ± 4.4 kg. After five years, body mass was still lower than initially in 14 women, while in 16 it was higher (the so-called 'yo-yo effect'). A significant decrease of plasma TNF-alpha and IL-6 and increase of sTNFR1 and sTNFR2 levels obtained after weight loss therapy were maintained after five years, including in the subgroup with the yo-yo effect. During the follow-up period, the increase of body fat mass was similar in the subgroup that maintained reduced weight (+4.4 ± 10.7 kg) and in the subgroup with the yo-yo effect (+4.1 ± 7.1 kg), while a significant difference was found in changes of body free fat mass (-7.1 ± 7.1 v. -0.7 ± 4.5 kg, respectively). The yo-yo effect has a modest influence on systemic microinflammation and seems not to abolish the benefit achieved via a weight loss programme. This may suggest that the persistence of changes in lifestyle implemented during the programme such as regular physical activity and diet composition may have a significant impact on the level of systemic microinflammation in the obese. (Endokrynol Pol 2012; 63 (6): 432-438).

  4. Partial achilles tendon rupture presenting with giant hematoma; MRI findings of 4 year follow up.

    Science.gov (United States)

    Sarsilmaz, Aysegul; Varer, Makbule; Coskun, Gulten; Apaydın, Melda; Oyar, Orhan

    2011-12-01

    In the young population, spontaneous rupture of Achilles tendon is very rare. The big hematoma is also rare finding of the Achilles tendon partial rupture. It is usually seen with complete rupture. We presented imaging findings of 4 years follow up of the spontaneous partial rupture of Achilles tendon presenting with giant expanding hematoma and mimicking complete rupture radiologically. We discussed the alterations of tendon signal intensity and result of conservative therapy after partial rupture with big hematoma in the long term. A 29 year-old man, applied with pain and swelling in the retrocalcaneal region of left ankle. He did not have chronic metabolic disease. He was not active in physical activities. X-ray radiograms were normal. At magnetic resonance images (MRI), there was an intratendinous big hematoma, subcutanous fat planes were edematous around tendon. The diagnosis was partial rupture and giant hematoma. Hematoma was drained. The conservative treatment was applied and his complaints disappeared. After treatment, approximately 4 years later, control MRI showed thickened and hypointense tendon in all images. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  5. Synthetic Patch Rotator Cuff Repair: A 10-year Follow-Up.

    Science.gov (United States)

    Shepherd, Henry M; Lam, Patrick H; Murrell, George A C

    2014-01-01

    The present study aimed to determine the long-term outcome as a result of the use of synthetic patches as tendon substitutes to bridge massive irreparable rotator cuff defects. All patients who previously had a rotator cuff repair with a synthetic patch (2-mm Gore DUALMESH ePTFE patch; Gore, Flagstaff, AZ, USA; or a 2.87-mm Bard PTFE Felt pledgets; CR Bard, Warwick, RI, USA) were followed-up at a minimum of 8.5 years postoperatively. Assessment of shoulder pain, function, range of motion, strength and imaging was performed. Six patients had an interpositional repair with a synthetic patch. One patient had died. In the remaining five patients, the mean tear size at repair was 27 cm(2). At 9.7 years postoperatively, all the patches remained in situ and no patient required further surgery. The repair was intact in four out of five patients. Patients had improved external rotation and abduction compared to before surgery (p < 0.02). We describe the long-term outcomes of patients who had undergone synthetic patch rotator cuff repair for an irreparable rotator cuff tear. At 9.7 years postoperatively, patients reported less severe and more infrequent pain, as well as greater overall shoulder function, compared to before surgery. Patients also had increased passive external rotation and abduction. All the patches remain in situ and there have been no further operations on these shoulders.

  6. Results and complications of vertebrectomy with posterior approach after 2-year follow-up

    Directory of Open Access Journals (Sweden)

    Juliano Almeida e Silva

    2015-06-01

    Full Text Available OBJECTIVE: To describe the surgical technique for vertebrectomy by posterior single approach in the thoracic and thoracolumbar spine with circumferential reconstruction and arthrodesis, and evaluate retrospectively the results and complications after 2 years of follow-up in patients undergoing this technique.METHODS: Retrospective analysis of medical records and imaging studies of 12 patients with vertebrectomy indication for various pathologies, undergoing this surgical technique.RESULTS: Eight (66.67% patients were male and four patients (33.33% were females aged 13-66 years (mean 40 years. There were nine patients with involvement of the thoracic spine and three of the lumbar, and one patient with two consecutive vertebrae affected. All patients had improved or remained with the neurological condition. Surgical complications were two cases of hemothorax, two cases of loosening of the screws, one of them requiring surgical revision, and a case of material failure and pseudarthrosis.CONCLUSION: Vertebrectomy by posterior approach in thoracolumbar spine with circumferential reconstruction and fusion can be performed safely for a variety of indications.

  7. Over 10 years follow-up of Coats' disease in adulthood

    Directory of Open Access Journals (Sweden)

    Otani T

    2011-12-01

    , Coats’ disease, treatment, follow-up

  8. Response to hepatitis A and B vaccination in patients with chronic hepatitis C: 8-year follow-up.

    Science.gov (United States)

    Kalyoncu, Derya; Urganci, Nafiye

    2012-08-01

    In patients with chronic hepatitis C (CHC), superinfection with hepatitis A (HAV) or B (HAB) viruses is associated with increased morbidity and mortality. The seroconversion rate of these patients following vaccination is considered to be lower than in healthy subjects. To evaluate the response to HAV and HBV vaccination in children with CHC. Thirty patients with CHC aged from 7.3 to 18 years were compared with 50 healthy age-, gender- and body-mass-index-matched controls. Post-vaccination serological evaluation was performed 1 month after the last dose of primary vaccination, 1 month after the booster dose and once a year during follow-up. Twenty-two patients received hepatitis A vaccine and response rate was 95.4%. Thirty patients received hepatitis B vaccine and 80% responded (hepatitis Bs titres ≥10 mIU/ml). Thirty-five controls received hepatitis A vaccine and protective anti-HAV antibodies developed in all. All of the controls were vaccinated against hepatitis B virus and 90% responded. After the whole vaccination series, overall seroprotection rates were 86% in patients and 96% in controls. No significant reduction in antibody response was observed in patients or controls during 8-years follow-up. The rate of seroconversion to the HBV vaccine is lower in patients with CHC than in healthy controls but response to HAV is adequate.

  9. Seven-years follow-up on trial of Interferon alpha in patients with HCV RNA positive chronic hepatitis C

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    Bao Zhang Tang; Lin Zhuarg; Jing You; Hong Bing Zhang; Lu Zhang

    2000-01-01

    AIM To study the long-term efficiency of therapy with Interferon alpha (IFN-a) in patients with HCVRNA positive chronic hepatitis C.METHODS Ten patients were enrolled in the study, whose age 31 -62 years (mean 53 years), course 6- 72months (mean 24 months), of whom, 6 patients with mild CHC, 4 moderate CHC. All patients receivedIFN-a 3 MU three times weekly for six to twelve months, and then followed up for seven years after the endof treatment. The results of hepatic functions and HCV RNA at the end of treatment and follow-up period inall patients were observed.RESULTS ( At the end of treatment, clinical symptoms recovered obviously in all patients, virologicalresponse (defined as HCV RNA loss) occurred in 5 of 7 (71.4%) patients (60 years old). At the end of follow-up, the rates of HCV RNA loss were 42.9% (3/7)and 33.3% (1/3), respectively, in these group. Virological sustained response (defined as HCV RNA loss atthe end of treatment and follow-up) occurred in 3 of 6 (50%) patients (6 - 12 month-course) and in 1 of 4(25%) patients (> 12 month-course). A sustained HCV RNA response was observed in 2 of 7 (28.6%)patients with IFN-a therapy for 6m and in 2 of 3 (66.7%) patients with IFN-a therapy for more than 6 m. Ofall patients, 4 patients with sustained HCV RNA response were mild CHC, 4 patients with sustained HCVRNA positive were mild CHC (2 patients), moderate CHC (2 patients), respectively; other 2 patients withHCV RNA loss at the end of treatment but recurred at the end of follow-up, were moderate CHC. ②Biochemically sustained response (defined as ALT normalization at the end of treatment and follow-up) wasobserved in 5 out of 10 (50%) patients, and these 5 patients were mild CHC, of whom, 4 patients with HCVRNA sustained negative, 1 patient with HCV RNA loss and then recurred again. Two patients with ALTnormalization at the end of follow-up were one mild CHC, one moderate CHC, respectively. Other 3patients with no response were moderate CHC, of whom, 2

  10. NINE-YEAR FOLLOW-UP OF SPECIFIC PHOBIA IN A POPULATION SAMPLE OF OLDER PEOPLE.

    Science.gov (United States)

    Sigström, Robert; Skoog, Ingmar; Karlsson, Björn; Nilsson, Johan; Östling, Svante

    2016-04-01

    Little is known about the long-term course of specific phobia (SP) in the general population. We examined the prevalence and course of SP and subthreshold fears in an older population followed over 9 years. A psychiatric examination was performed in a population-based sample of 558 70-year-olds, among whom 303 dementia-free survivors were followed up at both ages 75 and 79. Fears were rated with respect to level of anxiety and social or other consequences. DSM-IV SP was diagnosed when fears were associated with prominent anxiety and had social or other consequences. All other fears were labeled subthreshold fears. The prevalence of SP declined from 9.9% at age 70 to 4.0% at age 79. The reason was that the prevalence of fears associated with prominent anxiety (mandatory in the diagnosis) decreased whereas the prevalence of fears that gave social or other consequences remained stable. A total of 14.5% of the population had SP at least once during the study. Among these, 11.4% had SP and 65.9% had specific fear at all three examinations. The prevalence of fears associated with prominent anxiety decreased with age, resulting in an overall decline in the prevalence of SP. SP seems to be a fluctuating disorder, and in most cases an exacerbation of chronic subthreshold fears. © 2015 Wiley Periodicals, Inc.

  11. Cause-specific mortality by income adequacy in Canada: A 16-year follow-up study.

    Science.gov (United States)

    Tjepkema, Michael; Wilkins, Russell; Long, Andrea

    2013-07-01

    People with lower incomes tend to have less favourable health outcomes than do people with higher incomes. Because death registrations in Canada do not contain information about the income of the deceased, vital statistics cannot be used to examine mortality by income at the individual level. However, through record linkage, information on the individual or family income of people followed for mortality can be obtained. Recently, a large, population-based sample of Canadian adults was linked to almost 16 years of mortality data. This study examines cause-specific mortality rates by income adequacy among Canadian adults. It is based on data from the 1991 to 2006 Canadian census mortality and cancer follow-up study, which followed 2.7 million people aged 25 or older at baseline, 426,979 of whom died during the 16-year period. Age-standardized mortality rates (ASMRs), rate ratios, rate differences and excess mortality were calculated by income adequacy quintile for various causes of death. For most causes examined, ASMRs were clearly graded by income: highest among people in the in the lowest income quintile, and lowest among people in the highest income quintile. Inter-quintile rate ratios (quintile 1/quintile 5) were greater than 2.00 for HIV/AIDS, diabetes mellitus, suicide, cancer of the cervix, and causes of death closely associated with smoking and alcohol. These individually based results provide cause-specific information by income adequacy quintile that was not previously available for Canada.

  12. Social functioning and survival: A 10-year follow-up study.

    Science.gov (United States)

    Arve, Seija; Lavonius, Sirkku; Savikko, Niina; Lehtonen, Aapo; Isoaho, Hannu

    2009-01-01

    Although otherwise extensively researched, one aspect of social functioning in older people that has received less attention is its association with staying at home for as long as possible. This 10-year follow-up examines factors of social functioning that support older people's independent living in their own homes and that reduce the risk of mortality. The data were collected in 1991 by a postal questionnaire that was sent to all residents of Turku, Finland, born in 1920. A physical examination was also conducted. Ten years later, in 2001, the mortality rate of this population was determined. The data were examined statistically. Female gender reduced the risk of mortality. In addition, daily outdoor activities, and not needing help (from different sources) were associated with a reduced risk of mortality. No need for help and a more positive attitude towards life reduced the risk of mortality of women. There were found only non-significant trends for men. Having plans for the future also reduced the risk of mortality. The findings of this study offer useful clues for planning the services provided by home health care personnel. In planning these services it is important that home health care workers take into account the differences between women and men customers: men may need and want different things from the home health care service than women do.

  13. Topographic outcomes after corneal collagen crosslinking in progressive keratoconus: 1-year follow-up

    Directory of Open Access Journals (Sweden)

    Mauro C. Tiveron Jr

    Full Text Available ABSTRACT Purpose: We aimed to report and analyze topographic and refractive outcomes following corneal collagen crosslinking (CXL in patients with progressive keratoconus (KC. Methods: We performed a retrospective, analytical, and observational study of 100 eyes from 74 progressive KC patients who underwent CXL at the Eye Hospital of Paraná. Keratometric values were analyzed preoperatively as well as 3 and 12 months postoperatively. Results: For a total of 100 eyes, 68 belonged to male patients. The mean age of our study population was 19.9 ± 5.61 years. The average visual acuity and topographic parameters overall were stable after 1 year (p<0.05. After 3 months, steepest keratometry reading (K2 and maximum keratometry (Kmax were significantly decreased (p<0.05. Regarding topographic astigmatism (dK, there was no significant difference between the 3-month and 12-month follow-ups. When we made comparisons between genders following CXL, there were no significant differences related to the changes in Kmax, K2, and spectacle-corrected distance visual acuity (SCDVA. Conclusions: CXL promoted stabilization or improvement of keratometric values and visual acuity. We found that keratoconus apex stability may be achieved 3 months after the procedure. There was no significant difference in keratometric and refractive values measured between male and female patients.

  14. [Contralateral replantation after bilateral traumatic lower leg amputation. Case report with 6 year follow-up].

    Science.gov (United States)

    Betz, A; Stock, W; Hierner, R; Sebisch, E; Schweiberer, L

    1995-05-01

    A 66-year-old patient attempted suicide by jumping in front of a train. The lower extremities were amputated at different levels. On the right side, there was a complete amputation within the distal third of the lower leg. Proximal to the amputation site, there was an extensive soft-tissue and bone defect. On the left side, there was a crush injury of the tarsal and mid-tarsal bones. The left lower leg showed only few injuries. An ipsilateral (anatomical) replantation was not possible. In order to save one lower extremity, we decided to carry out a cross-over (contralateral) replantation of the right foot to the left lower leg. After a follow-up of six years, the patient is able to walk well with her prosthesis on the right side and the right foot hooked up to the left lower leg. Functionally, this treatment (cross-over replantation-one-side prosthesis of the lower leg) is much better than the prosthesis on both extremities, as the result has shown. Also from a psychological point of view, it seems to be better for the patient to preserve one extremity even with a cross-over replanted foot.

  15. Follow-up of preterm children: II. Growth and development at four years of age.

    Science.gov (United States)

    Forslund, M; Bjerre, I

    1990-11-01

    In a long-term prospective study, 46 unselected infants born before 35 completed weeks of gestation were compared with 26 full-term infants. At four years of age, 44 preterms and 25 full-terms were available to follow-up. The preterms were somewhat shorter in stature and lighter in weight than the full-terms but fell well within the normal range for Swedish children. Head circumference in the preterm group was significantly correlated to neurological development. Psychometric evaluation with Griffiths' mental developmental scale showed the preterms to fall within the normal range, though their performance was inferior to that of the full-terms. The greatest differences between the groups were in scores for the subscales eye and hand coordination, performance, and practical reasoning. There was no correlation within the preterm group between the test results and birthweight, gestational age, prenatal score, perinatal score, or parental social status or education. Language development was delayed among the preterms, more of whom required speech therapy. Visual and hearing disorders were more common among preterms than expected. Although they were all in good health, more preterms than full-terms needed hospital care during the first four years of life.

  16. Disability multilevel modelling in first episodes of psychosis at 3-year follow-up.

    Science.gov (United States)

    Mellor-Marsá, Blanca; Caballero, Francisco Félix; Cabello, María; Ayuso-Mateos, José Luis; Setién-Suero, Esther; Vázquez-Bourgon, Javier; Crespo-Facorro, Benedicto; Ayesa-Arriola, Rosa

    2017-07-01

    The description of longitudinal bio-psycho-social profiles in FEP samples may be useful for the prediction of disability trajectories. This study aimed to describe the differences between disability status of FEP patients at baseline and their change over time, analysing how variables associated to the psychological status, and the environment of the patient can affect his or her disability trajectory, once the influence of health condition and socio-demographic variables has been controlled for. Using data from a 3-year follow-up study on early psychosis (PAFIP), a multilevel structure in which the longitudinal measurements (within level) were nested within the individuals (between level), was modeled. The contribution of the different time-varying and time-invariant variables to the patients' disability outcomes was tested through eight nested models. Consecutive models, that successively added health related, socio-demographic, psychological and environmental variables to the unconditional model were estimated, by means of deviance and fit statistics. The present work revealed the importance of psychological and environmental factors in the explanation of disability changes in the context of FEP. We may conclude that longitudinal assessments of time-varying predictors - living situation (b=-0.10, pdisability variation over time, independently from symptoms' severity, duration of untreated psychosis, age, gender and years of education. Additionally, the level of premorbid adjustment (b=0.05, pdisability outcomes among FEP patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Obesity and mortality among older Thais: a four year follow up study

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    Prasartkul Pramote

    2010-10-01

    Full Text Available Abstract Background To assess the association of body mass index with mortality in a population-based setting of older people in Thailand. Methods Baseline data from the National Health Examination Survey III (NHES III conducted in 2004 was linked to death records from vital registration for 2004-2007. Complete information regarding body mass index (BMI (n = 15997 and mortality data were separately analysed by sex. The Cox Proportional Hazard Model was used to test the association between BMI and all-cause mortality controlling for demographic, socioeconomic, and health risk factors. Results During a mean follow-up time of 3.8 years (60545.8 person-years, a total of 1575 older persons, (936 men and 639 women had died. A U-shaped and reverse J-shaped of association between BMI and all-cause mortality were observed in men and women, respectively. However there was no significant increased risk in the higher BMI categories. Compared to those with BMI 18.5-22.9 kg/m2, the adjusted hazard ratios (HR of all-cause mortality for those with BMI Conclusions The results of this study support the obesity paradox phenomenon in older Thai people, especially in women. Improvement in quality of mortality data and further investigation to confirm such association are needed in this population.

  18. Posterior arthroscopic subtalar arthrodesis: ten cases at one-year follow-up.

    Science.gov (United States)

    Albert, A; Deleu, P-A; Leemrijse, T; Maldague, P; Devos Bevernage, B

    2011-06-01

    Isolated subtalar arthrodesis is the treatment of choice for several conditions -mostly subtalar arthritis, tarsal coalition and posterior tibial tendon dysfunction- unresponsive to conservative treatment. Arthroscopic procedures are an interesting recent alternative, less invasive than conventional open techniques. Posterior arthroscopy, in prone position, could be more advantageous than the conventional lateral and/or anterior approach. Ten cases, from 20 to 59-years-old, were prospectively followed up for minimum of one-year (range 12 to 31 months). Arthritis and tarsal coalition were the most common indications. Fusion was observed in all cases at a maximum of nine weeks. Mean average AOFAS score improved from 47 to 78. No complications were noted related to the technique. Only two patients, operated for a symptomatic subtalar coalition, complained of some residual pain due to a lateral submalleolar impingement. Interest of preservation of vascular talar supply and bone grafting are discussed. The good results using this innovative technique are encouraging. Long-term randomized studies remain necessary to confirm the reliability of the procedure in these different indications, and the type of bone graft to favour, if really needed. Level IV therapeutic study. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  19. Two-Year Follow-Up of a Sexual Health Promotion Program for Spanish Adolescents.

    Science.gov (United States)

    Espada, Jose P; Escribano, Silvia; Morales, Alexandra; Orgilés, Mireia

    2016-06-15

    The aim is to evaluate the effects of the Competencias para adolescentes con una sexualidad saludable (COMPAS) program and compare them with an evidence-based program (¡Cuídate!) and a control group (CG). Eighteen public high schools were randomly assigned to one of the three experimental conditions. Initially, 1,563 Spanish adolescents between 14 and 16 years of age participated, and 24 months after their implementation, 635 of them completed a survey. Self-report measures collected data on sexual behavior, knowledge, attitudes, intention, sexual risk perception, and perceived norm. Compared to the CG, COMPAS increased the level of knowledge about sexually transmitted infections and improved the attitudes toward people living with human immunodeficiency virus at the 2-year follow-up. Neither intervention had a long-term impact on behavioral variables. Results suggest that COMPAS has a comparable impact to the other intervention on the variables predicting consistent condom use. Reinforcing the messages and skills that have the greatest impact on condom use and adding booster sessions following program completion as strategies to maintain long-term effects are necessary. © The Author(s) 2016.

  20. Coverage Root after Removing Peripheral Ossifying Fibroma: 5-Year Follow-Up Case Report

    Science.gov (United States)

    Okajima, Luciana S.; Nunes, Marcelo P.; Montalli, Victor A. M.

    2016-01-01

    When lesions in soft tissue reach the gingival margin, they can produce aesthetic defects during its permanence and after its removal. Periodontal plastic surgery allows the correction of the gingival contour using different techniques. This paper is a case report of a peripheral ossifying fibroma removal in the interproximal area of teeth 21 and 22 in addition to root coverage of the affected area through two surgical phases: keratinized gingival tissue augmentation surgery with free gingival graft concurrent with removal of the lesion and, in a second stage, root coverage by performing coronally advanced flap technique with a follow-up of five years. The initial results achieved, which were root coverage of 100% after 6 months, promoted an adequate gingival contour and prevented the development of a mucogingival defect or a root exposure with its functional and aesthetic consequences. After five years, the results showed long term success of the techniques, where the margin remained stable with complete root coverage and tissues were stable and harmonic in color. PMID:27891263

  1. Conservative management of external root resorption after tooth reimplantation: a 3-year follow-up.

    Science.gov (United States)

    Ionta, Franciny Querobim; de Oliveira, Gabriela Cristina; de Alencar, Catarina Ribeiro Barros; Gonçalves, Priscilla Santana Pinto; Alcalde, Murilo Priori; Minotti, Paloma Gagliardi; Machado, Maria Aparecida de Andrade Moreira; Rios, Daniela

    2016-01-01

    The aim of this case report is to describe the treatment of a 9-year-old patient who suffered external root resorption of the permanent maxillary left lateral incisor following reimplantation of the avulsed left central and lateral incisors. Sixteen days after reimplantation and splinting of the incisors in a hospital emergency department, the patient was brought to the pediatric department of a dental school for further treatment. Root canal access was created in the maxillary left lateral and central incisors, and calcium hydroxide paste was used as intracanal dressing. At the 5-month follow-up, a radiograph revealed extensive external root resorption, a communicating root canal, and a periodontal lesion affecting the left lateral incisor. Management of the root resorption included obturation of the apical third of the canal with gutta percha and the middle third with mineral trioxide aggregate (MTA). At the 3-year recall examination, the patient was asymptomatic, and no mobility or soft tissue alterations were observed clinically. There was no radiographic sign that resorption had progressed. Despite the success of treatment, observation is still required. The use of MTA may be considered an alternative treatment for external root resorption after tooth reimplantation. The technique may allow tooth preservation in children until skeletal growth and development are completed and implant treatment may be considered.

  2. Preprosthetic mandibular vestibuloplasty with split-skin graft. A 2-year follow-up study.

    Science.gov (United States)

    Hillerup, S

    1987-06-01

    17 patients with lower denture malfunction problems related to insufficient residual ridges had a vestibuloplasty with split-skin graft performed in the mandible under local analgesia on an out-patient basis. The patients were followed-up for 2 years and records of vestibular extension showed a maximum of relapse at the 1-month control (24%). Most of the lost extension was regained at the 6-month check, and the 2-year outcome was 92% of the surgically-created vestibular sulcus extension as a mean value of records obtained at the midline and canine regions. A comparison with a previous study on buccal mucosal graft vestibuloplasty led to the conclusion that free grafts of skin and buccal mucosa prevent a relapse equally well under the same circumstances. 13 patients were satisfied with the improvement achieved, 3 reported fair, and 1 was dissatisfied with the result of the operation. The split-skin graft underwent a change of appearance in 5 cases interpreted as a skin graft candidosis. Indication of this condition accelerating the residual ridge resorption is discussed.

  3. An implantable neuroprosthesis for standing and walking in paraplegia: 5-year patient follow-up

    Science.gov (United States)

    Guiraud, David; Stieglitz, Thomas; Koch, Klaus Peter; Divoux, Jean-Louis; Rabischong, Pierre

    2006-12-01

    We present the results of a 5-year patient follow-up after implantation of an original neuroprosthesis. The system is able to stimulate both epimysial and neural electrodes in such a way that the complete flexor-extensor chain of the lower limb can be activated without using the withdrawal reflex. We demonstrate that standing and assisted walking are possible, and the results have remained stable for 5 years. Nevertheless, some problems were noted, particularly regarding the muscle response on the epimysial channels. Analysis of the electrical behaviour and thresholds indicated that the surgical phase is crucial because of the sensitivity of the functional responses to electrode placement. Neural stimulation proved to be more efficient and more stable over time. This mode requires less energy and provides more selective stimulation. This FES system can be improved to enable balanced standing and less fatiguing gait, but this will require feedback on event detection to trigger transitions between stimulation sequences, as well as feedback to the patient about the state of his lower limbs.

  4. Coverage Root after Removing Peripheral Ossifying Fibroma: 5-Year Follow-Up Case Report

    Directory of Open Access Journals (Sweden)

    Paulo S. G. Henriques

    2016-01-01

    Full Text Available When lesions in soft tissue reach the gingival margin, they can produce aesthetic defects during its permanence and after its removal. Periodontal plastic surgery allows the correction of the gingival contour using different techniques. This paper is a case report of a peripheral ossifying fibroma removal in the interproximal area of teeth 21 and 22 in addition to root coverage of the affected area through two surgical phases: keratinized gingival tissue augmentation surgery with free gingival graft concurrent with removal of the lesion and, in a second stage, root coverage by performing coronally advanced flap technique with a follow-up of five years. The initial results achieved, which were root coverage of 100% after 6 months, promoted an adequate gingival contour and prevented the development of a mucogingival defect or a root exposure with its functional and aesthetic consequences. After five years, the results showed long term success of the techniques, where the margin remained stable with complete root coverage and tissues were stable and harmonic in color.

  5. Treatment of the Mal de Debarquement Syndrome: A 1-Year Follow-up

    Directory of Open Access Journals (Sweden)

    Mingjia Dai

    2017-05-01

    Full Text Available The mal de debarquement syndrome (MdDS is a movement disorder, occurring predominantly in women, is most often induced by passive transport on water or in the air (classic MdDS, or can occur spontaneously. MdDS likely originates in the vestibular system and is unfamiliar to many physicians. The first successful treatment was devised by Dai et al. (1, and over 330 MdDS patients have now been treated. Here, we report the outcomes of 141 patients (122 females and 19 males treated 1 year or more ago. We examine the patient’s rocking frequency, body drifting, and nystagmus. The patients are then treated according to these findings for 4–5 days. During treatment, patients’ heads were rolled while watching a rotating full-field visual surround (1. Their symptom severity after the initial treatment and at the follow-up was assessed using a subjective 10-point scale. Objective measures, taken before and at the end of the week of treatment, included static posturography. Significant improvement was a reduction in symptom severity by more than 50%. Objective measures were not possible during the follow-up because of the wide geographic distribution of the patients. The treatment group consisted of 120 classic and 21 spontaneous MdDS patients. The initial rate of significant improvement after a week of treatment was 78% in classic and 48% in spontaneous patients. One year later, significant improvement was maintained in 52% of classic and 48% of spontaneous subjects. There was complete remission of symptoms in 27% (32 of classic and 19% (4 of spontaneous patients. Although about half of them did not achieve a 50% improvement, most reported fewer and milder symptoms than before. The success of the treatment was generally inversely correlated with the duration of the MdDS symptoms and with the patients’ ages. Prolonged travel by air or car on the way home most likely contributed to the symptomatic reversion from the initial successful treatment

  6. Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage

    Directory of Open Access Journals (Sweden)

    Stanley Fiona J

    2010-02-01

    Full Text Available Abstract Background Many western nations continue to have high rates of teenage pregnancies and births, which can result in adverse outcomes for both mother and child. This study identified possible antecedents of teenage pregnancy using linked data from administrative sources to create a 14-year follow-up from a cross-sectional survey. Methods Data were drawn from two sources - the 1993 Western Australian Child Health Survey (WACHS, a population-based representative sample of 2,736 children aged 4 to 16 years (1,374 girls; and administrative data relating to all their subsequent births and hospital admissions. We used weighted population estimates to examine differences between rates for teenage pregnancy, motherhood and abortion. We used Cox proportional hazards regression to model risk for teenage pregnancy. Results There were 155 girls aged less than 20 years at the time of their first recorded pregnancy. Teenage pregnancy was significantly associated with: family type; highest school year completed by primary carer; combined carer income; whether the primary carer was a smoker; and whether the girl herself displayed aggressive and delinquent behaviours. An age-interaction analysis on the association with aggressive and delinquent behaviours found that while girls with aggressive and delinquent behaviours who were older at the time of the survey were at highest risk of teenage pregnancy, there was elevated risk for future teenage pregnancy across all ages. Conclusions Our findings suggest that interventions to reduce teenage pregnancy rates could be introduced during primary school years, including those that are focused on the prevention and management of aggressive and delinquent behaviour.

  7. Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage.

    Science.gov (United States)

    Gaudie, Jennifer; Mitrou, Francis; Lawrence, David; Stanley, Fiona J; Silburn, Sven R; Zubrick, Stephen R

    2010-02-11

    Many western nations continue to have high rates of teenage pregnancies and births, which can result in adverse outcomes for both mother and child. This study identified possible antecedents of teenage pregnancy using linked data from administrative sources to create a 14-year follow-up from a cross-sectional survey. Data were drawn from two sources - the 1993 Western Australian Child Health Survey (WACHS), a population-based representative sample of 2,736 children aged 4 to 16 years (1,374 girls); and administrative data relating to all their subsequent births and hospital admissions. We used weighted population estimates to examine differences between rates for teenage pregnancy, motherhood and abortion. We used Cox proportional hazards regression to model risk for teenage pregnancy. There were 155 girls aged less than 20 years at the time of their first recorded pregnancy. Teenage pregnancy was significantly associated with: family type; highest school year completed by primary carer; combined carer income; whether the primary carer was a smoker; and whether the girl herself displayed aggressive and delinquent behaviours. An age-interaction analysis on the association with aggressive and delinquent behaviours found that while girls with aggressive and delinquent behaviours who were older at the time of the survey were at highest risk of teenage pregnancy, there was elevated risk for future teenage pregnancy across all ages. Our findings suggest that interventions to reduce teenage pregnancy rates could be introduced during primary school years, including those that are focused on the prevention and management of aggressive and delinquent behaviour.

  8. Treatment Outcomes and Mediators of Parent Management Training: A One-Year Follow-Up of Children with Conduct Problems

    Science.gov (United States)

    Hagen, Kristine Amlund; Ogden, Terje; Bjornebekk, Gunnar

    2011-01-01

    This effectiveness study presents the results of a 1-year follow-up of a randomized controlled trial of Parent Management Training. Families of 112 Norwegian girls and boys with clinic-level conduct problems participated, and 75 (67%) families were retained at follow-up. Children ranged in age from 4 to 12 at intake (M = 8.44). Families randomized…

  9. Asperger Syndrome and Autism: A Comparative Longitudinal Follow-Up Study More than 5 Years after Original Diagnosis

    Science.gov (United States)

    Cederlund, Mats; Hagberg, Bibbi; Billstedt, Eva; Gillberg, I. Carina; Gillberg, Christopher

    2008-01-01

    Prospective follow-up study of 70 males with Asperger syndrome (AS), and 70 males with autism more than 5 years after original diagnosis. Instruments used at follow-up included overall clinical assessment, the Diagnostic Interview for Social and Communication Disorders, Wechsler Intelligence Scales, Vineland Adaptive Behavior Scales, and Global…

  10. Patient-reported outcomes of symptomatic cholelithiasis patients following cholecystectomy after at least 5 years of follow-up

    NARCIS (Netherlands)

    Lamberts, Mark P.; Den Oudsten, Brenda L.; Keus, Frederik; De Vries, Jolanda; van Laarhoven, Cornelis J. H. M.; Westert, Gert P.; Drenth, Joost P. H.; Roukema, Jan A.

    2014-01-01

    Up to 41 % of patients report pain after cholecystectomy and in most studies follow-up for these symptoms did not exceed 5 years. The episodic nature of abdominal pain associated with symptomatic cholelithiasis warrants long-term follow-up studies. We assessed which patient and surgical factors were

  11. Adolescent idiopathic scoliosis (AIS treated with arthrodesis and posterior titanium instrumentation: 8 to 12 years follow up without late infection

    Directory of Open Access Journals (Sweden)

    Gluch Herbert

    2009-08-01

    Full Text Available Abstract Background There are no data in the peer-reviewed literature regarding long term results in patients treated for AIS with a posterior titanium instrumentation. Therefore we assessed the outcome in 50 patients treated by titanium implant. Methods A total of 50 patients with a mean age of 16.6 years were treated. In all patients, titanium hooks and pedicle screws were used in combination. The demographic data and the pre- and post-operative radiographs of all 50 patients were re-examined, and 49 of the 50 patients (98% attended a radiological and clinical follow up-examination on average 10.1 years post-operatively. The clinical results were recorded by means of the SRS 24 questionnaire. Results In the frontal plane, the mean pre-operative thoracic and lumbar curve had been 62.4° and 43.5° respectively, post-operatively the curves were reduced to 26.9° and 16.3°, resulting in a correction rate of 56.9% for thoracic and 62.5% for lumbar curve. At the follow up-evaluation, the Cobb angle of the thoracic and lumbar curve was 31.0° and 21.3° respectively, giving a final correction rate of 50.3% for thoracic, and 51.0% for lumbar curve. 7 of the 50 patients (14.3% had undergo revision surgery for complications, but complete implant removal was necessary in only one case. Analysis of the SRS 24 questionnaire showed an average score of 95.8 points. Conclusion Posterior titanium instrumentation is a safe and effective procedure in the surgical correction of AIS. In this retrospective study with small patient number, it shows favourable long-term results; in particular, the loss of correction is low, no late infection occurred and there was a very high survival rate of the implant itself.

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

    Science.gov (United States)

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

    2012-03-01

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

  13. Ranibizumab in neovascular age-related macular degeneration: a 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Cvetkova NP

    2016-06-01

    Full Text Available Nadezhda P Cvetkova, Kristina Hölldobler, Philipp Prahs, Viola Radeck, Horst Helbig, David Märker Department of Ophthalmology, University of Regensburg, Regensburg, Germany Purpose: Our aim was to evaluate an optical coherence tomography (OCT and visual acuity (VA-guided, variable-dosing regimen with intravitreal ranibizumab injection for treating patients with neovascular age-related macular degeneration (AMD from 2007 to 2012. Design: This was a retrospective clinical study of 5 years follow-up in a tertiary eye center. Patients and methods: In this study, 66 patients with neovascular AMD (mean age of 74 years, SD 8.7 years were included. We investigated the development of best-corrected visual acuity (BCVA, the number of intravitreal injections, and the central retinal thickness measured with OCT (OCT Spectralis over 5 years of intravitreal treatment. Results: The mean number of intravitreal ranibizumab injections over 5 years was 8.8. The mean BCVA before therapy was 0.4 logarithm of the minimum angle of resolution (logMAR. After 5 years of therapy, the mean BCVA was 0.6 logMAR. In all, 16% of treated patients had stable VA over 5 years and 10% of study eyes approved their VA. The mean OCT-measured central retinal thickness at the beginning of this study was 295 µm; after 5 years of treatment, the mean central retinal thickness was 315 µm. There was an increase in central retinal thickness in 47.5% of examined eyes. Conclusion: Other studies showed VA improvement in OCT-guided variable-dosing regimens. Our study revealed a moderate decrease in VA after a total mean injection number as low as 8.8 injections over 5 years. In OCT, an increase in central retinal thickness over 5 years could be observed. Probably, this is due to deficient treatment when comparing the total injection number to other treatment regimens. Anti-VEGF therapy helps to keep the VA stable for a period of time, but cannot totally stop the progression of

  14. Six-Year Experience of a Nurse-Led Colorectal Cancer Follow-Up Clinic

    OpenAIRE

    2014-01-01

    Aims and Objectives. To review the experience of a nurse-led colorectal cancer follow-up clinic in a tertiary referral colorectal cancer centre. Methodology. Data from the nurse-led colorectal cancer follow-up clinic in our unit was prospectively maintained in a colorectal cancer database. Data was analysed from January 1, 2006 until the December 31, 2011. Results. 1125 patients were diagnosed with colorectal cancer, and referred to our unit as a tertiary centre for specialised colorectal can...

  15. Five-year follow-up of cognitive impairment in older adults with bipolar disorder.

    Science.gov (United States)

    Schouws, Sigfried N T M; Comijs, Hannie C; Dols, Annemieke; Beekman, Aartjan T F; Stek, Max L

    2016-03-01

    To date, cognitive impairment has been thought to be an integral part of bipolar disorder. In clinical staging models, cognitive impairment is one of the hallmarks to define the clinical stage and it plays an important role in identifying the risk factors for progression to later stages of the illness. It is important to examine neurocognitive performance over longer periods to test the hypothesis of neuroprogression of bipolar disorder. A comprehensive neuropsychological test battery was applied at baseline and five years later to 56 euthymic older outpatients with bipolar disorder (mean age = 68.35 years, range: 60-90 years) and to a demographically matched sample of 44 healthy subjects. A group-by-time repeated measures multivariate analysis of variance was performed to measure changes over time for the two groups. The impact of baseline illness characteristics on the intra-individual change in neurocognitive performance within the bipolar disorder group was studied by using logistic regression analysis. At baseline and at follow-up, patients with bipolar disorder performed worse on all neurocognitive measures compared to the matched healthy subjects. However, there was no significant group-by-time interaction between the patients with bipolar disorder and the comparison group. Although older patients with bipolar disorder had worse cognitive function than healthy subjects, they did not have greater cognitive decline over a five-year period. The change in acquired cognitive impairment of patients with bipolar disorder might parallel the cognitive development as seen in normal aging. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Four-year follow up of hepatitis C patients vaccinated against hepatitis B virus

    Institute of Scientific and Technical Information of China (English)

    Slawomir Chlabicz; Tadeusz Wojciech Lapinski; Anna Grzeszczuk; Danuta Prokopowicz

    2005-01-01

    AIM: Patients with chronic hepatitis C have been recommended to receive vaccinations against hepatitis B. Our study aimed at evaluating the hepatitis B immunogenicity and efficacy against hepatitis B virus infection 4 years after primary immunization series in a group of patients with chronic hepatitis C.METHODS: We recruited 36 out of 48 hepatitis C virus (HCV) infected individuals who were vaccinated against hepatitis B virus (20 μg of recombinant HBsAg at 0-1-6mo schedule) in 1998. Here we measured anti-HBs titers and anti-HBc 4 years after delivery of the third dose of primary immunization series.RESULTS: After 4 years a total of 13/36 (36%) HCV infected patients had seroprotective titers of anti-HBs compared with 9/10 (90%) in the control group, (P<0.05).Similarly the mean concentration of anti-HBs found in hepatitis C patients was significantly lower than that found in healthy subjects (18.3 and 156.0 mIU/mL respectively (P<0.05). None of the HCV infected patients or controls became infected with HBV during the study period as confirmed by anti-HBc negativity.CONCLUSION: We demonstrated that 4 years after HBV immunizations' more than 60% of vaccinated HCV patients did not maintain seroprotective levels of anti-HBs, which might put them at risk of clinically significant breakthrough infections. Further follow-up studies are required to clarify whether memory B and T lymphocytes can provideprotection in chronic hepatitis C patients in the absence or inadequate titers of anti-HBs.

  17. Vitamin D Intake and Status in 6-Year-Old Icelandic Children Followed up from Infancy.

    Science.gov (United States)

    Thorisdottir, Birna; Gunnarsdottir, Ingibjorg; Steingrimsdottir, Laufey; Palsson, Gestur I; Birgisdottir, Bryndis E; Thorsdottir, Inga

    2016-02-04

    High serum 25-hydroxyvitamin D (25(OH)D) levels have been observed in infants in Nordic countries, likely due to vitamin D supplement use. Internationally, little is known about tracking vitamin D status from infancy to childhood. Following up 1-year-old infants in our national longitudinal cohort, our aims were to study vitamin D intake and status in healthy 6-year-old Icelandic children (n = 139) and to track vitamin D status from one year of age. At six years, the mean 25(OH)D level was 56.5 nmol/L (SD 17.9) and 64% of children were vitamin D sufficient (25(OH)D ≥ 50 nmol/L). A logistic regression model adjusted for gender and breastfeeding showed that higher total vitamin D intake (Odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.08-1.49), blood samples collected in summer (OR = 8.88, 95% CI = 1.83-43.23) or autumn (OR = 5.64, 95% CI = 1.16-27.32) compared to winter/spring, and 25(OH)D at age one (OR = 1.02, 95% CI = 1.002-1.04) were independently associated with vitamin D sufficiency at age six. The correlation between 25(OH)D at age one and six was 0.34 (p = 0.003). Our findings suggest that vitamin D status in infancy, current vitamin D intake and season are predictors of vitamin D status in early school age children. Our finding of vitamin D status tracking from infancy to childhood provides motivation for further studies on tracking and its clinical significance.

  18. Combined rotation scarf and Akin osteotomies for hallux valgus: a patient focussed 9 year follow up of 50 patients

    Directory of Open Access Journals (Sweden)

    Kilmartin Timothy E

    2010-02-01

    Full Text Available Abstract Background The Cochrane review of hallux valgus surgery has disputed the scientific validity of hallux valgus research. Scoring systems and surrogate measures such as x-ray angles are commonly reported at just one year post operatively but these are of dubious relevance to the patient. In this study we extended the follow up to a minimum of 8 years and sought to address patient specific concerns with hallux valgus surgery. The long term follow up also allowed a comprehensive review of the complications associated with the combined rotation scarf and Akin osteotomies. Methods Between 1996 and 1999, 101 patients underwent rotation scarf and Akin osteotomies for the treatment of hallux valgus. All patients were contacted and asked to participate in this study. 50 female participants were available allowing review of 73 procedures. The average follow up was over 9 years and the average age at the time of surgery was 57. The participants were physically examined and interviewed. Results Post-operatively, in 86% of the participants there were no footwear restrictions. Stiffness of the first metatarsophalangeal joint was reported in 8% (6 feet; 10% were unhappy with the cosmetic appearance of their feet, 3 feet had hallux varus, and 2 feet had recurrent hallux valgus. There were no foot-related activity restrictions in 92% of the group. Metatarsalgia occurred in 4% (3 feet. 96% were better than before surgery and 88% were completely satisfied with their post-operative result. Hallux varus was the greatest single cause of dissatisfaction. The most common adverse event in the study was internal fixation irritation. Hallux valgus surgery is not without risk and these findings could be useful in the informed consent process. Conclusions When combined the rotation scarf and Akin osteotomies are an effective treatment for hallux valgus that achieves good long-term correction with a low incidence of recurrence, footwear restriction or metatarsalgia

  19. Effect of inflammation in the periodontium in early old age on mortality at 21-year follow-up

    DEFF Research Database (Denmark)

    Avlund, Kirsten; Schultz-Larsen, Kirsten; Krustrup, Ulla;

    2009-01-01

    To analyze whether inflammatory processes in the periodontium in early old age are related to subsequent mortality during 21 years of follow-up in a nondisabled 70-year-old population.......To analyze whether inflammatory processes in the periodontium in early old age are related to subsequent mortality during 21 years of follow-up in a nondisabled 70-year-old population....

  20. Flat affect and social functioning: a 10 year follow-up study of first episode psychosis patients.

    Science.gov (United States)

    Evensen, Julie; Røssberg, Jan Ivar; Barder, Helene; Haahr, Ulrik; Hegelstad, Wenche Ten Velden; Joa, Inge; Johannessen, Jan Olav; Larsen, T K; Melle, Ingrid; Opjordsmoen, Stein; Rund, Bjørn Rishovd; Simonsen, Erik; Vaglum, Per; McGlashan, Thomas; Friis, Svein

    2012-08-01

    Affective flattening has been described as enduring, but long term follow-up studies of first episode psychosis patients are lacking. The aim of this study was to follow the symptom development of flat affect (FA), over a 10 year follow-up period, with focus on prevalence, predictors and outcome factors including social functioning. Three-hundred-and-one patients with FEP were included at baseline, 186 participated in the 10 year follow-up. These were followed on PANSS item N1 (FA) from baseline through 5 follow-up assessments over 10 years. Patients were grouped as having never-present, improving, deteriorating, fluctuating or enduring FA. The groups were compared on baseline variables, variables at 10 year follow-up, and social functioning throughout the follow-up period. Twenty nine percent never displayed FA, 66% had improving, deteriorating or fluctuating FA, while 5% of patients had enduring FA. Premorbid social function predicted enduring FA. The patients with enduring, fluctuating and deteriorating FA did poorer on all outcome variables, including remission and recovery rates. The enduring FA group did significantly poorer in social functioning over the 10 year period. FA is expressed at some point of time in the majority of FEP patients in a 10 year follow-up period, and appears more fluctuant than expected from the relevant literature. FA is associated with poorer outcome after 10 years, and enduring FA to poorer social function at all points of assessment. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. Prognosis of acute and chronic pancreatitis - a 30-year follow-up of a Danish cohort.

    Science.gov (United States)

    Nøjgaard, Camilla

    2010-12-01

    Acute and chronic pancreatitis are most frequently caused by a high consumption of alcohol and tobacco but often the aetiology is unknown. The diseases have a high risk of complications, but the long-term prognosis and the natural course of the diseases are only sparsely described. The aims of the study were to investigate the long-term prognosis of acute pancreatitis (AP) and chronic pancreatitis (CP), the risk of progression to CP, and the natural course of progressive acute pancreatitis. Hereby, describe the prognostic factors associated with mortality and the causes of death in these patients. The study was based on the large prospective cohort study - Copenhagen Pancreatitis Study - of patients in the Copenhagen Municipality admitted with either AP or CP fulfilling specific diagnostic criteria and enrolled in the study during 1977 to 1982 and in 2008 followed up by linkage to the Danish registries. Factors associated with mortality in AP patients were high age, alcohol and diabetes, whereas female gender, employment, and co-living were associated with better survival. Level of S-amylase had no impact on the mortality. AP can progress to CP not only from alcoholic but also from idiopathic AP within a mean interval of 3.5 years. The mortality of progressive AP was 5-7 times higher compared with the background population. Patients with definite CP had a 4-fold higher mortality than the background population and patients with a suspicion of CP had twice the mortality compared with the background population. Unlike alcohol and smoking, both non-employment and being underweight had a significant impact on survival in CP patients. In the future, when diagnosing AP, we suggest focusing more on the elimination of differential diagnosis than on the level of S-amylase. The high mortality in progressive AP indicates that patients with risk factors for CP should be followed up. As both AP and CP are multifaceted, treatment for smoking dependency, alcohol dependency, and

  2. Delayed manifestations of CNS effects in formerly exposed printers--a 20-year follow-up.

    Science.gov (United States)

    Nordling Nilson, Linda; Karlson, Björn; Nise, Gun; Malmberg, Birgitta; Orbæk, Palle

    2010-01-01

    Whether long-term occupational exposure to organic solvents may affect mental and cognitive functioning later in life, remains unclear. In this study, twelve rotogravure printers formerly exposed to toluene and 19 referents, all initially examined in the mid-1980s, were reexamined after twenty years, applying neuropsychological tests, symptoms and social interaction questionnaires, medical examination, and exposure assessment of each individual's cumulative exposure. By far the most extensive exposure, mainly toluene, had occurred before 1985. The printers were found to have deteriorated more than their referents in cognitive functioning affecting reasoning and associative learning. No relevant additional exposure during the lengthy time period between assessments could explain this discrepancy. In addition, printers performed significantly worse than the referents in verbal memory and sustained attention at follow-up, where also a dose-effect relationship was noted for reasoning. While the printers did not report more subjective cognitive complaints than the referents, a slightly higher depression score was noted for the printers. The findings of significantly worse deteriorations in cognitive functioning in previously toluene-exposed printers are in line with our hypothesis that sub-clinical deficits during the working life may become manifest later in life, indicating that exposure may in fact interact with ageing. However, considering the small study groups the results must be interpreted with caution. Copyright © 2010 Elsevier Inc. All rights reserved.

  3. Fragile-X syndrome--a 20-year follow-up study of male patients.

    Science.gov (United States)

    Arvio, M

    2016-01-01

    In 1994, a multi-professional team examined clinically 34 males with fragile X syndrome (FXS). Since then, these patients have been clinically evaluated twice at a 10-year interval. With the aid of the Portage method we were able to chart the course of their adaptive skills. The FXS males learned new abilities on average up to the age of 25; this was followed by a plateau stage until they reached 50, after which time, physical symptoms evidencing weakened overall motor skills were apparent. During follow-up, a total of 10 men died, 9 of them suddenly. Of these, three were under the age of 40 at death, and the oldest was 77. The FXS men were socially interactive, helpful, but shy. Typical symptoms of FXS boys such as poor eye contact, tactile defensiveness, and perseverative speech did not disappear with age. At the end of the study, 75% of the study subjects had long-standing health problems. Most aged over 50 suffered from symptoms arising from an enlarged prostate; one fourth were on psychotropic-, and one fifth on antiepileptic drug treatment.

  4. Early treatment of Class III malocclusion: 10-year clinical follow-up

    Directory of Open Access Journals (Sweden)

    Marcio Rodrigues de Almeida

    2011-08-01

    Full Text Available Angle Class III malocclusion has been a challenge for researchers concerning diagnosis, prognosis and treatment. It has a prevalence of 5% in the Brazilian population, and may have a genetic or environmental etiology. This malocclusion can be classified as dentoalveolar, skeletal or functional, which will determine the prognosis. Considering these topics, the aim of this study was to describe and discuss a clinical case with functional Class III malocclusion treated by a two-stage approach (interceptive and corrective, with a long-term follow-up. In this case, the patient was treated with a chincup and an Eschler arch, used simultaneously during 14 months, followed by corrective orthodontics. It should be noticed that, in this case, initial diagnosis at the centric relation allowed visualizing the anterior teeth in an edge-to-edge relationship, thereby favoring the prognosis. After completion of the treatment, the patient was followed for a 10-year period, and stability was observed. The clinical treatment results showed that it is possible to achieve favorable outcomes with early management in functional Class III malocclusion patients.

  5. Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up

    Directory of Open Access Journals (Sweden)

    Ricardo Yuji Abe

    2013-02-01

    Full Text Available OBJECTIVE: To analyze the recovery of visual acuity (VA and graft survival after first episode of endothelial rejection in penetrating keratoplasty (PKP treated with intravenous (IV and topic corticosteroid. METHODS: Interventional, prospective, non-comparative case series study evolving 32 PKP patients in one year follow up, who presented first episode of corneal endothelial rejection. The patients were submitted to 500 mg IV injection of methylprednisolone in association with topical prednisolone. Main outcome measures included VA recovery and corneal edema regression. Second outcome included new rejections and graft failure. Multivariate analysis techniques were used to estimate rates of graft outcome events and the impact of risk factors. RESULTS: A total of 32 eyes from 32 patients (13 male and 19 female were included in the study. The mean VA (in number of letters before rejection was 48 (22 to 88 letters. Patients treated within 7 days or less of initial symptoms had better VA recovery, corneal edema regression and less graft failure (p<0.001. Patients with previous ocular surgery had worse VA recovery and more graft failure (p<0.047. CONCLUSION: The association between the other risk factors and the outcomes did not reach statistical significance in the multivariate model because of the small numbers of patients. Methylprednisolone in association with topical prednisolone is an alternative treatment for graft rejection. Our study showed that patients treated within 7 days of symptoms and no previous anterior segment surgery had better visual outcome and graft survival after treatment.

  6. Circumferential proximal femoral allografts in revision hip arthroplasty: four to 20 years follow-up.

    Science.gov (United States)

    Roos, Bruno Dutra; Roos, Milton Valdomiro; Camisa, Antero

    2013-01-01

    The purpose of this study was to analyze the clinical and radiographic results of revision of loose total hip replacements, using proximal femoral allografts and a cemented implant. We retrospectively reviewed of 28 consecutive patients. Twenty patients were available for study. Each patient was scored using a modified Harris Hip Score. Radiographs were examined for endosteal and periosteal reabsorption, allograft-host union, trochanteric migration, component loosening and heterotrophic calcification. The mean pre-operative Harris hip Score was 34 points. At the latest follow-up, the meanscore was 80 points. Nineteen cases (95%) had combined femoral defects and one patient (5%) had a segmental defect, according to the AAOS classification. Allograft resorption was seen in eight (40%) hips. There were 18 cases (90%) of allograft union, one (5%) of partial union and one (5%) of nonunion. There was one case of trochanteric migration (more than 1 cm). All femoral components were radiographically stable. The reconstruction was considered successful in 18 patients (90%). The use of proximal femoral allografts in femoral revision of loose total hip replacements has high survival and satisfactory clinical results at an average period of eight years postoperatively.

  7. Effectiveness of a tinnitus management programme: a 2-year follow-up study

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    Sørensen Jan

    2009-06-01

    Full Text Available Abstract Background Tinnitus impairs the possibility of leading a normal life in 0.5–1% of the population. While neither medical nor surgical treatment appears effective, counselling may offer some relief. An intervention combining counselling and hearing devices is offered to clients referred to the Centre for Help Aids and Communication (CHC in southern Denmark. The aims of this exploratory study were to examine i the characteristics of CHC's clients and their tinnitus, ii the effectiveness of the treatment, and iii whether particular client groups benefit more than others. Methods One hundred new clients presenting with tinnitus completed the Tinnitus Handicap Inventory (THI three times – before their first consultation, after one month and after 1–2 years. The scores were tested for significant differences over time using tests for paired data. Logistic regression was used to examine factors associated with a clinically important difference (i.e. THI score improvement of at least 20 points. Results At final follow-up, total THI score was significantly lower than baseline, i.e. 29.8 (CI 25.5–34.2 vs. 37.2 (CI 33.1–37.2, p Conclusion The tinnitus management programme appeared to provide significant benefit to many clients at a relatively low cost. It would be useful to conduct a randomised controlled study comparing the current programme with alternative forms of combination counselling/sound therapy approaches.

  8. A 3-year clinical follow-up study of a ceramic (Optec) inlay system.

    Science.gov (United States)

    Molin, M; Karlsson, S

    1996-06-01

    To evaluate the clinical quality of ceramic (Optec) inlays, the inlay production of 10 dentists, served by 3 dental laboratories, was examined independently by 2 calibrated examiners. Of the 57 patients with 205 inlays participating in the first examination, 47 patients with 145 remaining inlays participated in the 3-year follow-up reexamination. For 14 of the participants in the reexamination, altogether 21 inlays had fractured. The mean time in service before fracture was 26.4 months (range, 12-53 months). The inlays were rated using the California Dental Association (CDA) quality evaluation system. This examination showed that the mismatch of color had increased from the first examination to the reexamination and registered slightly roughened surfaces. As to anatomic form, a reduced number of inlays did not receive an excellent CDA rating at the reexamination. Visible evidence of ditching along the margin had increased by almost 50%, and an apparent discoloration of the margin between the restoration and the tooth structure was seen in 73% of the reexamined inlays, compared with 7% at the first examination.

  9. Radiological evaluation of percutaneous endoscopic lumbar discectomy: a three-year follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Seung Eun; Lee, Sang Ho; Ahn, Yong; Shin, Song Woo; Jo, Byung June; Park, Jee Young [Wooridul Spine Hospital, Seoul (Korea, Republic of); Kim, Tae Hong [Inje University College of Medicine, Seoul (Korea, Republic of)

    2006-05-15

    We wanted to analyze the radiological changes of the patients who underwent percutaneous endoscopic lumbar discectomy (PELD) for treating soft disc herniation. We retrospectively reviewed 30 patients (32 cases) who were observed for a minimum of 3 years after they underwent PELD. The authors investigated the postoperative radiological changes after PELD and the related clinical outcomes. All the patients received plain X-rays, CT and MRI both preoperatively and at the final follow-up. The radiological parameters were evaluated, including the disc height, the disc signal intensity, the subchondral marrow signal intensity, the sagittal plane instability and the facet joint osteoarthritis. The average amount of removed disc was 1.363 g and a significant correlation was detected between the narrowing of disc height and the amount of removed disc. Although the disc height and the disc height ratio were significantly decreased (-0.97 mm and 86.9%, respectively), the angle of sagittal rotation was well maintained. There were 18 (56.3%) cases of disc signal changes, six cases (18.8%) of subchondral marrow signal changes, and three cases (9.4%) of facet joint osteoarthritis. The success rate was 90.6%. Although disc height narrowing was observed, there was no postoperative instability and the overall clinical outcome was satisfactory. Our results show that PELD is a useful and minimal invasive procedure for the selected patients who are suffering with lumbar disc herniation.

  10. Testing the Oregon delinquency model with 9-year follow-up of the Oregon Divorce Study.

    Science.gov (United States)

    Forgatch, Marion S; Patterson, Gerald R; Degarmo, David S; Beldavs, Zintars G

    2009-01-01

    This paper presents experimental tests of the Oregon delinquency model applied within a randomized design of an at-risk sample of single mothers and their elementary school-aged sons. In the theoretical model, ineffective parenting practices and deviant peer association serve as the primary mechanisms for growth in adolescent delinquent behavior and early arrests. Multiple-method assessments of 238 mothers and sons include delinquency as measured by teacher reports and official arrest records, parenting skills measured by observations of parent-child interactions, and deviant peer association as reported by focal boys. Analyses of the 9-year follow-up data indicate that the Oregon model of parent management training significantly reduced teacher-reported delinquency and police arrests for focal boys. As hypothesized, the experiments demonstrated that improving parenting practices and reducing contacts with deviant peers served as mediating mechanisms for reducing rates of adolescent delinquency. As predicted, there was also a significant delay in the timing of police arrests for youth in the experimental as compared to the control group.

  11. Botulinum toxin type A and cervical dystonia: a seven-year follow-up

    Directory of Open Access Journals (Sweden)

    Carlos Henrique F. Camargo

    2011-10-01

    Full Text Available Most cases of cervical dystonia (CD are idiopathic, and focal injections of botulinum toxin A (BoNT/A are the treatment of choice. The objective of our study was to document the effects of long-term BoNT/A treatment in idiopathic CD patients. Fifty-eight patients with idiopathic CD were recruited from March 2001 to May 2002. Twenty-eight of the subjects were available for reassessment after seven years. During this period, all had received regular treatment with BoNT/A injections. Clinical information about patients and the severity of CD (TWSTRS and VAPS at baseline assessment (2001-2002 and follow-up (2008-2009 was compared. Significant motor improvement was detected based on TWSTRS scale scores, which were used to analyze clinical severity (19.6±6.6 and 17.7±4.8; p<0.05. There was no improvement in the severity of cervical pain (p=0.43. In conclusion, BoNT/A was a safe and effective long-term therapy for CD.

  12. Involvement in bullying and suicidal ideation in middle adolescence: a 2-year follow-up study.

    Science.gov (United States)

    Heikkilä, Hanna-Kaisa; Väänänen, Juha; Helminen, Mika; Fröjd, Sari; Marttunen, Mauri; Kaltiala-Heino, Riittakerttu

    2013-02-01

    The objective of the study was to ascertain whether involvement in bullying increases the risk for subsequent suicidal ideation. A total of 2,070 Finnish girls and boys aged 15 were surveyed in the ninth grade (age 15) in schools, and followed upyears later in the Adolescent Mental Health Cohort Study. Involvement in bullying was elicited at age 15 by two questions focusing on being a bully and being a victim of bullying. Suicidal ideation was elicited by one item of the short Beck Depression Inventory at age 17. Baseline depressive symptoms and externalizing symptoms, age and sex were controlled for. Statistical analyses were carried out using cross-tabulations with Chi-square/Fisher's exact test and logistic regression. Suicidal ideation at age 17 was 3-4 times more prevalent among those who had been involved in bullying at age 15 than among those not involved. Suicidal ideation at age 17 was most prevalent among former victims of bullying. Being a victim of bullying at age 15 continued to predict subsequent suicidal ideation when depressive and externalizing symptoms were controlled for. Being a bully at age 15 also persisted as borderline significantly predictive of suicidal ideation when baseline symptoms were controlled for. Findings indicate adolescent victims and perpetrators of bullying alike are at long-term risk for suicidal ideation.

  13. Sodium hypochlorite vs formocresol as pulpotomy medicaments in primary molars: 1-year follow-up.

    Science.gov (United States)

    Shabzendedar, Mahboobeh; Mazhari, Fatemeh; Alami, Maliheh; Talebi, Maryam

    2013-01-01

    The study evaluated the effects of 3 percent sodium hypochlorite (NaOCl) and formocresol (FC) as pulp dressing agents in pulpotomized primary molars. One hundred children between three and six years each with at least one primary mandibular second molar requiring pulpotomy were randomly allocated to two groups (of 50 each). All the teeth received stainless steel crown after conventional pulpotomy procedure with either NaOCI (applied for 15 second) or FC (applied for one minute). Clinical and radiographic signs/symptoms were blindly recorded at zero, six. and 12 months. The differences were statistically analyzed using the Fisher's exact test. At six months, 100 percent clinical success was found with both NaOCl, and FC. Radiographic success rates for NaOCl were 98 percent and 92 percent at 6- and 12-month recalls respectively. FC group showed 94 percent and 93 percent radiographic success rates at the same periods respectively. There was no statistically significant difference between the groups. NaOCl can be suggested as a pulpotomy agent for primary teeth pulpotomies. However further clinical studies with long-term follow-ups are needed to test the efficacy of NaOCl as a pulpotomy medicament in primary teeth.

  14. Two-year follow-up of percutaneous coronary intervention using EucaTax or Cypher

    Energy Technology Data Exchange (ETDEWEB)

    Shuvalova, Yulia A., E-mail: shuvalovaj@mail.ru [Russian Cardiology Research and Production Complex, Department of Atherosclerosis Problems (Russian Federation); Shirokov, Roman O. [Russian Cardiology Research and Production Complex, Laboratory of Radio Vascular Therapy (Russian Federation); Kaminnaya, Violetta I. [Russian Cardiology Research and Production Complex, Department of Atherosclerosis Problems (Russian Federation); Samko, Anatoliy N. [Russian Cardiology Research and Production Complex, Laboratory of Radio Vascular Therapy (Russian Federation); Kaminnyi, Alexander I. [Russian Cardiology Research and Production Complex, Department of Atherosclerosis Problems (Russian Federation)

    2013-09-15

    Background: The EucaTax stent (EUPES) is a coronary stent with biodegradable polymer and camouflage coating that has been developed to promote the complete elution of drugs and decrease the risk of late complications. The aim of this study was to evaluate the efficacy and safety of the double-coated EUPES in patients with stable angina versus sirolimus-eluting stent CYPHER (SES) with permanent polymer coating. Methods and Materials: The study included consecutive patient with at least 70% de novo coronary lesions in one or two native coronary arteries and who had undergone the coronary stenting using either EUPES or SES. We evaluated the 2-year major adverse cardiac events (MACE) rates, including total death (cardiac, non-cardiac), myocardial infarction (MI), target lesion revascularisation (TLR) and stent thrombosis. Results: Between 2006 and 2009 this observational, prospective, single centre study included 602 patients (282 with EUPES and 320 with SES). At 2 years, the rates of TLR (16.3% versus 6.25%; p = 0.0001) and MACE (18.4% versus 7.8%; p = 0.001) were significantly higher in the EUPES than in the SES group. The rate of TLR was significantly higher in the EUPES group compared with SES group in stenting of artery with a diameter less than 3 mm, using stent length more than 18 mm, as well as when the residual stenosis was more than 12%. Conclusions: We found that EUPES was inferior to SES during the 2-year follow-up with respect to rates of MACE and TLR that were significantly higher in the EUPES than in the SES group.

  15. Exclusive Alternating Chemotherapy and Radiotherapy in Nonmetastatic Inflammatory Breast Cancer: 20 Years of Follow-Up

    Energy Technology Data Exchange (ETDEWEB)

    Bourgier, Celine, E-mail: bourgier@igr.fr [Department of Radiation Oncology, Breast Unit, Institut Gustave Roussy, Villejuif (France); Pessoa, Eduardo Lima [Department of Radiation Oncology, Breast Unit, Institut Gustave Roussy, Villejuif (France); Dunant, Ariane [Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif (France); Heymann, Steve [Department of Radiation Oncology, Breast Unit, Institut Gustave Roussy, Villejuif (France); Spielmann, Marc [Department of Medical Oncology, Institut Gustave Roussy, Villejuif (France); Uzan, Catherine [Department of Breast Surgery, Institut Gustave Roussy, Villejuif (France); Mathieu, Marie-Christine [Department of Pathology, Institut Gustave Roussy, Villejuif (France); Arriagada, Rodrigo [Department of Radiation Oncology, Breast Unit, Institut Gustave Roussy, Villejuif (France); Department of Radiation Oncology, Karolinska Institutet, Stockholm (Sweden); Marsiglia, Hugo [Department of Radiation Oncology, Breast Unit, Institut Gustave Roussy, Villejuif (France); Radiation Department University of Florence, Florence (Italy)

    2012-02-01

    Background: Locoregional treatment of inflammatory breast cancer (IBC) is crucial because local relapses may be highly symptomatic and are commonly associated with distant metastasis. With a median follow-up of 20 years, we report here the long-term results of a monocentric clinical trial combining primary chemotherapy (CT) with a schedule of anthracycline-based CT and an alternating split-course of radiotherapy (RT Asterisk-Operator CT) without mastectomy. Methods and Materials: From September 1983 to December 1989, 124 women with nonmetastatic IBC (T4d M0) were treated with three cycles of primary AVCMF chemotherapy (anthracycline, vincristine, cyclophosphamide, methotrexate, and 5-fluorouracil) and then an alternating RT Asterisk-Operator CT schedule followed by three cycles of FAC. Hormonal therapy was systematically administered: ovarian irradiation (12 Gy in four fractions) or tamoxifen 20 mg daily. Results: Local control was achieved in 82% of patients. The 10- and 20-year local relapse rates were 26% and 33%, respectively, but only 10% of locally controlled cases were not associated with concurrent distant metastasis. The 10- and 20-year overall survival rates were 39% and 19%, respectively. Severe fibrosis occurred in 54% of patients, grade 3 brachial plexus neuropathy in 4%, grade 2 pneumonitis in 9%. Grade 1, 2 and 3 cardiac toxicity was observed in 3.8%, 3.8% and 1.2% of cases respectively. Conclusions: This combined regimen allowed good long-term local control without surgery. Survival rates were similar to those obtained with conventional regimens (primary chemotherapy, total mastectomy, and adjuvant radiotherapy). Since IBC continues to be an entity with a dismal prognosis, this approach, safely combining preoperative or postoperative radiation therapy and systemic treatments, should be reassessed when suitable targeted agents are available.

  16. Treatment of cellulite using a 1440-nm pulsed laser with one-year follow-up.

    Science.gov (United States)

    DiBernardo, Barry E

    2011-03-01

    Cellulite is characterized by a thickened hypodermal fat layer, along with hypodermal fat lobules that extend upward into the dermis, expanding and stretching the fibrous septae that separate the fat lobules. Eventually, the septae sclerose, contract, and harden, holding the skin at an inflexible length while the surrounding tissue continues to expand. The author evaluates the efficacy, safety, and duration of clinical benefit associated with a pulsed laser that delivers 1440-nm energy to the dermal-hypodermal interface for the treatment of cellulite. The changes in the dermal structure that affect the appearance of cellulite are also examined. Ten healthy women with cellulite on their thighs enrolled in a prospective Institutional Review Board-approved study conducted in the author's private plastic surgery clinic. Patients received a single treatment with a 1440-nm pulsed laser. Energy was delivered to the subdermal tissue through a fiber that was designed for side firing and enclosed in a cannula. Treatment addressed the thickened hypodermal fat layer, hypodermal fat lobules that extended upward into the dermis, and fibrous septae by thermal subcision. The mean age of the patients was 47 years ± 5.4 years. Mean skin thickness (as shown by ultrasound) and skin elasticity were shown by objective measurements to increase significantly at one, three, six, and 12 months. Subjective physician and subject evaluations indicated improvement, high subject satisfaction, and minimal adverse effects. In this study, a single treatment with the 1440-nm pulsed laser improved the appearance of cellulite, an improvement that persisted through at least one year of follow-up with minimal adverse effects.

  17. 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.

  18. Prenatal Fish Oil Supplementation and Allergy: 6-Year Follow-up of a Randomized Controlled Trial.

    Science.gov (United States)

    Best, Karen P; Sullivan, Thomas; Palmer, Debra; Gold, Michael; Kennedy, Declan John; Martin, James; Makrides, Maria

    2016-06-01

    Evidence from randomized controlled trials in early infancy suggest that prenatal supplementation with Ω-3 (n-3) long-chain polyunsaturated fatty acids (LCPUFA) reduces the incidence of allergic disease characterized by an immunoglobulin E (IgE) response. We aimed to determine whether protective effects were evident in the 6-year-old offspring of women supplemented with n-3 rich fish oil during pregnancy. Six-year follow-up of children (n = 706) with a family history of allergic disease from the Docosahexaenoic Acid to Optimize Mother Infant Outcome (DOMInO) trial. Women were randomly allocated to receive n-3 LCPUFA-rich fish oil capsules (800 mg/d docosahexaenoic acid DHA and 100mg/d eicosapentaenoic acid) or vegetable oil capsules (without n-3 LCPUFA). Allergic disease symptoms including eczema, wheeze, rhinitis, and rhino-conjunctivitis, were assessed using the International Study of Asthma and Allergies in Childhood questionnaire and sensitization to allergens was measured by skin prick test. There was no difference in the percentage of children with any IgE-associated allergic disease between the n-3 LCPUFA and control groups (116/367 [31.5%] vs 106/336 [31.5%]; adjusted relative risk, 1.04; 95% confidence interval, 0.82-1.33; P = .73). There was a reduction in the percentage of children sensitized to house dust mite Dermatophagoides farinae (49/367 [13.4%] vs 68/336 [20.3%]; adjusted relative risk, 0.67, 95% confidence interval, 0.44-1.00; P = .0495). Prenatal n-3 LCPUFA supplementation did not reduce IgE-associated allergic disease at 6 years of age. Secondary outcomes were suggestive of a protective effect of the intervention on the incidence of D. farinae sensitization. Copyright © 2016 by the American Academy of Pediatrics.

  19. Physical activity levels after treatment for breast cancer: one-year follow-up.

    Science.gov (United States)

    Devoogdt, Nele; Van Kampen, Marijke; Geraerts, Inge; Coremans, Tina; Fieuws, Steffen; Lefevre, Johan; Philippaerts, Renaat; Truijen, Steven; Neven, Patrick; Christiaens, Marie-Rose

    2010-09-01

    Among patients with breast cancer, few studies have examined the pattern of change of physical activity levels over time or the predictive factors for this change. Particularly sparse are studies comparing pre-surgical physical activity levels with those 12 months post-surgery. Patients with a primary operable breast cancer (N = 267) filled in the Physical Activity Computerised Questionnaire before breast surgery and 1, 3, 6 and 12 months post-operatively. Patient-, disease- and treatment-related factors were prospectively collected. Total physical activity level and occupational, sport and household activity levels were significantly decreased the first month post-operatively and did not recover during the first year after surgery. 'Being employed' was a predictive factor for a larger decrease of the total activity level, comparing the pre-operative and 12 months post-surgery stages. Having a spouse, a pN2-3 lesion and over 20 lymph nodes dissected predicted a decrease in occupational activity. Advanced age and smoking behaviour predicted a decrease in sport activities, and not having a spouse predicted a decrease in household activities. This study showed that 1 year after breast cancer surgery, pre-operative physical activity levels were not recovered. Breast cancer patients, and in particular those at risk for a decreased physical activity level, should be identified, encouraged and guided to increase their activities.

  20. Thirty-two-year follow-up study of Herbst therapy: a biometric dental cast analysis.

    Science.gov (United States)

    Pancherz, Hans; Bjerklin, Krister; Lindskog-Stokland, Birgitta; Hansen, Ken

    2014-01-01

    The aim of this study was to analyze the very long-term effects of Herbst treatment on tooth position and occlusion. Fourteen patients from a sample of 22 with Class II Division 1 malocclusions consecutively treated with the banded Herbst appliance were reexamined 32 years after therapy. Dental casts were analyzed from before (T1) and after (T2) treatment, and at 6 years (T3) and 32 years (T4) after treatment. Minor changes in maxillary and mandibular dental arch perimeters and arch widths were seen during treatment (T1-T2) and posttreatment (T2-T4). Mandibular incisor irregularity remained, on average, unchanged from T1 to T2 but increased continuously during the 32-year follow-up period (T2-T4). Class II molar and canine relationships were normalized in most patients from T1 to T2. During the early posttreatment period (T2-T3), there was a minor relapse; during the late posttreatment period (T3-T4), molar and canine relationships remained, on average, unchanged. Overjet and overbite were reduced to normal values in all subjects during treatment (T1-T2). After treatment (T2-T4), overjet remained, on average, unchanged, but overbite increased insignificantly. Thirty-two years after Herbst therapy, overall, acceptable long-term results were seen. Stability was found in 64% of the patients for sagittal molar relationships, in 14% for sagittal canine relationships, in 86% for overjet, and in 86% for overbite. A Class II relapse seemed to be caused by an unstable interdigitation of the occluding teeth, a persisting oral habit, or an insufficient retention regimen after treatment. Most posttreatment changes occurred during the first 6 years after treatment. After the age of 20 years, only minor changes were noted. Long-term posttreatment changes in maxillary and mandibular dental arch perimeters and widths as well as in mandibular incisor irregularity seemed to be independent of treatment and a result of physiologic dentoskeletal changes throughout adulthood. Copyright

  1. [Clinical results of double versus single mammary artery myocardiac revascularization: 15 years of follow-up].

    Science.gov (United States)

    López Rodríguez, F J; Voces, R; Lima, P; Reyes, G; Silva, J; Ruiz, M; Rico, M; González De Diego, F; Fortuny, R; Garrido, G; González Santos, J M; Albertos, J; Fernández Calella, D; Vallejo, J L

    2001-07-01

    Use of the left internal mammary artery to bypass the left anterior descending coronary artery reduces cardiac events and increases survival. However, there is some controversy as to the benefits of using both mammary arteries. To assess the long-term outcome of the use of both mammary arteries in comparison with the use of only one. A retrospective cohort study with a mean follow-up of 9.0 +/- 4.2 years was performed including 108 patients consecutively revascularized using both mammary arteries (II) and 108 patients randomly chosen in whom one mammary artery (I) was used for this purpose. Both groups were similar. There were no differences between the groups in operative morbidity or mortality. The survival at 10 years was similar (II: 84.61 +/- 4%; I: 85.18 +/- 3.8%), whereas recurrence of angina (II: 29.63 +/- 5.3%; I: 47.55 +/- 5.6%) (p = 0.012), the requirement for percutaneous angioplasty (II: 3.98 +/- 2%; I: 12.99 +/- 4.1%) (p = 0.009) and cardiologic events (II: 33.48 +/- 5.5%; I: 48.48 +/- 5.5%)(p = 0.022) were all lower in the group in which both mammary arteries were used. In the multivariate analysis, the use of both mammary arteries was an independent protective factor against angina recurrence (RR = 0.55), angioplasty (RR = 0.18) and cardiologic event (RR = 0.60). The use of both mammary arteries for revascularization does not increase operative morbidity. Since this procedure acts as an independent factor against angina recurrence, angioplasty and cardiologic event

  2. Long term functioning in early onset psychosis: Two years prospective follow-up study

    Directory of Open Access Journals (Sweden)

    Taha Ghada RA

    2011-07-01

    Full Text Available Abstract Background There were few studies on the outcome of schizophrenia in developing countries. Whether the outcome is similar to or different from developed world is still a point for research. The main aim of the current study was to know if patients with early onset non affective psychosis can behave and function properly after few years from start of the illness or not. Other aims included investigation of possible predictors and associated factors with remission and outcome. Method The study prospectively investigated a group of 56 patients with onset of psychosis during childhood or adolescence. Diagnosis made according to DSM-IV criteria and included; schizophrenia, psychotic disorder not otherwise specified and acute psychosis. Severity of psychosis was measured by PANSS. Measures of the outcome included; remission criteria of Andreasen et al 2005, the children's global assessment scale and educational level. Results Analysis of data was done for only 37 patients. Thirty patients diagnosed as schizophrenia and 7 with Psychotic disorder not otherwise specified. Mean duration of follow up was 38.4 +/- 16.9 months. At the end of the study, 6 patients (16.2% had one episode, 23(62.1% had multiple episodes and 8 (21.6% continuous course. Nineteen patients (51.4% achieved full remission, and only 11(29.7% achieved their average educational level for their age. Twenty seven percent of the sample had good outcome and 24.3% had poor outcome. Factors associated with non remission and poor outcome included gradual onset, low IQ, poor premorbid adjustment, negative symptoms at onset of the illness and poor adherence to drugs. Moreover, there was tendency of negative symptoms at illness start to predict poor outcome. Conclusion Some patients with early onset non affective psychosis can behave and function properly after few years from the start of the illness. Although remission is a difficult target in childhood psychosis, it is still achievable.

  3. Six-year follow-up of the treatment of patients with dissociative disorders study.

    Science.gov (United States)

    Myrick, Amie C; Webermann, Aliya R; Loewenstein, Richard J; Lanius, Ruth; Putnam, Frank W; Brand, Bethany L

    2017-01-01

    Objective: Literature on the treatment of dissociative disorders (DDs) suggests that these individuals require long-term and specialized treatment to achieve stabilization and functionality. There is considerable empirical support for specialized phasic, dissociation-focused treatment in reducing a myriad of psychological symptoms and self-harm in this population. However, until recently, there has been a paucity of longitudinal treatment research on DD patients. Method: In the present six-year follow-up study, 61 therapists who participated in the initial phase of the Treatment of Patients with Dissociative Disorders (TOP DD) study answered questionnaires about their study patient's stressors, quality of life, global functioning, victimization, and safety. These results provided a view of patients' progress six years since the beginning of the TOP DD study. Results: Longitudinal analyses demonstrated patients had significantly fewer stressors (Χ(2) (6) = 18.76, p < .01, canonical r = .48, N = 76), instances of sexual revictimization (X(2)(1) = 107.05, p < .001) and psychiatric hospitalizations (t(54) = 2.57, p < .05, Cohen's d = .43), as well as higher global functioning (Χ(2) (2) = 59.27, p < .001, canonical r = .65, N = 111). Conclusions: These findings continue to support the initial results of the TOP DD study that, despite marked initial difficulties and functional impairment, DD patients benefit from specialized treatment.

  4. CARDIAC RUPTURE IN MYOCARDIAL INFARCTION: INCIDENCE AND PREDISPOSING FACTORS (15 YEAR FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    V. A. Shulman

    2015-12-01

    Full Text Available Aim. To evaluate the incidence of cardiac rupture (CR in patients with acute myocardial infarction (MI as well as predisposing factors during 15-year follow-up.Material and methods. 1453 patients with acute MI who were admitted to Krasnoyarsk cardiological center during 1989, 1993 and 2003 years were studied. All patients were divided into three groups: group I - 447 patients, who were on treatment in 1989, group II - 475 patients of 1993, and group III – 531 patients of 2003. There were no differences in groups on patient sex, location and depth of MI, previous MI, arrhythmias, heart failure and diabetes mellitus.Results. CR was found in 18 of 447 patients (4% of group I (1989, in 16 of 475 patients (3,4% of group II (1993 and in 10 of 531 patients (1,9% of group 3 (2003, (p1,3 <0,05. Incidence of CR significantly decreased from 1989 to 2003 in female patients (7,2%; 5,7% and 1,6% in 1989, 1993 and 2003, respectively; p1,3 < 0,01, p2,3 < 0,05. Incidence of CR in male patients didn’t changed (2,5%, 1,8% and 2,1%, respectively. The average blood pressure (BP during the first day of MI in female patients was higher than this in male ones in 1989 and 1993. There were no significant differences in BP between women and men in 2003. Heart rate (HR during the first day of MI in female patients was higher than this in male patients in 1989. However in 1993 and 2003 there were no differences in HR between women and men. MI therapy more often included betablockers, angiotensin converting enzyme inhibitors, intravenous nitrates, statins, thrombolythics and anticoagulants in 2003 than in 1989 and 1993.Conclusion. Effective BP and HR control is the most effective way to prevent CR in patients with MI.

  5. CARDIAC RUPTURE IN MYOCARDIAL INFARCTION: INCIDENCE AND PREDISPOSING FACTORS (15 YEAR FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    V. A. Shulman

    2007-01-01

    Full Text Available Aim. To evaluate the incidence of cardiac rupture (CR in patients with acute myocardial infarction (MI as well as predisposing factors during 15-year follow-up.Material and methods. 1453 patients with acute MI who were admitted to Krasnoyarsk cardiological center during 1989, 1993 and 2003 years were studied. All patients were divided into three groups: group I - 447 patients, who were on treatment in 1989, group II - 475 patients of 1993, and group III – 531 patients of 2003. There were no differences in groups on patient sex, location and depth of MI, previous MI, arrhythmias, heart failure and diabetes mellitus.Results. CR was found in 18 of 447 patients (4% of group I (1989, in 16 of 475 patients (3,4% of group II (1993 and in 10 of 531 patients (1,9% of group 3 (2003, (p1,3 <0,05. Incidence of CR significantly decreased from 1989 to 2003 in female patients (7,2%; 5,7% and 1,6% in 1989, 1993 and 2003, respectively; p1,3 < 0,01, p2,3 < 0,05. Incidence of CR in male patients didn’t changed (2,5%, 1,8% and 2,1%, respectively. The average blood pressure (BP during the first day of MI in female patients was higher than this in male ones in 1989 and 1993. There were no significant differences in BP between women and men in 2003. Heart rate (HR during the first day of MI in female patients was higher than this in male patients in 1989. However in 1993 and 2003 there were no differences in HR between women and men. MI therapy more often included betablockers, angiotensin converting enzyme inhibitors, intravenous nitrates, statins, thrombolythics and anticoagulants in 2003 than in 1989 and 1993.Conclusion. Effective BP and HR control is the most effective way to prevent CR in patients with MI.

  6. Three year follow-up of an early childhood intervention: is movement skill sustained?

    Directory of Open Access Journals (Sweden)

    Zask Avigdor

    2012-10-01

    Full Text Available Abstract Background Movement skill competence (e.g. the ability to throw, run and kick is a potentially important physical activity determinant. However, little is known about the long-term impact of interventions to improve movement skills in early childhood. This study aimed to determine whether intervention preschool children were still more skill proficient than controls three years after a 10 month movement skill focused intervention: ‘Tooty Fruity Vegie in Preschools’. Methods Children from 18 intervention and 13 control preschools in NSW, Australia were assessed at ages four (Time1, five (T2 and eight years (T3 for locomotor (run, gallop, hop, leap, horizontal jump, slide and object control proficiency (strike, bounce, catch, kick, overhand throw, underhand roll using the Test of Gross Motor Development-2. Multi-level object control and locomotor regression models were fitted with variables time, intervention (yes/no and a time*intervention interaction. Both models added sex of child and retained if significant, in which case interactions of sex of child with other variables were modelled and retained. SPSS (Version 17.0 was used. Results Overall follow-up rate was 29% (163/560. Of the 137 students used in the regression models, 53% were female (n = 73. Intervention girls maintained their object control skill advantage in comparison to controls at T3 (p = .002, but intervention boys did not (p = .591. At T3, there were no longer intervention/control differences in locomotor skill (p = .801. Conclusion Early childhood settings should implement movement skill interventions and more intensively target girls and object control skills.

  7. 50 years follow-up on plasma creatinine levels after spinal cord injury

    DEFF Research Database (Denmark)

    Elmelund, Marlene; Oturai, P S; Biering-Sørensen, F

    2014-01-01

    STUDY DESIGN: Retrospective chart review. OBJECTIVES: To investigate the role of plasma creatinine (p-creatinine) in monitoring renal deterioration in patients up to 50 years after spinal cord injury (SCI). SETTING: The Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark. METHODS: A total...... of 119 patients with a traumatic SCI during the years 1944-1975 were included in the study. P-creatinine measurements, results from renography and glomerular filtration rate (GFR) measured with 51Cr-EDTA clearance were obtained from medical records and analyzed using a linear mixed model and linear...... regression analyses. RESULTS: When compared with median p-creatinine level in the first 5-year period after injury, the level of p-creatinine was stable throughout the first 30 years and decreased significantly after the 30th until 45th year post injury. Only patients with a functional distribution outside...

  8. Survival outcome of radioiodine therapy in post thyroidectomy thyroid carcinoma patients: Outcome of long term follow up

    Science.gov (United States)

    Haque, F.; Nahar, N.; Sultana, S.; Nasreen, F.; Jabin, Z.; Alam, A. S. M. M.

    2016-03-01

    The overall prognosis of patients with thyroid carcinoma is excellent whenever managed following best practice guidelines. Objective: To calculate sex and age group affected by thyroid cancer; to compare between single or multiple dose of radio ablation needed after thyroidectomy and to determine the percentage of patients become disease free during their follow up. Methods: This was a retrospective study done in NINMAS, Bangladesh on 687 patients from 1984 to 2004. In all cases total or near total thyroidectomy was done before commencing radioiodine therapy. Patients TG level, neck ultrasonography, thyroid scan, whole body I131 scans, neck examination were done every six monthly/yearly. Results: Among 687 patients, female were more sufferers (68.1%) and female to male ratio was 2:1. Age group 19-40 years was mostly affected (57.8%). Most common type seen was papillary carcinoma (81.8%). After ablation 100 patients did not follow-up. Total 237 patients discontinued within 4 years. Remaining 450 patients undergone regular follow-up for 5 years and more, 394 were disease free (87.6%). Total recurrence of metastasis was 23 and 12 patients expired at different times. Conclusions: Long-term regular follow-up is necessary after radioiodine ablation to become free of disease.

  9. Patient attendance in a recall program after prosthodontic rehabilitation: a 5-year follow-up.

    Science.gov (United States)

    Wolfart, Stefan; Weyer, Nils; Kern, Matthias

    2012-01-01

    This study evaluated the recall attendance and maintenance for a patient population after prosthodontic treatment in undergraduate student courses. Four hundred ninety-three patients who received fixed restorations (FRs; crowns or fixed partial dentures) or removable partial dentures (RPDs; conical crown-retained or precision attachment-retained dental prostheses) were included in a recall program. The number of patients attending regularly scheduled follow-up visits every 6 months was recorded. On the basis of the complexity of the performed treatment, all follow-up interventions were assigned to the categories minimal, moderate, or extensive. After 60 months, a cumulative follow-up attendance rate between 63% (RPD) and 74% (FR) was evident and not gender related. Altogether, 399 patients (193 FR, 206 RPD) regularly attended the follow-up visits. Between 61.9% (RPD) and 93.8% (FR) of these patients did not need any extensive treatment; however, only 19.2% (RPD) to 85.6% (FR) did not need any moderate or extensive treatment between follow-up visits. Patients treated with FRs showed a higher recall attendance than patients treated with RPDs. Further, patients with RPDs needed more extensive and moderate treatments than patients with FRs. This difference should be taken into consideration during prosthetic planning and patient consultation.

  10. The INDUS knee prosthesis - Prospective multicentric trial of a posteriorly stabilized high-flex design: 2 years follow-up

    Directory of Open Access Journals (Sweden)

    Sancheti Kantilal

    2009-01-01

    Full Text Available Background: The anatomical and morphological differences and high-flexion daily activities in the Asian population have since ever prompted for development of customized knee replacement systems. INDUS knee system has advantages both of high-flex designs and is developed by keeping the anatomical variations of the native population in mind. The purpose of this study is to analyze the 2-year follow-up results using the INDUS prosthesis. Materials and Methods: Two hundred and ninety-seven knees in 276 patients were prospectively analyzed. There were 65 men (72 knees and 211 (225 knees women with a mean age of 64.56 years. Two hundred and forty-five knees had primary osteoarthritis, 48 knees had rheumatoid arthritis, and four knees had post-traumatic arthritis. Clinical parameters, including the Knee Society scores (knee score and function score, range of motion, post-operative anterior knee pain, and complications were recorded. Pre- and post-operative serial radiographs were analyzed for limb alignment, component positioning, and evidence of loosening. Results: The patients were followed-up for an average of 2.59 years (range, 2-3.3 years. The mean knee score and the mean function score were significantly improved from a pre-operative value of 39.4 points and 46.7 points to a post-operative value of 87 points and 86 points, respectively (P value < 0.05. Two hundred and thirty four knees had no anterior knee pain while 63 knees had mild to moderate pain, but none of the patients requested any intervention for the same. Of the 276 patients (297 knees, 79 knees had flexion above 140°, 167 had a flexion range of 130-140°, 27 had a flexion range of 100-130°, and 24 knees had a flexion < 100°, with the mean range of movement being 132.9°. Improvements in the range of movement were retained over time and a total of 205 patients (224 knees, 75.7% could squat or sit cross-legged at the final follow-up. The mean tibiofemoral angle was 8.5°± 6.9º of

  11. Bevacizumab compared with Diode Laser in stage 3 posterior retinopathy of prematurity: a 5 year follow-up

    LENUS (Irish Health Repository)

    O’Keeffe, N

    2016-02-01

    We conducted a prospective randomized study to compare outcomes of intravitreal Bevacizumab versus diode laser in thirty eyes of fifteen premature babies with zone 1 or posterior zone 2 retinopathy of prematurity (ROP). We recorded complications, regression\\/reactivation of ROP, visual outcome, refractive error and systemic complications. The Bevacizumab-treated eyes showed rapid regression of the ROP with resolution of plus disease and flattening of the ridge at 48 hours post injection. In 3 Bevacizumab-treated eyes, reactivation occurred and were treated with laser (3 eyes) or a further Bevacizumab injection (1 eye). Of the diode laser treated eyes, one showed progression and was treated with Bevacizumab. At 5-year follow-up, good outcomes were observed in both treatment groups. However, less myopia was found in the Bevacizumab compared with the diode laser treated eyes.

  12. Preventing repetition of attempted suicide-III. The Amager Project, 5-year follow-up of a randomized controlled trial

    DEFF Research Database (Denmark)

    Lahoz, Titia; Hvid, Marianne; Wang, August G

    2016-01-01

    BACKGROUND: The Amager Project was initiated as a quasi-experimental study in 2005, based on an active outreach suicide preventive intervention inspired by the Norwegian Baerum Model. A 1-year follow-up study was conducted as a randomized controlled trial showing that this kind of active outreach...... follow-up study. METHOD: One hundred and thirty-three suicide attempters were included at this 5-year follow-up RCT study at Copenhagen University Hospital, Amager, and randomized to a rapid outreach suicide preventive intervention (OPAC) or TAU. RESULTS: Offering OPAC intervention to patients after...

  13. Schnitzler's syndrome: 3-year radiological follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Bertrand, A. [Hopital Bichat, Department of Radiology, Paris (France); Feydy, A. [Hopital Bichat, Department of Radiology, Paris (France); Hopital Cochin, Service de Radiologie B, Paris (France); Belmatoug, N.; Fantin, B. [Hopital Beaujon, Department of Internal Medicine, Clichy (France)

    2007-02-15

    Schnitzler's syndrome comprises urticaria, monoclonal gammapathy, inflammatory signs (fever, enlarged lymph nodes, hyperleukocytosis), and bone lesions. We report the imaging findings and follow-up of a new case with extensive osteosclerosis of the iliac bone, associated with inflammatory signal changes on MRI and foci of increased uptake on bone scintigraphy. When a diagnosis of Schnitzler's syndrome is established, treatment should be towards symptoms only; a long follow-up is warranted, as a delayed evolution towards a lymphoproliferative syndrome is possible. (orig.)

  14. [Efficacy of an intensive prevention programme of coronary heart disease: 5 year follow-up outcomes].

    Science.gov (United States)

    Muñoz, Miguel A; Subirana, Isaac; Ramos, Rafael; Franzi, Alicia; Vila, Joan; Marrugat, Jaume

    2008-04-19

    Most evidence on the efficacy of intensive preventive programs of secondary prevention of coronary diseases comes from Anglo-Saxon countries and effectiveness remains controversial. We have scarce information about the efficacy of these types of programs in Spain. In the present analysis we show the results of the ICAR (Intervención en la Comunidad de Alto Riesgo coronario) study, aimed to analyze the efficacy of an intensive preventive program primary care based in reducing the cardiovascular recurrences and mortality in patients with coronary heart disease. We designed a randomized clinical trial, multicenter and community based, which included 23 health care areas in Catalonia, Spain. We followed for 5 years 2 cohorts of patients with coronary heart disease, aged 30-80 years. The intervention group was quarterly examined by their general practitioner, who adjusted treatments to control their cardiovascular risk factors thoroughly and reinforced life style behaviours. In order to do that, patient's weight and blood pressure were determined in each visit and laboratory test carried out twice a year. Patients in the control group received the usual care. In order to analyze the effect of the intervention cardiovascular recurrences and mortality were registered. We included 983 patients. Mean (standard deviation) age was 64 (10) and 74.5% were men. During the follow-up 235 patients suffered some non-fatal cardiovascular recurrence (109 vs 126 in the control and intervention group, respectively; p = 0.84), and 45 died from cardiovascular recurrences (23 vs 22, respectively; p = 0.57). Adjusted hazard ratio of cardiovascular event and total mortality, for the intervention group were 1.01 (95% confidence interval, 0.74-1.39), and 0.92 (95% confidence interval, 0.54-1.56), respectively. The implementation of an intensive secondary prevention program based on periodical reminds to patients with stable coronary heart disease to attend their general practitioners did not

  15. Five-year follow-up for women with subclinical hypothyroidism in pregnancy.

    Science.gov (United States)

    Shields, Beverley M; Knight, Bridget A; Hill, Anita V; Hattersley, Andrew T; Vaidya, Bijay

    2013-12-01

    Increasing numbers of women are being treated with l-thyroxine in pregnancy for mild thyroid dysfunction because of its association with impaired neuropsychological development in their offspring and other adverse obstetric outcomes. However, there are limited data to indicate whether treatment should be continued outside of pregnancy. We aimed to determine whether subclinical hypothyroidism and maternal hypothyroxinemia resolve postdelivery. A total of 523 pregnant healthy women with no known thyroid disorders were recruited during routine antenatal care and provided blood samples at 28 weeks of pregnancy and at a mean of 4.9 years postpregnancy. TSH, free T₄, free T₃, and thyroid peroxidase antibody levels were measured in serum taken in pregnancy and at follow-up. Subclinical hypothyroidism in pregnancy (TSH >3 mIU/L) was present in 65 of 523 (12.4%) women. Of these, 49 (75.4%) women had normal thyroid function postpregnancy; 16 of 65 (24.6%) had persistent high TSH (TSH >4.5 mIU/L postpregnancy) with 3 women receiving l-thyroxine treatment. A total of 44 of 523 (8.4%) women had isolated maternal hypothyroxinemia in pregnancy (free T₄ 4.5 mIU/L outside pregnancy. Of the women with subclinical hypothyroidism in pregnancy with antibody measurements available, those with thyroid peroxidase antibodies in pregnancy were more likely to have persistently elevated TSH or be receiving l-thyroxine replacement after pregnancy (6 of 7 [86%] vs 10 of 57 [18%], P hypothyroidism in pregnancy are transient, so treatment with l-thyroxine in these patients should be reviewed because it may not be warranted after pregnancy.

  16. One Year Follow-Up After Veriflex Phakic Intraocular Lenses Implantation for Correction of Myopia

    Science.gov (United States)

    Pjano, Melisa Ahmedbegovic; Biscevic, Alma; Grisevic, Senad; Pidro, Ajla; Ratkovic, Mirko; Bohac, Maja; Husovic, Amila Alikadic; Gojak, Refet

    2016-01-01

    Objectives: The aim of this study was to evaluate visual and refractive outcomes after Veriflex phakic intraocular lenses (pIOL) implantation in moderately myopic eyes as well as postoperative complications. Methods: This prospective clinical study included 40 eyes of 26 patients which underwent implantation of Veriflex for correction of myopia from -6.00 to -14.50 diopters (D) in the Eye Clinic Svjetlost Sarajevo, from January 2011 to January 2014. Uncorrected distance visual acuity (UDVA), manifest residual spherical equivalent (MRSE), intraocular pressure (IOP), endothelial cell (EC) density were evaluated at one, three, six and 12 months. Other complications in postoperative period were evaluated. For statistical analysis SPSS for Windows and Microsoft Excel were used. Results: Out of 26 patients 14 had binocular and 12 monocular procedure, with mean age of 29.8±6.5 years. After 12 months mean UDVA was 0.73±0.20. Mean MRSE was -0.39±0.31D and 90% of eyes had MRSE within ±1D. EC loss was 7.18±4.33%. There was no significant change of IOP by the end of 12 months follow up period. The only intraoperative complication was hyphema and occurred in one eye. Few postoperative complications were: subclinical inflammation in three eyes (7,5%), pigment dispersion in four eyes (10%), ovalisation of papilla in 2 eyes (5%) and decentration of pIOL in 2 eyes (5%). Conclusion: Implantation of iris-claw phakic lenses Veriflex for treating moderately high myopia is a procedure with good visual and refractive results and few postoperative complications. PMID:27482131

  17. Response to hydroxycarbamide in pediatric β-thalassemia intermedia: 8 years' follow-up in Egypt.

    Science.gov (United States)

    El-Beshlawy, Amal; El-Ghamrawy, Mona; EL-Ela, Mona Abou; Said, Fadwa; Adolf, Sonia; Abdel-Razek, Abdel-Rahman Ahmed; Magdy, Rania Ismail; Abdel-Salam, Amina

    2014-12-01

    Hydroxycarbamide (hydroxyurea or HU) has been shown to increase fetal hemoglobin (HbF) in patients with β-thalassemia intermedia (TI). The reported effects of HU in increasing the total hemoglobin (Hb) have been inconsistent. Studies of long-term therapy with HU in pediatric TI are rather uncommon. A retrospective observational study was carried out to evaluate the clinical responses to HU in Egyptian patients with β-TI. One hundred patients; children (n = 82, mean age 9.9 ± 4.1 years) and adults (n = 18) were studied for the mean Hb, HbF%, median serum ferritin, transfusion history, and splenic size before and after HU therapy (mean dose 20.0 ± 4.2 mg/kg/day, range 10-29 mg/kg/day) over a follow-up period 4 to 96 months (mean 35.4 ± 19.2 months). Molecular studies were also done for group of patients (n = 42). The overall response rate to HU was 79 %; 46 % were minor responders (with a reduction in transfusion rate by 50 % or more and/or an increase in their total hemoglobin level by 1-2 g/dl) and 33 % major responders (becoming transfusion-free and/or having an increase in total hemoglobin level by >2 g/dl). Mean hemoglobin increased among responders from 6.9 ± 0.9 g/dl to 8.3 ± 1.4 g/dl (p C) in 32/42 (76 %) of studied patients; 28/32 were responders. Bivariate analysis showed no predictors of response as regards sex, pediatric and adult age, splenic status, or genotype. Hydroxycarbamide is a good therapeutic modality in the management of pediatric as in adult TI patients. It can minimize the need for blood transfusion, concomitant iron overload, and blood-born viral transmission especially in developing countries like Egypt.

  18. Rheumatic heart disease: 15 years of clinical and immunological follow-up

    Directory of Open Access Journals (Sweden)

    Roney O Sampaio

    2008-01-01

    Full Text Available Roney O Sampaio, Kellen C Fae, Lea MF Demarchi, Pablo MA Pomerantzeff, Vera D Aiello, Guilherme S Spina, Ana C Tanaka, Sandra E Oshiro, Max Grinberg, Jorge Kalil, Luiza GuilhermeHeart Institute (InCor, University of São Paulo, BrazilAbstract: Rheumatic fever (RF is a sequel of group A streptococcal throat infection and occurs in untreated susceptible children. Rheumatic heart disease (RHD, the major sequel of RF, occurs in 30%–45% of RF patients. RF is still considered endemic in some regions of Brazil and is responsible for approximately 90% of early childhood valvular surgery in the country. In this study, we present a 15-year clinical follow-up of 25 children who underwent surgical valvular repair. Histopathological and immunological features of heart tissue lesions of RHD patients were also evaluated. The patients presented severe forms of RHD with congestive symptoms at a very young age. Many of them had surgery at the acute phase of RF. Histological analysis showed the presence of dense valvular inflammatory infiltrates and Aschoff nodules in the myocardium of 21% of acute RHD patients. Infiltrating T-cells were mainly CD4+ in heart tissue biopsies of patients with rheumatic activity. In addition, CD4+ and CD8+ infiltrating T-cell clones recognized streptococcal M peptides and cardiac tissue proteins. These findings may open the possibilities of new ways of immunotherapy. In addition, we demonstrated that the surgical procedure during acute phase of the disease improved the quality of life of young RHD patients.Keywords: rheumatic heart disease, Streptococcus pyogenes, heart failure, inflammatory infiltrate, T lymphocytes, molecular mimicry

  19. Schizophrenia: a five-year follow-up of patient outcome following psycho-education for caregivers.

    LENUS (Irish Health Repository)

    McWilliams, S

    2012-01-01

    There is evidence that psycho-education courses for caregivers of individuals with schizophrenia improve the short-term outcome of the condition. However, most of the outcome studies are limited to two-year follow-up.

  20. Effects of Stimulant Medication on Growth Rates across 3 Years in the MTA Follow-up

    Science.gov (United States)

    Swanson, James M.; Elliott, Glen R.; Greenhill, Laurence L.; Wigal, Timothy; Arnold, L. Eugene; Vitiello, Benedetto; Hechtman, Lily; Epstein, Jeffery N.; Pelham, William E.; Abikoff, Howard B.; Newcorn, Jeffrey H.; Molina, Brooke S. G.; Hinshaw, Stephen P.; Wells, Karen C.; Hoza, Betsy; Jensen, Peter S.; Gibbons, Robert D.; Hur, Kwan; Stehli, Annamarie; Davies, Mark; March, John S.; Conners, C. Keith; Caron, Mark; Volkow, Nora D.

    2007-01-01

    Objective: To evaluate the hypothesis of stimulant medication effect on physical growth in the follow-up phase of the Multimodal Treatment Study of Children With ADHD. Method: Naturalistic subgroups were established based on patterns of treatment with stimulant medication at baseline, 14-, 24-, and 36-month assessments: not medicated (n = 65),…

  1. Smith-Petersen Vitallium mould arthroplasty: a 62-year follow-up.

    LENUS (Irish Health Repository)

    Baker, J F

    2011-09-01

    A variety of materials were used for early hip prostheses. The introduction of Vitallium by Smith-Petersen represented a further advance in this surgical field. We present the longest known follow-up of a Smith-Petersen Vitallium mould arthroplasty.

  2. Vagus nerve stimulation in patients with catastrophic childhood epilepsy, a 2-year follow-up study.

    NARCIS (Netherlands)

    Majoie, H.J.; Berfelo, M.W.; Aldenkamp, A.P.; Renier, W.O.; Kessels, A.G.H.

    2005-01-01

    PURPOSE: To establish the long-term efficacy and tolerability of vagus nerve stimulation (VNS) in children with a Lennox-like syndrome. METHOD: This study was a longitudinal observational prospective cohort analysis. Baseline: 6 months. Follow-up: 24 months. Screening (baseline and every 6 months):

  3. Effects of Stimulant Medication on Growth Rates across 3 Years in the MTA Follow-up

    Science.gov (United States)

    Swanson, James M.; Elliott, Glen R.; Greenhill, Laurence L.; Wigal, Timothy; Arnold, L. Eugene; Vitiello, Benedetto; Hechtman, Lily; Epstein, Jeffery N.; Pelham, William E.; Abikoff, Howard B.; Newcorn, Jeffrey H.; Molina, Brooke S. G.; Hinshaw, Stephen P.; Wells, Karen C.; Hoza, Betsy; Jensen, Peter S.; Gibbons, Robert D.; Hur, Kwan; Stehli, Annamarie; Davies, Mark; March, John S.; Conners, C. Keith; Caron, Mark; Volkow, Nora D.

    2007-01-01

    Objective: To evaluate the hypothesis of stimulant medication effect on physical growth in the follow-up phase of the Multimodal Treatment Study of Children With ADHD. Method: Naturalistic subgroups were established based on patterns of treatment with stimulant medication at baseline, 14-, 24-, and 36-month assessments: not medicated (n = 65),…

  4. Five-year follow-up using a prostate stent as fiducial in image-guided radiotherapy of prostate cancer.

    Science.gov (United States)

    Carl, Jesper; Sander, Lotte

    2015-06-01

    To report results from the five-year follow-up on a previously reported study using image-guided radiotherapy (IGRT) of localized or locally advanced prostate cancer (PC) and a removable prostate stent as fiducial. Patients with local or locally advanced PC were treated using five-field 3D conformal radiotherapy (3DRT). The clinical target volumes (CTV) were treated to 78 Gy in 39 fractions using daily on-line image guidance (IG). Late genito-urinary (GU) and gastro-intestinal (GI) toxicities were scored using the radiotherapy oncology group (RTOG) score and the common toxicity score of adverse events (CTC) score. Urinary symptoms were also scored using the international prostate symptom score (IPSS). Median observation time was 5.4 year. Sixty-two of the 90 patients from the original study cohort were eligible for toxicity assessment. Overall survival, cancer-specific survival and biochemical freedom from failure were 85%, 96% and 80%, respectively at five years after radiotherapy. Late toxicity GU and GI RTOG scores≥2 were 5% and 0%. Comparing pre- and post-radiotherapy IPSS scores indicate that development in urinary symptoms after radiotherapy may be complex. Prostate image-guided radiotherapy using a prostate stent demonstrated survival data comparable with recently published data. GU and GI toxicities at five-year follow-up were low and comparable to the lowest toxicity rates reported. These findings support that the precision of the prostate stent technique is at least as good as other techniques. IPSS revealed a complex development in urinary symptoms after radiotherapy.

  5. Work, diabetes and obesity: a seven year follow-up study among Danish health care workers.

    Science.gov (United States)

    Poulsen, Kjeld; Cleal, Bryan; Clausen, Thomas; Andersen, Lars L

    2014-01-01

    The rise in prevalence of diabetes is alarming and research ascribes most of the increase to lifestyle. However, little knowledge exists about the influence of occupational factors on the risk for developing diabetes. This study estimates the importance of work and lifestyle as risk factors for developing diabetes mellitus among healthcare workers and explores the association of work factors and obesity, which is a risk factor for diabetes. Questionnaire-based prospective cohort study among 7,305 health care workers followed for seven years in the Danish National Diabetes Register. We used bivariate comparisons to give an unadjusted estimate of associations, followed by adjusted survival analysis and logistic regression models to estimate the influences of potential risk factors related to job, health and lifestyle on diabetes and obesity. During seven years of follow up, 3.5% of participants developed diabetes, associated with obesity (HR  =  6.53; 95% CI 4.68-9.10), overweight (HR  =  2.89; CI 2.11-3.96) age 50-69 y (HR  =  2.27; 95% CI 1.57-3.43) and high quality of leadership (HR  =  1.60; CI 1.19-2.16). Obesity at baseline was most common among the youngest employees, and was mainly associated with developing diabetes (OR  =  3.84; CI 2.85-5.17), impaired physical capacity and physical inactivity. In the occupational setting, obesity was associated with shift work, severe musculoskeletal pain, low influence, but also by good management, fewer role conflicts and a positive work-life balance. Looking only at non-smokers, removed the influence of age and pain. However, non-smokers also had higher depression scores and more role conflicts. Confirming obesity as the strongest risk factor for developing diabetes, the present study identified few occupational risk factors. However, obesity, the key risk factor for diabetes, had a more variable relation with work than did diabetes.

  6. Periapical Bone Healing after Apicectomy with and without Retrograde Root Filling with Mineral Trioxide Aggregate: A 6-year Follow-up of a Randomized Controlled Trial.

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    Kruse, Casper; Spin-Neto, Rubens; Christiansen, René; Wenzel, Ann; Kirkevang, Lise-Lotte

    2016-04-01

    In cases of post-treatment periapical disease, retreatment may be necessary. To choose the most appropriate retreatment method, knowledge of the long-term prognosis is important. Surgical endodontic retreatment (SER) is a relevant treatment method. This study assessed changes in outcome from 1 to 6 years after surgery. SER was performed on teeth randomly allocated to have a MTA root-end filling (MTA group) or smoothing of the orthograde gutta-percha filling after apicectomy (GP group). Patients participating in the 1-year follow-up were reinvited for a 6-year clinical and radiographic examination. Three observers assessed treatment outcome both clinically and radiographically from the 1-year and 6-year follow-up examination. At the 6-year follow-up, 39 of 52 teeth were available and examined (75% participation rate). In the MTA group, 16 of 19 teeth (86%) and in the GP group 11 of 20 teeth (55%) were assessed as successful (P = .04). In the MTA group and the GP group, 80% and 90%, respectively, of teeth assessed as successful at the 1-year follow-up remained successful. All unsuccessful teeth in the MTA group (3 teeth) were lost because of vertical root fracture. The proportion of healed cases was larger in the MTA group than in the GP group at both the 1-year and 6-year follow-up. Findings indicate that a 1-year follow-up may not be sufficient in assessing the long-term outcome of surgical endodontic retreatment. With a longer follow-up, other factors not directly related to the endodontic treatment may be relevant for a successful outcome. This needs further investigation in larger patient samples. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  7. Use of computerized tomography for diagnosis and follow-up after endodontic surgery: clinical case report with 8 years of follow-up.

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    Tanomaru-Filho, Mario; Lima, Regina K P; Nakazone, Paula A; Tanomaru, Juliane M G

    2010-04-01

    Computerized tomography (CT) is a valuable tool for diagnosis and planning in conventional and surgical endodontic therapy. This case report describes the use of CT in the diagnosis of a periapical lesion undetected by periapical radiography in the mandibular molar area. The CT also showed a possible mesial root perforation associated with the lesion. Following CT, surgical planning, periradicular curettage, and sealing of the root perforation were performed. Eight years after surgery, cone beam CT revealed periapical bone repair. Computerized tomography can be an important resource for diagnosis and planning in conventional and surgical endodontic therapy, as well as for evaluation of post-treatment bone repair. Copyright 2010 Mosby, Inc. All rights reserved.

  8. Ultrasound guided foam sclerotherapy of recurrent varices of the great and small saphenous vein: 5-year follow up

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    Patrizia Pavei

    2014-11-01

    Full Text Available Ultrasound guided foam sclerotherapy (UGFS proved to be effective in recurrent varices. In this observational study from 2006 and 2012 we treated 142 neovascularization, 155 inguinal recurrence and 28 popliteal recurrent varices. For neovascularization 0.3-0.5% polidocanol (POL sclerosant foam (SF was injected for vein having diameter <3 mm and 0.5-1% POL or sodium tetradecylsulphate (STS SF for higher vein diameters. The patients with residual sapheno-femoral or sapheno-popliteal junctions were treated with 1% STS SF for diameter up to 5 mm, while for larger veins 3% STS was used. From 1 to 3 sessions were necessary in both groups with 4 to 10 ml injected per session. In the group of neovascularization the 3-5years follow up revealed good results in 90.8% of the cases. In the group of popliteal recurrences the 3-5 years follow up showed 60.7% of good results, while in the group of inguinal recurrences we observed 80% of good results at 3-5 years. We did not have major complication. As minor complications we had 0.2% of gastrocnemial vein thrombosis, 0.1% of minor neurological problems, 2.8% of superficial vein thrombosis, 3.9% of pigmentation and light to mild post-treatment pain in 16.5% of the cases. In conclusion our data show that UGFS is a well tolerate technique, preferred by previously operated patients, safe and easily repeatable with good medium-term results both in case of neovascularization and of recurrence from residual femoral or popliteal stump.

  9. The incidence and relative risk of stroke among patients with bipolar disorder: a seven-year follow-up study.

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    Hung-Chi Wu

    Full Text Available OBJECTIVE: This study aimed to estimate the incidence and relative risk of stroke and post-stroke all-cause mortality among patients with bipolar disorder. METHODS: This study identified a study population from the National Health Insurance Research Database (NHIRD between 1999 and 2003 that included 16,821 patients with bipolar disorder and 67,284 age- and sex-matched control participants without bipolar disorder. The participants who had experienced a stroke between 1999 and 2003 were excluded and were randomly selected from the NHIRD. The incidence of stroke (ICD-9-CM code 430-438 and patient survival after stroke were calculated for both groups using data from the NIHRD between 2004 and 2010. A Cox proportional-hazards model was used to compare the seven-year stroke-free survival rate and all-cause mortality rate across the two cohorts after adjusting for confounding risk factors. RESULTS: A total of 472 (2.81% patients with bipolar disorder and 1,443 (2.14% controls had strokes over seven years. Patients with bipolar disorder were 1.24 times more likely to have a stroke (95% CI = 1.12-1.38; p<0.0001 after adjusting for demographic characteristics and comorbid medical conditions. In addition, 513 (26.8% patients who had a stroke died during the follow-up period. The all-cause mortality hazard ratio for patients with bipolar disorder was 1.28 (95% CI = 1.06-1.55; p = 0.012 after adjusting for patient, physician and hospital variables. CONCLUSIONS: The likelihood of developing a stroke was greater among patients with bipolar disorder than controls, and the all-cause mortality rate was higher among patients with bipolar disorder than controls during a seven-year follow-up period.

  10. Formocresol versus calcium hydroxide direct pulp capping of human primary molars: two year follow-up.

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    Aminabadi, Naser Asl; Farahani, Ramin Mostofi Zadeh; Oskouei, Sina Ghertasi

    2010-01-01

    Clinical and radiographic evaluation of the premedicated direct pulp capping using formocresol (PDC) versus conventional direct pulp capping using calcium hydroxide (CDC) in human carious primary molars. A total of 120 vital primary molars with pinpoint exposure during caries removal in 84 patients aged 4-5 years were selected. In the PDC group (n = 60), 20% Buckley's formocresol solution, and in the CDC group (n = 60), calcium hydroxide powder were applied to the exposure sites followed by placement of zinc oxide-eugenol base. Teeth were restored with preformed stainless steel crowns. Clinical and radiographic evaluations of the treatment outcomes were performed at regular intervals of 6 and 12 months, respectively, for two years post-operatively. The prevalence of spontaneous pain, sensitivity on percussion, and fistula were significantly higher in the CDC group compared to the PDC group (P formocresol premedicated direct pulp capping could safely be used as a substitute for conventional direct pulp capping.

  11. Treatment and violent behavior in persons with first episode psychosis during a 10-year prospective follow-up study.

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    Langeveld, Johannes; Bjørkly, Stål; Auestad, Bjørn; Barder, Helene; Evensen, Julie; Ten Velden Hegelstad, Wenche; Joa, Inge; Johannessen, Jan Olav; Larsen, Tor Ketil; Melle, Ingrid; Opjordsmoen, Stein; Røssberg, Jan Ivar; Rund, Bjørn Rishovd; Simonsen, Erik; Vaglum, Per; McGlashan, Thomas; Friis, Svein

    2014-07-01

    First episode psychosis (FEP) patients have an increased risk for violence and criminal activity prior to initial treatment. However, little is known about the prevalence of criminality and acts of violence many years after implementation of treatment for a first episode psychosis. To assess the prevalence of criminal and violent behaviors during a 10-year follow-up period after the debut of a first psychosis episode, and to identify early predictors and concomitant risk factors of violent behavior. A prospective design was used with comprehensive assessments of criminal behavior, drug abuse, clinical, social and treatment variables at baseline, five, and 10-year follow-up. Additionally, threatening and violent behavior was assessed at 10-year follow-up. A clinical epidemiological sample of first-episode psychosis patients (n=178) was studied. During the 10-year follow-up period, 20% of subjects had been apprehended or incarcerated. At 10-year follow-up, 15% of subjects had exposed others to threats or violence during the year before assessment. Illegal drug use at baseline and five-year follow-up, and a longer duration of psychotic symptoms were found to be predictive of violent behavior during the year preceding the 10-year follow-up. After treatment initiation, the overall prevalence of violence in psychotic patients drops gradually to rates close to those of the general population. However, persistent illicit drug abuse is a serious risk factor for violent behavior, even long after the start of treatment. Achieving remission early and reducing substance abuse may contribute to a lower long-term risk for violent behavior in FEP patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Trabeculectomy with double low dose of mitomycin C – two years of follow-up

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    Errico D

    2011-12-01

    Full Text Available Donato Errico1, Francesca Scrimieri1, Roberta Riccardi1, Romolo Fedeli1, Giancarlo Iarossi21Opthalmology Unit, Glaucoma Service, Azienda Ospedaliera, Cardinale G Panìco, Tricase (Le, Italy; 2Department of Opthalmology, Ospedale Pediatrico Bambino Gesù, Rome, ItalyPurpose: To evaluate the efficacy and the safety of a surgical technique in which classic trabeculectomy ab externo is performed with a double application of low-dose mitomycin C (MMC in uncontrolled open-angle glaucoma (OAG patients.Method: A consecutive series of 43 white patients (43 eyes with uncontrolled primary OAG underwent trabeculectomy surgery. A double application of MMC (0.1% was performed: the first under the Tenon's capsule for 3 minutes, and the second below the scleral flap for 1 or 2 minutes, according to the risk factors. Complete success was defined as intraocular pressure (IOP <14 mmHg without any additional glaucoma surgery or medication. Qualified success was defined as IOP <14 mmHg with additional needling revision.Results: Mean preoperative IOP was 29.9 mmHg (SD 3.8 for all eyes evaluated. At 1 day postoperative, mean IOP was 6.7 mmHg (SD 1.26. At the end of the first 2 weeks postoperative, mean IOP was 8.6 mmHg (SD 1.7, at 12 months mean IOP was 11.3 mmHg (SD 1.4; P < 0.0001 and at 24 months mean IOP was 11.4 mmHg (SD 1.5; P < 0.0001. At 3 months, two eyes (5.4% underwent needling of the bleb for cystic blebs formation.Conclusion: In this study we presented the results after 2 years of follow-up of OAG undergoing trabeculectomy with dual administration of MMC (0.1 mg/mL. After 24 months, complete success was achieved in 93% of patients and a qualified success in 100% of patients.Keywords: glaucoma, trabeculectomy, mitomycin C

  13. Five-Year Follow-up Study of Monoclonal Gammopathy of Undetermined Significance in a Korean Elderly Urban Cohort

    Science.gov (United States)

    Lee, Yun-Gyoo; Bang, Soo-Mee; Lee, Jeong-Ok; Kim, Jin Won; Lee, Keun-Wook; Kim, Jee Hyun; Song, Jung Han; Kim, Tae-Hee; Kim, Ki Woong; Lee, Jong-Seok

    2015-01-01

    Purpose We previously reported the prevalence of monoclonal gammopathy of undetermined significance (MGUS) to be 3.3% among an elderly Korean urban cohort recruited during 2005-2006. Here, we report a 5-year follow-up study of the previously identified MGUS cohort. Materials and Methods The 680 participants from the initial cohort were followed-up for a median of 5 years. Sera were collected between 2010 and 2011. Two-step screening was performed with standard serum electrophoresis followed by immunofixation and determination of the serum concentration of monoclonal-protein (M-protein). Results Of the 680 participants (21 with MGUS), 348 (51%) agreed to participate in the follow-up study and 10 were found to have MGUS. Among the 21 MGUS patients initially identified, nine were followed-up, six had persistent M-protein, and one patient had progressed to multiple myeloma (progression rate, 1.0%/yr). The M-protein disappeared in the remaining two individuals. Among the 339 participants without MGUS who were followed-up, four developed an M-protein. There was no significant difference in survival with respect to the presence of MGUS (p=0.66). Conclusion The 5-year follow-up data show that the natural clinical course of MGUS in Korea is similar to that in Western countries. MGUS was not associated with an increased risk of death over the 5-year study period. PMID:25345461

  14. Three-Year Follow-Up of Insomnia and Hypnotics after Controlled Internet Treatment for Insomnia.

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    Blom, Kerstin; Jernelöv, Susanna; Rück, Christian; Lindefors, Nils; Kaldo, Viktor

    2016-06-01

    To investigate the long-term effects of therapist-guided Internet-based insomnia treatment on insomnia severity and sleep medication use, compared with active control. This study was an 8 week randomized controlled trial with follow-up posttreatment and at 6, 12, and 36 months, set at the Internet Psychiatry Clinic, Stockholm, Sweden. Participants were 148 media-recruited nondepressed adults with insomnia. Interventions were Guided Internet-based cognitive behavioral therapy for insomnia (ICBT-i) or active control treatment (ICBT-ctrl). Primary outcome was insomnia severity, measured with the Insomnia Severity Index. Secondary outcomes were sleep medication use and use of other treatments. The large pretreatment to posttreatment improvements in insomnia severity of the ICBT-i group were maintained during follow-up. ICBT-ctrl exhibited significantly less improvement posttreatment (between-Cohen d = 0.85), but after 12 and 36 months, there was no longer a significant difference. The within-group effect sizes from pretreatment to the 36-months follow-up were 1.6 (ICBT-i) and 1.7 (ICBT-ctrl), and 74% of the interviewed participants no longer had insomnia diagnosis after 36 mo. ICBT-ctrl used significantly more sleep medication (P = 0.017) and underwent significantly more other insomnia treatments (P CBT for insomnia has long-term effects. After 36 months, the groups did not differ in insomnia severity, but ICBT-ctrl had used more sleep medication and undergone more other additional insomnia treatments during the follow-up period. The trial was registered, together with a parallel trial, at Clinicaltrials.gov as "Internet-CBT for Insomnia" registration ID: NCT01256099. © 2016 Associated Professional Sleep Societies, LLC.

  15. Scheduled Follow-Up Referrals and Simple Prevention Kits Including Counseling to Improve Post-Discharge Outcomes Among Children in Uganda: A Proof-of-Concept Study

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    Wiens, Matthew O; Kumbakumba, Elias; Larson, Charles P; Moschovis, Peter P; Barigye, Celestine; Kabakyenga, Jerome; Ndamira, Andrew; English, Lacey; Kissoon, Niranjan; Zhou, Guohai; Ansermino, J Mark

    2016-01-01

    ABSTRACT Background: Recurrent illness following hospital discharge is a major contributor to childhood mortality in resource-poor countries. Yet post-discharge care is largely ignored by health care workers and policy makers due to a lack of resources to identify children with recurrent illness and a lack of cohesive systems to provide care. The purpose of this proof-of-concept study was to evaluate the effectiveness of a bundle of interventions at discharge to improve health outcomes during the vulnerable post-discharge period. Methods: The study was conducted between December 2014 and April 2015. Eligible children were between ages 6 months and 5 years who were admitted with a suspected or proven infectious disease to one of two hospitals in Mbarara, Uganda. A bundle of interventions was provided at the time of discharge. This bundle included post-discharge referrals for follow-up visits and a discharge kit. The post-discharge referral was to ensure follow-up with a nearby health care provider on days 2, 7, and 14 following discharge. The discharge kit included brief educational counseling along with simple preventive items as incentives (soap, a mosquito net, and oral rehydration salts) to reinforce the education. The primary study outcome was the number of post-discharge referral visits completed. Secondary study outcomes included satisfaction with the intervention, rates of readmission after 60 days, and post-discharge mortality rates. In addition, outcomes were compared with a historical control group, enrolled using the same inclusion criteria and outcome-ascertainment methods. Results: During the study, 216 children were admitted, of whom 14 died during hospitalization. Of the 202 children discharged, 85% completed at least 1 of the 3 follow-up referral visits, with 48% completing all 3 visits. Within 60 days after discharge, 22 children were readmitted at least once and 5 children (2.5%) died. Twelve (43%) readmissions occurred during a scheduled follow-up

  16. [A 8-year-forgotten ureteral stent after kidney transplantation: treatment and long-term follow-up].

    Science.gov (United States)

    Lasaponara, Fedele; Dalmasso, Ettore; Santià, Silvia; Sedigh, Omidreza; Bosio, Andrea; Pasquale, Giovanni; Segoloni, Giuseppe P; Fontana, Dario

    2013-01-01

    Forgotten indwelling ureteral stents can cause significant urological complications. Only few cases are reported after kidney transplantation. We present a case of a 39-year-old woman, transplanted in 1993 and referred to our Transplant Center 8 years later, because of a serious urinary tract infection with renal function impairment. Abdominal CT scan showed pyelonephritis and hydronephrosis in the transplanted kidney and the presence of a calcific ureteral stent, which had been forgotten in situ for 8 years. The stent was removed, but it was impossible to replace it with a new stent both retrogradely and anterogradely, because of a tight obstruction of the mid ureter. So a uretero-ureteral anastomosis with up urinary tract was performed. No intra- or post-operative complications occurred. At 9 years' follow-up, the patient shows an optimal renal function, with no urinary tract infection. A forgotten ureteral stent in a transplanted kidney can cause a lot of complications and can lead to graft loss. The prosthesis may cause an irreversible ureteral damage, so, as in our experience, forgetting a ureteral stent can result in a complex surgery.

  17. Atraumatic restorative treatment - glass ionomer sealants survival after a postgraduate training program in Ecuador: 2-year follow-up

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    Edisson Lopez Rios

    2015-02-01

    Full Text Available This study aimed to evaluate the survival of atraumatic restorative treatment high-viscosity glass ionomer sealants (ART-hvGIS and its relationship with carious lesions incidence in underserved communities of Ecuador. A total of 483 first permanent molars with ART-hvGIS were included after treatment, in which fifteen students of the First Preventive Dentistry Post Graduate Program of Universidad Central del Ecuador assisted 176 schoolchildren, from 5 to 12 year-old. All the students had previously participated in a training course in ART approach. After one and two years follow-up, schoolchildren were reevaluated in relation to sealants retention and new carious lesions development. After first year of evaluation ART-hvGIS retention rate was about 30% and after second year 20%. Incidence of carious lesions was 4.0 and 3.4% after first and second periods, respectively. Although there was an extensive ART-hvGIS loss, carious lesions incidence was low in both the periods of evaluation. ART-hvGIS might be an important key to prevent tooth decay in underserved communities.

  18. Spirometric assessment of lung transplant patients: one year follow-up

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    Paulo M. Pêgo-Fernandes

    2009-06-01

    Full Text Available OBJECTIVE: The purpose of this study was to compare spirometry data between patients who underwent single-lung or double-lung transplantation the first year after transplantation. INTRODUCTION: Lung transplantation, which was initially described as an experimental method in 1963, has become a therapeutic option for patients with advanced pulmonary diseases due to improvements in organ conservation, surgical technique, immunosuppressive therapy and treatment of post-operative infections. METHODS: We retrospectively reviewed the records of the 39 patients who received lung transplantation in our institution between August 2003 and August 2006. Twenty-nine patients survived one year post-transplantation, and all of them were followed. RESULTS: The increase in lung function in the double-lung transplant group was more substantial than that of the single-lung transplant group, exhibiting a statistical difference from the 1st month in both the forced expiratory volume in one second (FEV1 and the forced vital capacity (FVC in comparison to the pre-transplant values (p <0.05. Comparison between double-lung transplant and single lung-transplant groups of emphysema patients demonstrated a significant difference in lung function beginning in the 3rd month after transplantation. DISCUSSION: The analyses of the whole group of transplant recipients and the sub-group of emphysema patients suggest the superiority of bilateral transplant over the unilateral alternative. Although the pre-transplant values of lung function were worse in the double-lung group, this difference was no longer significant in the subsequent months after surgery. CONCLUSION: Although both groups demonstrated functional improvement after transplantation, there was a clear tendency to greater improvement in FVC and FEV1 in the bilateral transplant group. Among our subjects, double-lung transplantation improved lung function.

  19. Percutaneous fixation of fractures of the spine: 1-year clinical and radiological follow-up

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    Carlos Fernando Pereira da Silva Herrero

    2014-12-01

    Full Text Available Objective: To evaluate the preliminary results of the surgical treatment through minimally invasive fixation technique in patients with thoracolumbar spinal fractures. Methods: Retrospective study of 17 patients with fractures of thoracolumbar vertebrae who underwent surgery with percutaneous fixation in the period of 2009 to 2011. The clinical evaluation of the results was performed using the SF-36 and Oswestry questionnaires. The radiographic parameters evaluated were: fracture classification according to Magerl's criteria, wedge angle of the fractured vertebrae and bisegmental Cobb angle. These measurements were made in the preoperative, immediate postoperative and 1 year after surgery. Other data such as associated injuries, neurological deficit, post-surgical infection, loosening and breakage of implants were also considered. Results: The data revealed average scores above 80% in all domains of the SF-36 questionnaire while in Oswestry Questionnaire, 79% of patients had minimal or absent physical limitations with a mean score of 12.4±11.89%. The average Cobb angle for preoperative kyphosis was 5.53º±13.80o, 2.18º±13.38o in the early postoperative period and 5.26º±13.95o one year after surgery. The average correction obtained after surgery was 3.35º and the average correction loss was 3.19º. No complications such as post-surgical infection, permanent neurological deficits and implant loosening and breakage were observed. Conclusion: The surgical treatment of fractures of thoracolumbar vertebrae using a minimally invasive technique provides satisfactory clinical and radiographic results with low complication rates.

  20. The incidence of HIV among women recruited during late pregnancy and followed up for six years after childbirth in Zimbabwe

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    Chirenje Mike Z

    2010-11-01

    Full Text Available Abstract Background HIV incidence is a useful tool for improving the targeting of populations for interventions and assessing the effectiveness of prevention strategies. A study in Harare, Zimbabwe reported cumulative incidences of 3.4% (3.0-3.8 and 6.5% (5.7-7.4 among post-partum women followed for 12 and 24 months respectively between 1997 and 2001. According to a Government report on HIV the prevalence of HIV fell from about 30% in 1999 to 14% in 2008. The purpose of this study was to determine the incidence of HIV-1 among women enrolled during late pregnancy and followed for six years after childbirth and to identify risk factors associated with acquisition of HIV. Methods HIV-uninfected pregnant women around 36 weeks gestation were enrolled from primary health care clinics in peri-urban settlements around Harare and followed-up for up to six years after childbirth. At every visit a questionnaire was interview-administered to obtain socio-demographic data and sexual history since the previous visit. A genital examination was performed followed by the collection of biological samples. Results Of the 552 HIV-uninfected women 444 (80.4% were seen at least twice during the six years follow-up and 39 acquired HIV, resulting in an incidence (95% CI of 2.3/100 woman-years-at-risk (wyar (1.1-4.1. The incidence over the first nine months post-partum was 5.7/100 wyar (3.3-8.1. A greater proportion of teenagers (15.3% contributed to a high incidence rate of 2.9/100 (0.6-8.7 wyar. In multivariate analysis lower education of participant, RR 2.1 (1.1-4.3 remained significantly associated with HIV acquisition. Other risk factors associated with acquisition of HIV-1 in univariate analysis were young age at sexual debut, RR 2.3, (1.0-5.6 and having children with different fathers, RR 2.7(1.3-5.8. Women that knew that their partners had other sexual partners were about four times more likely to acquire HIV, RR 3.8 (1.3-11.2. Conclusion The incidence of HIV

  1. The Impacts of Migraine among Outpatients with Major Depressive Disorder at a Two-Year Follow-Up.

    Science.gov (United States)

    Hung, Ching-I; Liu, Chia-Yih; Yang, Ching-Hui; Wang, Shuu-Jiun

    2015-01-01

    No study has investigated the impacts of migraine on depression, anxiety, and somatic symptoms and remission at the two-year follow-up point among patients with major depressive disorder (MDD). This study aimed to investigate the above issues. Psychiatric outpatients with MDD recruited at baseline were investigated at a two-year follow-up (N = 106). The Hamilton Depression Rating Scale, Hospital Anxiety and Depression Scale, and Depression and Somatic Symptoms Scale were used. Migraine was diagnosed according to the International Classification of Headache Disorders, 2nd edition. The patients were divided into no migraine, inactive migraine, and active migraine subgroups. Multiple logistic regressions were used to investigate the significant factors related to full remission of depression. Among patients without pharmacotherapy at the follow-up, patients with active migraine had significantly greater severities of anxiety and somatic symptoms as compared with patients without migraine; moreover, patients with active migraine had the lowest improvement percentage and full remission rate. There were no significant differences in depression, anxiety, and somatic symptoms between patients with inactive migraine and those without migraine. Active headache at follow-up was a significant factor related to a lower full remission rate. Active headache at follow-up was associated with a lower rate of full remission and more residual anxiety and somatic symptoms at follow-up among patients with migraine. Physicians should integrate a treatment plan for depression and migraine for the treatment of patients with MDD.

  2. Stereotactic radiosurgery for vestibular schwannomas: average 10-year follow-up results focusing on long-term hearing preservation.

    Science.gov (United States)

    Watanabe, Shinya; Yamamoto, Masaaki; Kawabe, Takuya; Koiso, Takao; Yamamoto, Tetsuya; Matsumura, Akira; Kasuya, Hidetoshi

    2016-12-01

    serviceable hearing before SRS who were followed up, hearing acuity was preserved in 23 (35%). Actuarial serviceable hearing preservation rates were 49%, 24%, and 12% at the 60th, 120th, and 180th post-SRS month, respectively. On univariable analysis, only cystic-type tumor (HR 3.36, 95% CI 1.18-9.36; p = 0.02) was shown to have a significantly unfavorable association with FP. Multivariable analysis followed by univariable analysis revealed that higher age (≥ 65 years: HR 2.66, 95% CI 1.16-5.92; p = 0.02), larger tumor volume (≥ 8 cm(3): HR 5.36, 95% CI 1.20-17.4; p = 0.03), and higher cochlear dose (mean cochlear dose > 4.2 Gy: HR 2.22, 95% CI 1.07-4.77; p = 0.03) were unfavorable factors for hearing preservation. CONCLUSIONS Stereotactic radiosurgery achieved good long-term results in this series. Tumor control was acceptable, and there were few serious complications in patients with small- to medium-sized VSs. Unfortunately, hearing preservation was not satisfactory. However, the longer the observation period, the more important it becomes to compare post-SRS hearing decreases with the natural decline in untreated cases.

  3. Prehypertension and Chronic Kidney Disease in Chinese Population: Four-Year Follow-Up Study.

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    Hao Xue

    Full Text Available Hypertension is a well established cause of chronic kidney disease (CKD. However, the effect of prehypertension on risk of CKD is controversial. The aim of this study is to determine whether prehypertension increases the risk of CKD events in the Chinese population. We enrolled 20,034 with prehypertension and 12,351 with ideal blood pressure in this prospective study. CKD was defined as an estimated glomerular filtration rate (eGFR <60 ml/min 1.73 m2. The new occurrences of CKD events were collected during follow-up. Cumulative survival and freedom for the occurrence of new CKD events was analyzed using the Kaplan-Meier approach. Multivariate Cox Regression was used to analyze the effect of prehypertension on CKD. The median follow-up time was 47 (interquartile range 44-51 months. 601 new onset CKD events occurred during the follow-up period. The cumulative incidence of new CKD events was higher in the prehypertensive population than that in the ideal blood pressure population (2.10% vs 1.46%, P = 0.0001. Multivariate Cox Regression showed that relative risks (RRs for the new onset CKD events in the prehypertensive population were 1.69 (95% confidence intervals (CI: 1.41~2.04, P = 0.001 higher than those in the ideal blood pressure population. Similarly, the risks were 1.68 (95% CI: 1.33~2.13 P = 0.001 times higher in females and 2.14 (95% CI: 1.58~2.91 P = 0.001 times higher in males by adjustment for traditional CV risk factors. Our findings demonstrated prehypertension is an independent risk factor for the occurrence of new CKD events in the Chinese population.

  4. A 5-year follow-up study on the prosthetic rehabilitation of the elderly in Helsinki, Finland.

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    Nevalainen, M J; Närhi, T O; Ainamo, A

    2004-07-01

    In 1990, 364 elderly (76-86 years) inhabitants of Helsinki, Finland, attended a dental and oral examination study that was conducted as part of the Helsinki Aging Study. In spring 1996, these subjects were recalled for a 5-year follow-up. Between the baseline and follow-up examinations, 114 (31%) subjects had deceased (86 women and 28 men), whereas 134 had either moved, were too ill, or refused to participate in the follow-up. Follow-up examination was conducted for 113 subjects (79 women and 34 men), with the participating rate being 46%. Five subjects became edentulous during the follow-up. Of the subjects, 61% had 1-32 teeth at follow-up. In these subjects, the mean number of teeth decreased from 14.9 (+/-8.3) to 13.5 (+/-8.6) (P Prosthetic status changed in 40% of the elderly dentate people: 25% received new prostheses whereas 15% lost prostheses that were not replaced. New fixed partial dentures were made in five maxillae and in nine mandibles during the follow-up. Acrylic removable partial dentures (ARPD) were most frequently used: 35% of dentate subjects had an ARPD. Subjects with removable prostheses had higher levels of salivary microbes and higher root caries incidence than those with natural teeth. Furthermore, the presence of removable prostheses at baseline, together with the male gender, was clearly associated with tooth loss during follow-up. This study indicates that fixed rather than removable prostheses should be used in elderly patients. The need for a removable denture ought to be carefully considered.

  5. Cyclosporine nephrotoxicity in type 1 diabetic patients. A 7-year follow-up study

    DEFF Research Database (Denmark)

    Parving, H H; Tarnow, L; Nielsen, F S

    1999-01-01

    placebo-treated patients had normal UAER (P ...-2) declined from baseline to end of follow-up (1994) by 6.3 +/- 6.0 in the former CsA group, whereas it rose by 7.4 +/- 5.0 in the placebo group (P = 0.05). In 1994, 24-h blood pressure was nearly the same: 131/77 +/- 4/2 vs. 127/75 +/- 2/2 mmHg (NS) in the CsA and placebo groups, respectively. Five...

  6. Albendazole therapy of hydatid disease: 2-year follow-up of 40 cases.

    Science.gov (United States)

    el-Mufti, M; Kamag, A; Ibrahim, H; Taktuk, S; Swaisi, I; Zaidan, A; Sameen, A; Shimbish, F; Bouzghaiba, W; Haasi, S

    1993-06-01

    Forty patients with 63 Echinococcus granulosus cysts affecting different sites were treated with albendazole and have been followed up for at least 24 months from completion of therapy. Twenty-one patients (53%) with 37 cysts (59%) showed evidence of healing. The criteria and pattern of healing are outlined. The most serious complication of albendazole therapy was hepatoxic jaundice, which occurred in 5% of patients. Recurrence during the observation period was encountered in 9.5% of patients with a positive response. It is suggested that patients suffering from uncomplicated hydatid disease should be given the benefit of a trial course of albendazole therapy, before surgery is undertaken.

  7. Tyrosinemia type III: diagnosis and ten-year follow-up.

    Science.gov (United States)

    Cerone, R; Holme, E; Schiaffino, M C; Caruso, U; Maritano, L; Romano, C

    1997-09-01

    Tyrosinemia type III, caused by deficiency of 4-hydroxyphenylpyruvate dioxygenase, is a rare disorder of tyrosine catabolism. Primary 4-hydroxyphenylpyruvate dioxygenase deficiency has been described in only three patients. The biochemical phenotype shows hypertyrosinemia and elevated urinary excretion of 4-hydroxyphenyl derivatives. We report the clinical and biochemical findings and the results of long-term follow-up in a new patient with this disorder presenting with severe mental retardation and neurological abnormalities. The clinical phenotype is compared with those reported in the three previously described patients.

  8. RECURRENT SPINAL HYDATIDOSIS - A CASE REPORT WITH 3 YEARS FOLLOW UP AND REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    Avinash

    2014-05-01

    Full Text Available Spinal hydatid cyst, constituting 1% - 2.5 % of the total cases of hydatid disease, is a rare form of hydatid disease. We present a case of pathologically confirmed primary intradural and extradural spinal hydatid cyst in an otherwise healthy patient causing spinal cord compression. The patient had atypical symptoms on presentation with sudden onset of paraplegia and hence, the diagnosis was not established pre-operatively. The patient underwent spinal decompression surgery resulting in complete recovery. However there was a recurrence at the 24 months follow-up for which she was treated in a similar fashion

  9. Thyroid Nodules in an 11-Year DanThyr Follow-Up Study

    DEFF Research Database (Denmark)

    Krejbjerg, Anne; Bjergved, Lena; Pedersen, Inge Bulow

    2014-01-01

    Context: Limited longitudinal data are available on changes in the thyroid gland structure in a population and how this is influenced by iodine fortification (IF). Objective: Our objective was to clarify how IF influenced thyroid gland structure in 2 regions with different iodine intake at baseline...... was performed by the same sonographers using the same equipment, after controlling performances. Main Outcome Measure: Change in thyroid gland structure was evaluated. Results: The follow-up period saw an increased prevalence of multinodularity (9.8%-13.8%, P...

  10. Survival and psychosocial adjustment to stoma surgery and nonstoma bowel resection: a 4-year follow-up.

    NARCIS (Netherlands)

    Bekkers, M.J.T.M.; Knippenberg, F.C.E. van; Dulmen, A.M. van; Borne, H.W. van den; Berge Henegouwen, G.P. van

    1997-01-01

    A prospective 4-year follow-up study was conducted to compare the psychosocial adjustment process and survival rate of 59 stoma patients with 64 bowel-resected nonstoma patients. Adjustment was assessed at 4 months, 1 year, and 4 years after surgery by the Psychosocial Adjustment to Illness Scale

  11. Mortality and functional status at one-year of follow-up in elderly patients with prolonged ICU stay.

    Science.gov (United States)

    Pintado, M C; Villa, P; Luján, J; Trascasa, M; Molina, R; González-García, N; de Pablo, R

    2016-01-01

    To evaluate mortality and functional status at one year of follow-up in patients>75 years of age who survive Intensive Care Unit (ICU) admission of over 14 days. A prospective observational study was carried out. A Spanish medical-surgical ICU. Patients over 75 years of age admitted to the ICU. ICU admission: demographic data, baseline functional status (Barthel index), baseline mental status (Red Cross scale of mental incapacity), severity of illness (APACHE II and SOFA), stay and mortality. One-year follow-up: hospital stay and mortality, functional and mental status, and one-year follow-up mortality. A total of 176 patients were included, of which 22 had a stay of over 14 days. Patients with prolonged stay did not show more ICU mortality than those with a shorter stay in the ICU (40.9% vs 25.3% respectively, P=.12), although their hospital (63.6% vs 33.8%, P<.01) and one-year follow-up mortality were higher (68.2% vs 41.2%, P=.02). Among the survivors, one-year mortality proved similar (87.5% vs 90.6%, P=.57). These patients presented significantly greater impairment of functional status at hospital discharge than the patients with a shorter ICU stay, and this difference persisted after three months. The levels of independence at one-year follow-up were never similar to baseline. No such findings were observed in relation to mental status. Patients over 75 years of age with a ICU stay of more than 14 days have high hospital and one-year follow-up mortality. Patients who survive to hospital admission did not show greater mortality, though their functional dependency was greater. Copyright © 2015 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  12. Leisure time physical activity in a 22-year follow-up among Finnish adults

    Directory of Open Access Journals (Sweden)

    Borodulin Katja

    2012-10-01

    Full Text Available Abstract Background The aim of this study was to explore long-term predictors of leisure time physical activity in the general population. Methods This study comprised 718 men and women who participated in the national Mini-Finland Health Survey from 1978–1980 and were re-examined in 2001. Participants were aged 30–80 at baseline. Measurements included interviews, health examinations, and self-administered questionnaires, with information on socioeconomic position, occupational and leisure time physical activity, physical fitness, body mass index, smoking, alcohol consumption, and physical functional capacity. Analyses included persons who were working and had no limitations in functional capacity at baseline. Results The strongest predictor of being physically active at the follow-up was participation in physical activity at baseline, with an OR 13.82 (95%CI 5.50-34.70 for 3 or more types of regular activity, OR 2.33 (95%CI 1.22-4.47 for 1–2 types of regular activity, and OR 3.26 (95%CI 2.07-5.15 for irregular activity, as compared to no activity. Other determinants for being physically active were moving upwards in occupational status, a high level of baseline occupational physical activity and remaining healthy weight during the follow-up. Conclusions To prevent physical inactivity among older adults, it is important to promote physical activity already in young adulthood and in middle age and to emphasize the importance of participating in many types of physical activity.

  13. Permacol™ collagen paste injection for the treatment of complex anal fistula: 1-year follow-up.

    Science.gov (United States)

    Fabiani, B; Menconi, C; Martellucci, J; Giani, I; Toniolo, G; Naldini, G

    2017-03-01

    Optimal surgical treatment for anal fistula should result in healing of the fistula track and preserve anal continence. The aim of this study was to evaluate Permacol™ collagen paste (Covidien plc, Gosport, Hampshire, UK) injection for the treatment of complex anal fistulas, reporting feasibility, safety, outcome and functional results. Between May 2013 and December 2014, 21 consecutive patients underwent Permacol paste injection for complex anal fistula at our institutions. All patients underwent fistulectomy and seton placement 6-8 weeks before Permacol™ paste injection. Follow-up duration was 12 months. Eighteen patients (85.7%) had a high transsphincteric anal fistula, and three female patients (14.3%) had an anterior transsphincteric fistula. Fistulas were recurrent in three patients (14.3%). Seven patients (33%) had a fistula with multiple tracts. After a follow-up of 12 months, ten patients were considered healed (overall success rate 47.6%). The mean preoperative FISI score was 0.33 ± 0.57 and 0.61 ± 1.02 after 12 months. Permacol™ paste injection was safe and effective in some patients with complex anal fistula without compromising continence.

  14. Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment for drug dependence: a 5-year follow-up study.

    Science.gov (United States)

    Gossop, Michael; Stewart, Duncan; Marsden, John

    2008-01-01

    This study investigates the relationship between frequency of attendance at Narcotics Anonymous and Alcoholics Anonymous (NA/AA) meetings and substance use outcomes after residential treatment of drug dependence. It was predicted that post-treatment NA/AA attendance would be related to improved substance use outcomes. Using a longitudinal, prospective cohort design, interviews were conducted with drug-dependent clients (n = 142) at intake to residential treatment, and at 1 year, 2 years and 4-5 years follow-up. Data were collected by structured interviews. All follow-up interviews were carried out by independent professional interviewers. Abstinence from opiates was increased throughout the 5-year follow-up period compared to pre-treatment levels. Clients who attended NA/AA after treatment were more likely to be abstinent from opiates at follow-up. Abstinence from stimulants increased at follow-up but (except at 1-year follow-up) no additional benefit was found for NA/AA attendance. There was no overall change in alcohol abstinence after treatment but clients who attended NA/AA were more likely to be abstinent from alcohol at all follow-up points. More frequent NA/AA attenders were more likely to be abstinent from opiates and alcohol when compared both to non-attenders and to infrequent (less than weekly) attenders. NA/AA can support and supplement residential addiction treatment as an aftercare resource. In view of the generally poor alcohol use outcomes achieved by drug-dependent patients after treatment, the improved alcohol outcomes of NA/AA attenders suggests that the effectiveness of existing treatment services may be improved by initiatives that lead to increased involvement and engagement with such groups.

  15. Cementless acetabular fixation in patients 50 years and younger at 10 to 18 years of follow-up.

    Science.gov (United States)

    Teusink, Matthew J; Callaghan, John J; Warth, Lucian C; Goetz, Devon D; Pedersen, Douglas R; Johnston, Richard C

    2012-08-01

    The purpose of the study was to evaluate the 10- to 18-year follow-up of cementless acetabular fixation in patients 50 years and younger. We retrospectively reviewed a consecutive group of 118 patients (144 hips) in whom primary total hip arthroplasty had been performed by 2 surgeons using a cementless acetabular component. Two (1.4%) cementless acetabular components were revised because of aseptic loosening. Twenty-four hips (16.7%) were revised for any mechanical failure of the acetabular component mostly related to acetabular liner wear and osteolysis. The average linear wear rate was 0.19 mm per year, which was higher than our previous reports with cemented acetabular fixation. The fiber mesh ingrowth surface of the cementless acetabular component in this study was superior to cemented acetabular components in terms of fixation. However, the high rates of wear and osteolysis have led to poor overall acetabular component construct survivorship.

  16. Two-year follow-up of a randomized effectiveness trial evaluating MST for juveniles who sexually offend.

    Science.gov (United States)

    Letourneau, Elizabeth J; Henggeler, Scott W; McCart, Michael R; Borduin, Charles M; Schewe, Paul A; Armstrong, Kevin S

    2013-12-01

    Building on prior efficacy trials (i.e., university-based, graduate students as therapists), the primary purpose of this study was to determine whether favorable 12-month outcomes, obtained in a randomized effectiveness trial (i.e., implemented by practitioners in a community mental health center) of multisystemic therapy (MST) with juveniles who had sexually offended (JSO), were sustained through a second year of follow-up. JSO (n = 124 male youth) and their families were randomly assigned to MST, which was family based and delivered by community-based practitioners, or to treatment as usual (TAU), which was primarily group-based cognitive-behavioral interventions delivered by professionals within the juvenile justice system. Youth averaged 14.7 years of age (SD = 1.7) at referral, were primarily African American (54%), and 30% were Hispanic. All youth had been diverted or adjudicated for a sexual offense. Analyses examined whether MST effects reported previously at 1-year follow-up for problem sexual behaviors, delinquency, substance use, and out-of-home placement were sustained through a second year of follow-up. In addition, arrest records were examined from baseline through 2-year follow-up. During the second year of follow-up, MST treatment effects were sustained for 3 of 4 measures of youth problem sexual behavior, self-reported delinquency, and out-of-home placements. The base rate for sexual offense rearrests was too low to conduct statistical analyses, and a between-groups difference did not emerge for other criminal arrests. For the most part, the 2-year follow-up findings from this effectiveness study are consistent with favorable MST long-term results with JSO in efficacy research. In contrast with many MST trials, however, decreases in rearrests were not observed.

  17. Critical incident stress intervention after loss of an air ambulance: two-year follow up.

    Science.gov (United States)

    Macnab, A J; Russell, J A; Lowe, J P; Gagnon, F

    1999-01-01

    Following an air ambulance crash with five fatalities, critical incident stress debriefing (CISD) was provided for involved paramedics, physicians, and nurses. A study was conducted to evaluate the long-term effects of a critical incident with critical incident stress debriefing according to the Mitchell model. Six months following the incident, empirically designed questionnaires were mailed to all transport paramedics and directly involved medical staff, and a random sample of both nurses from the dispatch/receiving institution and paramedics from around the province. Twenty-four months post-incident, all members of the transport paramedics completed the Impact of Events Scale and the General Health Questionnaires. There were no differences between groups on any scores, except for disturbed sleep patterns, bad dreams, and the need for personal counseling being greater among transport paramedics at one day. There was no correlation between how well the deceased individuals were known, amount of debriefing, and symptom severity. A trend was seen for those with pre-existing stress management routines to have less severe symptoms at six months (p = 0.07). At two years, 16% of transport paramedics still had significant abnormal behavior. CISD did not appear to affect the severity of stress symptoms, whereas having pre-existing stress management strategies may. These findings give justification for proceeding to a randomized, controlled trial of different levels of critical incident stress intervention.

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  19. Subjective memory complaints in primary care patients and death from all causes: a four-year follow-up

    DEFF Research Database (Denmark)

    Siersma, Volkert Dirk; Waldemar, Gunhild; Waldorff, Frans Boch

    2013-01-01

    -related quality of life were collected at the enrolment primary care consultation. Dates of death from all causes occurring during the four-year follow-up were retrieved from the national databases. Cox proportional hazard regression models on time to death (censored after four years) were used to examine......OBJECTIVE: To investigate the prognostic value of subjective memory complaints for all-cause mortality in order to determine whether elderly persons with subjective memory complaints may be regarded as a group of vulnerable patients who need close follow-up. DESIGN: Prospective cohort study...... the influence of subjective memory complaints on all-cause mortality. RESULTS: 88 patients died during the four-year follow-up. The association between subjective memory complaints and mortality had a statistically not significant hazard ratio (HR) of 0.91, adjusting for known confounders. Statistically...

  20. Clinical results of Maverick lumbar total disc replacement: two-year prospective follow-up.

    Science.gov (United States)

    Le Huec, J C; Mathews, H; Basso, Y; Aunoble, S; Hoste, D; Bley, B; Friesem, T

    2005-07-01

    Disc prosthesis is the new treatment for degenerative disc disease in the lumbar spine. Key to assessing the interest in this new motion technique is evaluating the results in terms of functional and radiologic outcomes. This prospective study reports the outcome of 64 Maverick devices implanted between January 2002 and November 2003. The degree of improvement was equivalent to that obtained with anterior fusion cages using the mini-invasive technique. Radiographic follow-up in this series showed a degree of mobility close to normal. The technique is safe because the intra- and postoperative complication rate is low. The Oswestry score improved for 75% of patients. This improvement is significantly correlated with facet arthrosis and muscle fatty degeneration.

  1. Forty-five-year follow-up on the renal function after spinal cord injury

    DEFF Research Database (Denmark)

    Elmelund, M; Oturai, P S; Toson, B;

    2016-01-01

    STUDY DESIGN: Retrospective chart review. OBJECTIVES: To investigate the extent of renal deterioration in patients with spinal cord injury (SCI) and to identify risk indicators associated with renal deterioration. SETTING: Clinic for Spinal Cord Injuries, Rigshospitalet, Hornbæk, Denmark. METHODS......: This study included 116 patients admitted to our clinic with a traumatic SCI sustained between 1956 and 1975. Results from renography and (51)Cr-EDTA plasma clearance were collected from medical records from time of injury until 2012, and the occurrence of renal deterioration was analysed by cumulative...... increased the risk of moderate and severe renal deterioration. CONCLUSION: Renal deterioration occurs at any time after injury, suggesting that lifelong follow-up examinations of the renal function are important, especially in patients with dilatation of UUT and/or renal/ureter stones....

  2. Determinants of aortic stiffness: 16-year follow-up of the Whitehall II study.

    Directory of Open Access Journals (Sweden)

    Nanna B Johansen

    Full Text Available BACKGROUND: Aortic stiffness is a strong predictor of cardiovascular disease endpoints. Cross-sectional studies have shown associations of various cardiovascular risk factors with aortic pulse wave velocity, a measure of aortic stiffness, but the long-term impact of these factors on aortic stiffness is unknown. METHODS: In 3,769 men and women from the Whitehall II cohort, a wide range of traditional and novel cardiovascular risk factors were determined at baseline (1991-1993 and aortic pulse wave velocity was measured at follow-up (2007-2009. The prospective associations between each baseline risk factor and aortic pulse wave velocity at follow-up were assessed through sex stratified linear regression analysis adjusted for relevant confounders. Missing data on baseline determinants were imputed using the Multivariate Imputation by Chained Equations. RESULTS: Among men, the strongest predictors were waist circumference, waist-hip ratio, heart rate and interleukin 1 receptor antagonist, and among women, adiponectin, triglycerides, pulse pressure and waist-hip ratio. The impact of 10 centimeter increase in waist circumference on aortic pulse wave velocity was twice as large for men compared with women (men: 0.40 m/s (95%-CI: 0.24;0.56; women: 0.17 m/s (95%-CI: -0.01;0.35, whereas the opposite was true for the impact of a two-fold increase in adiponectin (men: -0.30 m/s (95%-CI: -0.51;-0.10; women: 0.61 m/s (95%-CI: -0.86;-0.35. CONCLUSION: In this large prospective study, central obesity was a strong predictor of aortic stiffness. Additionally, heart rate in men and adiponectin in women predicted aortic pulse wave velocity suggesting that strategies to prevent aortic stiffening should be focused differently by sex.

  3. Floating shoulders: Clinical and radiographic analysis at a mean follow-up of 11 years

    Directory of Open Access Journals (Sweden)

    ReÌ gis Pailhes

    2013-01-01

    Full Text Available Context: The floating shoulder (FS is an uncommon injury, which can be managed conservatively or surgically. The therapeutic option remains controversial. Aims: The goal of our study was to evaluate the long-term results and to identify predictive factors of functional outcomes. Settings and Design: Retrospective monocentric study. Materials and Methods: Forty consecutive FS were included (24 nonoperated and 16 operated from 1984 to 2009. Clinical results were assessed with Simple Shoulder Test (SST, Oxford Shoulder Score (OSS, Single Assessment Numeric Evaluation (SANE, Short Form-12 (SF12, Disabilities of the Arm Shoulder and Hand score (DASH, and Constant score (CST. Plain radiographs were reviewed to evaluate secondary displacement, fracture healing, and modification of the lateral offset of the gleno-humeral joint (chest X-rays. New radiographs were made to evaluate osteoarthritis during follow-up. Statistical Analysis Used: T-test, Mann-Whitney test, and the Pearson′s correlation coefficient were used. The significance level was set at 0.05. Results: At mean follow-up of 135 months (range 12-312, clinical results were satisfactory regarding different mean scores: SST 10.5 points, OSS 14 points, SANE 81%, SF12 (50 points and 60 points, DASH 14.5 points and CST 84 points. There were no significant differences between operative and non-operative groups. However, the loss of lateral offset influenced the results negatively. Osteoarthritis was diagnosed in five patients (12.5% without correlation to fracture patterns and type of treatment. Conclusions: This study advocates that floating shoulder may be treated conservatively and surgically with satisfactory clinical long-term outcomes. However, the loss of gleno-humeral lateral offset should be evaluated carefully before taking a therapeutic option.

  4. Randomized Clinical Trials on Deep Carious Lesions: 5-Year Follow-up.

    Science.gov (United States)

    Bjørndal, L; Fransson, H; Bruun, G; Markvart, M; Kjældgaard, M; Näsman, P; Hedenbjörk-Lager, A; Dige, I; Thordrup, M

    2017-07-01

    Deep caries presents a dilemma in terms of which treatment that will render an optimal prognosis by maintaining pulp vitality with absence of apical pathology. Previously, 2 randomized clinical trials were performed testing the short-term effects of stepwise carious tissue removal versus nonselective carious removal to hard dentin with or without pulp exposure. The aim of this article was to report the 5-y outcome on these previously treated patients having radiographically well-defined carious lesions extending into the pulpal quarter of the dentin but with a well-defined radiodense zone between the carious lesion and the pulp. In this long-term study, 239 of 314 (76.2%) patients were analyzed. The stepwise removal group had a significantly higher proportion of success (60.2%) at 5-y follow-up compared with the nonselective carious removal to hard dentin group (46.3%) ( P = 0.031) when pulp exposures per se were included as failures. Pulp exposure rate was significantly lower in the stepwise carious removal group (21.2% vs. 35.5%; P = 0.014). Irrespective of pulp exposure status, the difference (13.3%) was still significant when sustained pulp vitality without apical radiolucency and unbearable pain was considered (95% confidence interval, 3.1-26.3, P = 0.045). After pulp exposure, only 9% ( n = 4) of the analyzed patients were assessed as successful, indicating that the prognosis is highly dubious following conventional pulp-capping procedures (direct pulp capping or partial pulpotomy) in deep carious lesions in adults. In conclusion, the stepwise carious removal group had a significantly higher proportion of pulps with sustained vitality without apical radiolucency versus nonselective carious removal of deep carious lesions in adult teeth at 5-y follow-up ( ClinicalTrials.gov NCT00187837 and NCT00187850).

  5. One-Year Follow-Up of Combined Parent and Child Intervention for Young Children with ADHD

    Science.gov (United States)

    Webster-Stratton, Carolyn; Reid, M. Jamila; Beauchaine, Theodore P.

    2013-01-01

    Efficacies of the Incredible Years (IY) interventions are well-established in children with oppositional defiant disorder (ODD) but not among those with a primary diagnosis of attention-deficit/hyperactivity disorder (ADHD). We sought to evaluate 1-year follow-up outcomes among young children with ADHD who were treated with the IY interventions.…

  6. Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: outcome is stable in 35-month follow-up.

    Science.gov (United States)

    Högberg, Göran; Pagani, Marco; Sundin, Orjan; Soares, Joaquim; Aberg-Wistedt, Anna; Tärnell, Berit; Hällström, Tore

    2008-05-30

    Post-traumatic stress disorder (PTSD) is an anxiety disorder that may follow major psychological trauma. The disorder is longstanding, even chronic, and there is a need for effective treatment. The most effective short-term treatments are cognitive behavioural therapy and eye movement desensitization and reprocessing (EMDR). Twenty subjects with chronic PTSD following occupational health hazards from "person under train" accidents or assault at work were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before treatment, directly after treatment, at 8 months, and at 35 months after the end of Therapy. The primary outcome variable was full diagnosis of PTSD according to the DSM-IV diagnostic criteria. Results from interview-based and self-evaluation psychometric scales were used as secondary outcome variables. Immediately following treatment, the patients were divided up into two groups, initial remitters (12 of 20) and non-remitters (8 of 20). There were no drop-outs during therapy, but three patients withdrew during follow-up. The initial result was maintained at the 35-month follow-up. The secondary outcome variables also showed a significant immediate change towards normality that was stable during the long-term follow-up. After 3 years of follow-up, 83% of the initial remitters had full working capacity.

  7. Pregnancy with aortic dissection in Ehler-Danlos syndrome. Staged replacement of the total aorta (10-year follow-up).

    Science.gov (United States)

    Babatasi, G; Massetti, M; Bhoyroo, S; Khayat, A

    1997-10-01

    Pregnancy complicated by aortic dissection in patients with hereditary disorder of connective tissue presents interesting considerations including management of caesarean section with the unexpected need for cardiac surgery in emergency. Generalizations can be made on management principles with long-term follow-up requiring an aggressive individualized approach by a multidisciplinary team. A 33-year-old parturient presenting an aortic dissection at 37 weeks gestation required prompt diagnosis of Ehlers-Danlos syndrome in combination with correct surgical therapy resulted in the survival of both the mother and infant. During the 10-year follow-up, multiple complex dissection required transverse aortic arch and thoracoabdominal aortic replacement.

  8. Treatment of Class II Division 2 Malocclusion Using the Forsus Fatigue Resistance Device and 5-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Ezgi Atik

    2016-01-01

    Full Text Available This case report presents the treatment of a 14-year-and-8-month-old boy with Class II division 2 mandibular retrusion, severe deep bite, and concave profile. The Forsus fatigue resistance device (FRD was effective in correcting both skeletal and dental parameters. At 5-year posttreatment follow-up, the teeth were well aligned and the occlusion was stable. FRD application with appropriate treatment time can result with prominent changes in the facial profile and dentition, and the outcomes can be maintained at the long-term follow-up periods.

  9. Nocardia asteroides sinusitis in a pediatric patient: Case report with 20 year follow-up and review of the literature.

    Science.gov (United States)

    Sorichetti, Brendan; Westerberg, Brian D; Tan, Rusung; Kozak, Frederick K

    2015-07-01

    Nocardia Asteroides infection in a non-immunocompromised pediatric patient is extremely rare. We present a case of ethmoid sinusitis and orbital subperiosteal abscess caused by N. asteroides with a 20 year follow up and a review of the literature. N. asteroides was grown from intraoperative cultures for mycobacteria following surgical incision and drainage of the abscess. Postoperatively, the patient received a seven month course of trimethoprim-sulfamethozaxole and had no subsequent sequelae. Nocardia infections are common in immunocompromised patients. We present what we believe to be the first case of pediatric Nocardia sinusitis with 20-year follow up.

  10. Comparative randomized study on the efficaciousness of endoscopic bipolar prostate resection versus monopolar resection technique. 3 year follow-up

    Directory of Open Access Journals (Sweden)

    Roberto Giulianelli

    2013-06-01

    Full Text Available Objective: Transurethral resection of the prostate (TURP is the current optimal thera- py for the relief of bladder outflow obstruction, with subjective and objective success rate of 85 to 90%. Aim of this study was to evaluate efficacy and safety of Plasmakinetic ener- gy (Gyrus electro surgical system, which produces vaporization of tissue immersed in isotonic saline against standard monopolar transurethral resection of the prostate. Methods: From January 2002 to April 2002, 160 consecutive patients, who had low urinary tract symptoms (LUTS of benign prostatic hyperplasia (BPH were enrolled in this study. Patients were randomised to undergo bipolar TURP (80 patients or monopolar TURP (80 patients. Preoperative work-up was assessed by administering IPSS, IIEF-5 and Qol questionnaires. All patients were submitted to uroflowmetry, transrectal ultrasound (TRUS, post-voidal residual urine measurement and PSA determination. In the two groups, IPSS, IIEF-5 and Qol, uroflowme- try, TRUS, post-voidal residual urine measurement, PSA determination and number of reopera- tions were evaluated at 1, 3, 6, 12, 18, 24, 30 and 36 months follow up, and then every year. Furthermore, in both groups operative time, resected tissue weight and perioperative complica- tions were analysed. Total postoperative catheter time, total post-operative hospital stay, haemo- globin loss were also recorded in the two groups. Results: Comparative data on IPSS symptom score, IIEF-5, Qol, PSA, peak urinary flow rate and post-void residual urine volume were similar in the two groups but showed a significant improve- ment respect to baseline values. The postoperative haemoglobin levels, postoperative catheteri- zation time, hospital stay and 3-year overall surgical re-treatment-free rate were significantly better in the bipolar group. Conclusions: Bipolar TURP has a comparable outcome to standard monopolar TURP at short and medium term regard to subjective and objective outcome

  11. Robot-assisted radical prostatectomy: histopathologic and biochemical recurrence data at one-year follow-up

    Science.gov (United States)

    Patel, Vipul; Thaly, Rahul; Shah, Ketul

    2007-02-01

    Introduction: Robotically assisted laparoscopic radical prostatectomy is a minimally invasive alternative for the treatment of prostate cancer. We report the histopathologic and short term PSA outcomes of 500 robotic prostatectomies. Materials and Methods: Five hundred patients underwent robotic radical prostatectomy. The procedure was performed via a six trocar transperitoneal technique. Prostatectomy specimens were analyzed for TNM Stage, Gleason's grade, tumor location, volume, specimen weight, seminal vesicle involvement and margin status. A positive margin was reported if cancer cells were found at the inked specimen margin. PSA data was collected every three months for the first year, then every six months for a year, then yearly. Results: Average pre-operative PSA was 6.9 (1-90) with Gleason's score of 5 (2%), 6 (52%), 7 (40%), 8 (4%), 9(2%). Post operatively histopathologic analysis showed Gleason's 6 (44%), 7(42%), 8(10%), 9(4%). 10%, 5%, 63%, 15%, 5% and 2% had pathologic stage T2a, T2b, T2c, T3a, T3b and T4 respectively. Positive margin rate was 9.4% for the entire series. The positive margin rate per 100 cases was: 13% (1-100), 8% (101-200), 13% (201-300), 5% (301-400) and 8% (401-500). By stage it was 2%, 4%, 2.5% for T2a, T2b, T2c tumors, 23% (T3a), 46% (T3b) and 53% (T4a). For organ confined disease (T2) the margin rate was 2.5% and 31% for non organ confined disease. There were a total of 47 positive margins, 26 (56%) posterolateral, 4 (8.5%) apical, 4 (8.5%) bladder neck, 2 (4%) seminal vesicle and 11 (23%) multifocally. Ninety five percent of patients (n=500) have undetectable PSA (<0.1) at average follow up of 9.7 months. Recurrence has only been seen with non organ confined tumors. Those patients with a minimum follow up of 1 year (average 15.7 months) 95% have undetectable PSA (<.1). Conclusion: Our initial experience with robotic radical prostatectomy is promising. Histopathologic outcomes are acceptable with a low overall margin positive rate

  12. One year follow-up of the multi-centre European PARTNER transcatheter heart valve study

    Science.gov (United States)

    Lefèvre, Thierry; Kappetein, Ari Pieter; Wolner, Ernst; Nataf, Patrick; Thomas, Martyn; Schächinger, Volker; De Bruyne, Bernard; Eltchaninoff, Hélène; Thielmann, Matthias; Himbert, Dominique; Romano, Mauro; Serruys, Patrick; Wimmer-Greinecker, Gerhard

    2011-01-01

    Background Transcatheter aortic valve implantation (TAVI) has emerged as a new therapeutic option in high-risk patients with severe aortic stenosis. Aims PARTNER EU is the first study to evaluate prospectively the procedural and mid-term outcomes of transfemoral (TF) or transapical (TA) implantation of the Edwards SAPIEN® valve involving a multi-disciplinary approach. Methods and results Primary safety endpoints were 30 days and 6 months mortality. Primary efficacy endpoints were haemodynamic and functional improvement at 12 months. One hundred and thirty patients (61 TF, 69 TA), aged 82.1 ± 5.5 years were included. TA patients had higher logistic EuroSCORE (33.8 vs. 25.7%, P = 0.0005) and more peripheral disease (49.3 vs. 16.4%, P< 0.0001). Procedures were aborted in four TA (5.8%) and six TF cases (9.8%). Valve implantation was successful in the remaining patients in 95.4 and 96.4%, respectively. Thirty days and 6 months survival were 81.2 and 58.0% (TA) and 91.8 and 90.2% (TF). In both groups, mean aortic gradient decreased from 46.9 ± 18.1 to 10.9 ± 5.4 mmHg 6 months post-TAVI. In total, 78.1 and 84.8% of patients experienced significant improvement in New York Heart Association (NYHA) class, whereas 73.9 and 72.7% had improved Kansas City Cardiomyopathy Questionnaire (KCCQ) scores in TA and TF cohorts, respectively. Conclusion This first team-based multi-centre European TAVI registry shows promising results in high-risk patients treated by TF or TA delivery. Survival rates differ significantly between TF and TA groups and probably reflect the higher risk profile of the TA cohort. Optimal patient screening, approach selection, and device refinement may improve outcomes. PMID:21075775

  13. EVOLUTION OF HIV-1 VIRAL LOAD IN PATIENTS FOLLOWED-UP FOR OVER 3 YEARS

    Directory of Open Access Journals (Sweden)

    Labayru C

    2006-02-01

    Full Text Available ABSTRACTObjectives: To describe the evolution of a Human Immunodeficiency Virus Type 1 (HIV-1 infected patient cohort monitored for over 1,000 days.Methods: HIV-1 Viral Load (VL, CD4/l lymphocyte values and antiretroviral therapies given to the patients were evaluated throughout the follow-up period. We present a retrospective descriptive study of the HIV-1 VL determinations performed on 369 individuals followed-up for over 1,000 days.Results: The "non-detectable" VL ( 100.000 copies/ml from the interval of 0-75 days up to the interval of 501-1,000 days (t-test, p=0.005; at that point, results switched to the opposite.Conclusions: Both CD4/ cell count lower than 200x106 and patients receiving highly active antiretroviral therapies (HAART were related to "non-detectable" VL levels. In our series the time period between 700 and 1,000 days can be the maximum interval for benefits from therapy and virology evaluation.RESUMENObjetivo: Describir la evolución de una cohorte de pacientes con infección por el Virus de la Inmunodeficiencia Humana (VIH monitorizados durante más 3 años.Métodos: Durante el período de seguimiento se han evaluado en 396 individuos con infección VIH, seguidos durante más de 1000 días los parámetros de carga viral, valores de linfocitos CD4 y terapia antirretroviral.Resultados: Las porcentajes de carga viral no detectable (100.000 copias/ARN/ml, y su rango adquirió significación desde el intervalo de 0-75 días de seguimiento al de 501-100 días (t-test, p=0.005. Los recuentos de CD4 bajos (<200 en pacientes que recibieron Terapia antirretroviral de alta eficacia se asociaron a valores indetectables de carga viral.Conclusiones: En nuestra serie el período situado entre 700-100 días representó el intervalo de máximo beneficio para la evaluación virológica y terapéutica.

  14. Preoperative pain neuroscience education for lumbar radiculopathy: a multicenter randomized controlled trial with 1-year follow-up.

    Science.gov (United States)

    Louw, Adriaan; Diener, Ina; Landers, Merrill R; Puentedura, Emilio J

    2014-08-15

    Multicenter, randomized, controlled trial on preoperative pain neuroscience education (NE) for lumbar radiculopathy. To determine if the addition of NE to usual preoperative education would result in superior outcomes with regard to pain, function, surgical experience, and health care utilization postsurgery. One in 4 patients after lumbar surgery (LS) for radiculopathy experience persistent pain and disability, which is nonresponsive to perioperative treatments. NE focusing on the neurophysiology of pain has been shown to decrease pain and disability in populations with chronic low back pain. Eligible patients scheduled for LS for radiculopathy were randomized to receive either preoperative usual care (UC) or a combination of UC plus 1 session of NE delivered by a physical therapist (verbal one-on-one format) and a NE booklet. Sixty-seven patients completed the following outcomes prior to LS (baseline), and 1, 3, 6, and 12 months after LS: low back pain (numeric rating scale), leg pain (numeric rating scale), function (Oswestry Disability Index), various beliefs and experiences related to LS (10-item survey with Likert scale responses), and postoperative utilization of health care (utilization of health care questionnaire). At 1-year follow-up, there were no statistical differences between the experimental and control groups with regard to primary outcome measure of low back pain (P = 0.183), leg pain (P = 0.075), and function (P = 0.365). In a majority of the categories regarding surgical experience, the NE group scored significantly better: better prepared for LS (P = 0.001); preoperative session preparing them for LS (P < 0.001) and LS meeting their expectations (P = 0.021). Health care utilization post-LS also favored the NE group (P = 0.007) resulting in 45% less health care expenditure compared with the control group in the 1-year follow-up period. NE resulted in significant behavior change. Despite a similar pain and functional trajectory during the 1-year

  15. Erosion or normal variant? 4-year MRI follow-up of the wrists in healthy children

    Energy Technology Data Exchange (ETDEWEB)

    Avenarius, Derk F.M. [University of Tromsoe, Faculty of Health Sciences, Tromsoe (Norway); University Hospital of North Norway, Department of Radiology, Tromsoe (Norway); Ording Mueller, Lil-Sofie [Oslo University Hospital, Department for Radiology and Intervention, Oslo (Norway); Rosendahl, Karen [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Department of Clinical Medicine K1, Bergen (Norway)

    2016-03-15

    A large proportion of healthy children have wrist changes on MRI, namely carpal depressions, findings that have been described as pathological in children with juvenile idiopathic arthritis. We performed follow-up imaging in a cohort of healthy children to evaluate carpal surface depressions over time, focusing on the presence of overlying cartilage as a potential discriminator between normal variants and true erosions. 74 of the initial cohort of 89 healthy children (83%) had a re-scan of their wrists using the same protocol, including coronal T1 and fat-saturated T2 sequences. A cartilage-selective sequence was added for this study. We registered number and location of bony depressions and presence of overlying cartilage. The total number of carpal depressions increased by age group and over time; their location was unchanged in 370 of 487 (76%) carpal sites and 91 of 117 (78%) metacarpal sites. In total, 426 of the 1,087 (39.2%) bony depressions were covered by cartilage, with a decreasing percentage by age (P = 0.001). Normal appearances during growth, such as bony depressions, should not be mistaken for pathology. There must be additional findings to support a diagnosis of disease. A cartilage sequence may add to the diagnostic image analysis. (orig.)

  16. Cause-specific mortality by education in Canada: a 16-year follow-up study.

    Science.gov (United States)

    Tjepkema, Michael; Wilkins, Russell; Long, Andrea

    2012-09-01

    People with lower levels of education tend to have higher rates of disease and death, compared with people who have higher levels of education. However, because death registrations in Canada do not contain information on the education of the deceased, unlinked vital statistics cannot be used to examine mortality differentials by education. This study examines cause-specific mortality rates by education in a broadly representative sample of Canadians aged 25 or older. The data are from the 1991 to 2006 Canadian census mortality follow-up study, which included about 2.7 million people and 426,979 deaths. Age-standardized mortality rates (ASMRs) were calculated by education for different causes of death. Rate ratios, rate differences and excess mortality were also calculated. All-cause ASMRs were highest among people with less than secondary graduation and lowest for university degree-holders. If all cohort members had the mortality rates of those with a university degree, the overall ASMRs would have been 27% lower for men and 22% lower for women. The causes contributing most to that "excess" mortality were ischemic heart disease, lung cancer, chronic obstructive pulmonary disease, stroke, diabetes, injuries (men), and respiratory infections (women). Causes associated with smoking and alcohol abuse had the steepest gradients. A mortality gradient by education was evident for many causes of death.

  17. Eight years of accurate photometric follow-up of transiting giant exoplanets

    CERN Document Server

    Mancini, Luigi

    2016-01-01

    Since 2008 we have run an observational program to accurately measure the characteristics of known exoplanet systems hosting close-in transiting giant planets, i.e. hot Jupiters. Our study is based on high-quality photometric follow-up observations of transit events with an array of medium-class telescopes, which are located in both the northern and the southern hemispheres. A high photometric precision is achieved through the telescope-defocussing technique. The data are then reduced and analysed in a homogeneous way for estimating the orbital and physical parameters of both the planets and their parent stars. We also make use of multi-band imaging cameras for probing planetary atmospheres via the transmission-photometry technique. In some cases we adopt a two-site observational strategy for collecting simultaneous light curves of individual transits, which is the only completely reliable method for truly distinguishing a real astrophysical signal from systematic noise. In this contribution we review the mai...

  18. Thirteen years follow-up of heart myxoma operated patients: what is the appropriate surgical technique?

    Science.gov (United States)

    Siminelakis, Stavros; Kakourou, Alexandra; Batistatou, Alexandra; Sismanidis, Stelios; Ntoulia, Alexandra; Tsakiridis, Kosmas; Syminelaki, Theodora; Apostolakis, Eleftherios; Tsiouda, Theodora; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Dryllis, Georgios; Machairiotis, Nikolaos; Mpakas, Andreas; Beleveslis, Thomas; Zarogoulidis, Konstantinos

    2014-01-01

    Background Cardiac myxoma is a benign neoplasm that represents the most prevalent primary tumor of the heart. If not treated with the right surgical technique recurrence occurs. Aim of our study is to present our surgical approach and the histology of the tumors resected. Methods All patients, except for one, underwent extracorporeal circulation and mild hypothermia, right atrial or both atrial incision and excision of the fossa ovalis, followed by prosthetic patch suturing. All specimens were submitted for microscopic evaluation (haematoxylin-eosin). We contacted personally each patient and asked them to complete a standardized questionnaire, concerning their peri-operative characteristics. Results Six cases were “active” myxomas, 3 were “mildly active” and 3 were “inactive”. “Normal differentiation” was seen in 6, “medium” in 1 and “poor” in 5 cases. In our series there were no recurrences recorded during the follow-up period. Conclusions The ideal approach, according to our experience is right atrial or both atrial incision as described by Shumacker and King, with excision of the fossa ovalis and the surrounding tissues and closure with a pericardial patch. Such a technique provides an excellent long-term survival in these patients. PMID:24672697

  19. Twenty-four years of follow-up for a Hanford plutonium wound case.

    Science.gov (United States)

    Carbaugh, Eugene H; Lynch, Timothy P; Antonio, Cheryl L; Medina-Del Valle, Fernando

    2010-10-01

    A 1985 plutonium puncture wound resulted in the initial deposition of 48 kBq of transuranic alpha activity, primarily 239+240Pu and 241Am, in a worker's right index finger. Surgical excisions in the week following reduced the long-term residual wound activity to 5.4 kBq, and 164 DTPA chelation therapy administrations over 17 mo resulted in urinary excretion of about 7 kBq. The case was published in 1988, but now 24 y of follow-up data are available. Annual bioassays have included in-vivo measurements of 241Am in the wound, skeleton, liver, lung, and axillary lymph nodes, and urinalyses for plutonium and 241Am. These measurements have shown relatively stable levels of 241Am at the wound site, with gradually increasing amounts of 241Am detected in the skeleton. Liver measurements have shown erratic detection of 241Am, and the lung measurements indicate Am but as interference from activity in the axillary lymph nodes and skeleton rather than activity in the lung. Urine excretion of Pu since termination of chelation therapy has typically ranged from 10 to 20 mBq d, with Am excretion about 10% of that for 239+240Pu. Annual routine medical exams have not identified any adverse health effects associated with the intake.

  20. Comparative evaluation of formocresol and mineral trioxide aggregate in pulpotomized primary molars--2 year follow up.

    Science.gov (United States)

    Airen, Priyanka; Shigli, Anand; Airen, Bhuvnesh

    2012-01-01

    The aim of the present study was to clinically and radiographically evaluate Mineral Trioxide Aggregate (MTA) as an agent for pulpotomy in primary teeth and to compare it with that of Formocresol (FC) pulpotomy. Seventy first and second primary mandibular molars of children were chosen on patients who required minimum two pulpotomies in either arch or same arch. After the standardized technique of Pulpotomy with MTA and Formocresol, all molars were treated with a thick mix of Zinc oxide Eugenol cement into the coronal pulp chamber followed by preformed stainless steel crown. The children were followed up for clinical and radio graphical examination after 6, 12 and 24 month for Pain, Swelling, Sinus/fistula, Periapical changes, Furcation radiolucency and internal resorption. MTA represents 97% clinical success rate in comparison to Formocresol with 85% success. Radiographically also MTA showed more promising results with 88.6% success in comparison to Formocresol with 54.3%. Thus, MTA pulpotomy has emerged as an easier line of treatment to save the premature loss of primary teeth due to caries or trauma.

  1. Mineral trioxide aggregate and formocresol pulpotomy of primary teeth: a 2-year follow-up.

    Science.gov (United States)

    Ansari, G; Ranjpour, M

    2010-05-01

    To compare the clinical and radiographic response of primary teeth to vital pulpotomy using mineral trioxide aggregate (MTA) or formocresol (FC). A group of 17 children aged 4-9 were selected from those referred to the Paedodontic Department at Shahid Beheshti University, Dental School. Cases with at least two matching teeth were selected (40 teeth), showing signs of pulp involvement. A pulpotomy procedure was carried out in all cases with FC in control teeth whilst MTA was placed in experimental teeth. Clinical and radiographic evaluations were performed at 1-, 6-, 12- and 24-month recall. Statistical analysis using a Fischer exact test was performed on the data to determine significant differences between the groups. Overall, 22 second and 18 first primary molars were included. The gender ratio was one male to three female. No significant difference was found between the clinical and radiographic outcomes of the two groups at 6-, 12- and 24-month follow-up (P > 0.05). Internal resorption was seen significantly more often in FC cases after 12 months than MTA cases. Overall radiographic appearance of normal structures at 24th month was seen in more than 95% of the cases in MTA and 90% in the FC-treated group (P > 0.05). Mineral trioxide aggregate for pulp treatment of primary teeth can be considered a replacement for FC.

  2. Treatment of chronic anorexia nervosa: a 4-year follow-up of adult patients treated in an acute inpatient setting.

    Science.gov (United States)

    Long, Clive G; Fitzgerald, Kirsty-Anne; Hollin, Clive R

    2012-01-01

    Despite evidence from a number of long-term follow-up studies of anorexia nervosa that nearly 50% of patients eventually make a full recovery, controlled trials of psychotherapy for anorexia nervosa are lacking. Those with severe and enduring problems represent a considerable therapeutic challenge. Thirty-four consecutive adult referrals to the inpatient treatment unit who fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for anorexia nervosa were examined pre-admission, post-discharge and 4 years after admission. Characteristics of remitted and non-remitted patients were examined. Secondary analyses considered the differences between patients with anorexia nervosa, restricting type and anorexia nervosa binging/purging type. The findings highlight a number of differences between patients with anorexia nervosa (restricting type) versus anorexia nervosa (binging/purging type) as well as remitted versus non-remitted patients. The use of a comprehensive battery of assessments found that resolution of eating disorder symptomatology was paralleled by improvements in emotional and psychological distress and improvement in body image perception and coping skills. Better results were obtained for those who had continuity of care on an outpatient basis. This pattern is particularly significant given the more 'chronic' nature of the sample that were older, with a higher incidence of binge-eating and purging than previous samples. Results provide some encouragement for the treatment of those adults with anorexia nervosa who typically have less favourable outcomes. 

  3. The risk of newly developed visual impairment in treated normal-tension glaucoma: 10-year follow-up.

    Science.gov (United States)

    Choi, Yun Jeong; Kim, Martha; Park, Ki Ho; Kim, Dong Myung; Kim, Seok Hwan

    2014-12-01

    To investigate the risk and risk factors for newly developed visual impairment in treated patients with normal-tension glaucoma (NTG) followed up on for 10 years. Patients with NTG, who did not have visual impairment at the initial diagnosis and had undergone intraocular pressure (IOP)-lowering treatment for more than 7 years, were included on the basis of a retrospective chart review. Visual impairment was defined as either low vision (0.05 [20/400] ≤ visual acuity (VA) visual field (VF) visual impairment, Kaplan-Meier survival analysis and generalized linear mixed effects models were utilized. During the 10.8 years mean follow-up period, 20 eyes of 16 patients were diagnosed as visual impairment (12 eyes as low vision, 8 as blindness) among 623 eyes of 411 patients. The cumulative risk of visual impairment in at least one eye was 2.8% at 10 years and 8.7% at 15 years. The risk factors for visual impairment from treated NTG were worse VF mean deviation (MD) at diagnosis and longer follow-up period. The risk of newly developed visual impairment in the treated patients with NTG was relatively low. Worse VF MD at diagnosis and longer follow-up period were associated with development of visual impairment. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  4. HPV E6/E7 mRNA testing is more specific than cytology in post-colposcopy follow-up of women with negative cervical biopsy.

    Directory of Open Access Journals (Sweden)

    Sveinung Wergeland Sørbye

    Full Text Available BACKGROUND: In Norway, women with negative or low-grade cervical biopsies (normal/CIN1 are followed up after six months in order to decide on further follow-up or recall for screening at three-year intervals. A high specificity and positive predictive value (PPV of the triage test is important to avoid unnecessary diagnostic and therapeutic procedures whereas a low risk of high-grade disease among triage negative women assures safety. MATERIALS AND METHODS: At the University Hospital of North Norway, cytology and the HPV mRNA test PreTect HPV-Proofer, detecting E6/E7 mRNA from HPV types 16, 18, 31, 33 and 45, are used in post-colposcopy follow-up of women with negative or low-grade biopsy. In this study, women with negative biopsy after high grade cytology (ASC-H/HSIL and/or positive HPV mRNA test in the period 2005-2009 were included (n = 520. Histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+ was used as study endpoint. RESULTS: Of 520 women with negative or low-grade biopsy, 124 women (23.8% had CIN2+ in follow-up biopsy. The sensitivity and specificity of the HPV mRNA test were 89.1% (95% CI, 80.1-98.1 and 92.5% (95% CI, 88.2-96.7, respectively. The ratios of sensitivity, specificity and PPV of HPV mRNA testing compared to repeat cytology for finding CIN2+ was 1.05 (95% CI: 0.92-1.21, 1.21 (95% CI: 1.12-1.32, and 1.49 (95% CI: 1.20-1.86, respectively. The PPV of mRNA was 77.3% (95% CI, 59.8-94.8 in women aged 40 or older. CONCLUSION: Women with negative cervical biopsy require follow-up before resumption of routine screening. Post-colposcopy HPV mRNA testing was as sensitive but more specific than post-colposcopy cytology. In addition, the HPV mRNA test showed higher PPV. A positive mRNA test post-colposcopy could justify treatment in women above 40 years.

  5. HPV E6/E7 mRNA Testing Is More Specific than Cytology in Post-Colposcopy Follow-Up of Women with Negative Cervical Biopsy

    Science.gov (United States)

    Sørbye, Sveinung Wergeland; Arbyn, Marc; Fismen, Silje; Gutteberg, Tore Jarl; Mortensen, Elin Synnøve

    2011-01-01

    Background In Norway, women with negative or low-grade cervical biopsies (normal/CIN1) are followed up after six months in order to decide on further follow-up or recall for screening at three-year intervals. A high specificity and positive predictive value (PPV) of the triage test is important to avoid unnecessary diagnostic and therapeutic procedures whereas a low risk of high-grade disease among triage negative women assures safety. Materials and Methods At the University Hospital of North Norway, cytology and the HPV mRNA test PreTect HPV-Proofer, detecting E6/E7 mRNA from HPV types 16, 18, 31, 33 and 45, are used in post-colposcopy follow-up of women with negative or low-grade biopsy. In this study, women with negative biopsy after high grade cytology (ASC-H/HSIL) and/or positive HPV mRNA test in the period 2005–2009 were included (n = 520). Histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) was used as study endpoint. Results Of 520 women with negative or low-grade biopsy, 124 women (23.8%) had CIN2+ in follow-up biopsy. The sensitivity and specificity of the HPV mRNA test were 89.1% (95% CI, 80.1–98.1) and 92.5% (95% CI, 88.2–96.7), respectively. The ratios of sensitivity, specificity and PPV of HPV mRNA testing compared to repeat cytology for finding CIN2+ was 1.05 (95% CI: 0.92–1.21), 1.21 (95% CI: 1.12–1.32), and 1.49 (95% CI: 1.20–1.86), respectively. The PPV of mRNA was 77.3% (95% CI, 59.8–94.8) in women aged 40 or older. Conclusion Women with negative cervical biopsy require follow-up before resumption of routine screening. Post-colposcopy HPV mRNA testing was as sensitive but more specific than post-colposcopy cytology. In addition, the HPV mRNA test showed higher PPV. A positive mRNA test post-colposcopy could justify treatment in women above 40 years. PMID:21998748

  6. Natural history of spontaneous aortic intramural hematoma progression: Six years follow-up with cardiovascular magnetic resonance

    Directory of Open Access Journals (Sweden)

    Zhao Lei

    2010-05-01

    Full Text Available Abstract We described a 6 years follow-up of a spontaneous aortic intramural hematoma (IMH with cardiovascular magnetic resonance (CMR examination. Since multiple factors may play roles in the natural history of IMH, the patient experienced the course of progression, which included hematoma absorption, ulcer-like lesion, aneurysm and limited dissection. The initial and follow-up CMR examination included 3D CE MRA and non-enhanced "bright blood" pulse sequence. The inherent advantage of outstanding contrast with plain scan, which shorten the scan time and avoid potential risk of contrast agent, might make the fast gradient echo sequence as an alternative method when following stable IMH.

  7. Management of a multiple dentoalveolar trauma in permanent dentition with avulsion of a canine: a 4-year follow-up.

    Science.gov (United States)

    Senes, Andrea Melo; Sakai, Vivien T; Oliveira, Thais Marchini; Machado, Maria Aparecida A M; Santos, Carlos F; Marzola, Clóvis

    2008-03-01

    Traumatic dental injuries are relatively frequent accidents that typically involve teeth in the maxillary anterior segment. The emergency treatment and the clinical decisions must be efficiently made at the time of injury, and there is a need for long-term follow-up because of the high incidence of complications. The aim of this article was to present the emergency and rehabilitation treatments of a multiple dentoalveolar trauma in the permanent dentition involving different extensions of enamel-dentin crown fracture, pulp exposure, and the avulsion of a canine. The treatment outcomes are reported up to the 4-year follow-up, and the clinical approaches and their rationale are discussed.

  8. The Need of Vitrectomy in Young Danish Type 1 Diabetic Patients – A 15-year Follow-up study

    DEFF Research Database (Denmark)

    Broe, Rebecca; Grauslund, Jakob; Sjølie, Anne Katrin

    the age of 18 (n=720) were examined in 1986-89. In 1995 45 % of the original cohort (n=324) participated in a clinical follow-up study focusing on vascular complications. In 2010 we used the Danish Patient Register to determine, how many in the remaining cohort who had undergone vitrectomy and the date...... worse than for the female patients. Conclusions: Our results indicate that high levels of HbA1c in childhood and adolescence increase the risk of severe diabetic retinopathy with a need of vitrectomy. One in ten patients had undergone vitrectomy in a 15-year follow-up of a population-based cohort...

  9. Ten-Year Follow-up on Tumor Growth and Hearing in Patients Observed With an Intracanalicular Vestibular Schwannoma

    DEFF Research Database (Denmark)

    Kirchmann, Malene; Karnov, Kirstine; Hansen, Søren

    2017-01-01

    growth and hearing loss in 156 patients diagnosed with an intracanalicular VS and managed conservatively.  METHODS: In this longitudinal cohort study, diagnostic and follow-up magnetic resonance imaging and audiometry were compared.  RESULTS: After a follow-up of 9.5 years, tumor growth had occurred...... in 37% and growth into the cerebellopontine angle had occurred in 23% of patients. Conservative treatment failed in 15%. The pure tone average had increased from 51- to 72-dB hearing level, and the speech discrimination score (SDS) had decreased from 60% to 34%. The number of patients with good hearing...

  10. Predictors of health related job loss: a two-year follow-up study in a general working population

    DEFF Research Database (Denmark)

    Haahr, J. P.; Frost, P.; Andersen, JH

    2007-01-01

    employees. METHODS: A total of 39 workplaces with 5,604 employees aged from 18 to 67 years participated. Questionnaires were obtained at baseline and follow up. Participants reported reason for job loss whilst employers' information provided the date. Hazard Ratios (HR) for HRJL with 95% confidence...... intervals (CI) were analysed. RESULTS: 4006 responses were obtained at baseline (71.5%), and 3,276 (81.8%) at follow up. About 567 (17.3%) had lost their job, and 135 (23.8%) reported HRJL. 51.5% of HRJL was related to pain, disease, or discomfort in the neck, the back, arms, or legs, and another 23...

  11. The Need of Vitrectomy in Young Danish Type 1 Diabetic Patients – A 15-year Follow-up study

    DEFF Research Database (Denmark)

    Broe, Rebecca; Grauslund, Jakob; Sjølie, Anne Katrin

    the age of 18 (n=720) were examined in 1986-89. In 1995 45 % of the original cohort (n=324) participated in a clinical follow-up study focusing on vascular complications. In 2010 we used the Danish Patient Register to determine, how many in the remaining cohort who had undergone vitrectomy and the date...... worse than for the female patients. Conclusions: Our results indicate that high levels of HbA1c in childhood and adolescence increase the risk of severe diabetic retinopathy with a need of vitrectomy. One in ten patients had undergone vitrectomy in a 15-year follow-up of a population-based cohort...

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

    Science.gov (United States)

    Powell, Shawn; McCone, Dave

    2004-01-01

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

  13. Maxillary and mandibular overlay removable partial dentures for restoration of worn teeth. A three-year follow-up.

    Science.gov (United States)

    Almog, Dov M; Ganddini, Mario R

    2006-01-01

    This clinical report describes the fabrication and a three-year follow-up of maxillary and mandibular cast overlay removable partial dentures for the restoration of severely worn dentition with accompanying loss of vertical dimension of occlusion. The frameworks supported porcelain veneers for esthetics, and metal occlusal surfaces for strength and durability.

  14. Development of Fatigue in Cancer Survivors : A Prospective Follow-Up Study From Diagnosis Into the Year After Treatment

    NARCIS (Netherlands)

    Goedendorp, Martine M.; Gielissen, Marieke F. M.; Verhagen, Constans A. H. H. V. M.; Bleijenberg, Gijs

    2013-01-01

    Context. There is a lack of longitudinal studies investigating fatigue from before cancer treatment to long after successful cancer treatment. Objectives. This prospective follow-up study aimed to determine the prevalence and predictors of persistent fatigue in cancer survivors in the first year aft

  15. Hyperplastic callus formation in osteogenesis imperfecta type V mimicking osteosarcoma: 4-year follow-up with resolution

    Energy Technology Data Exchange (ETDEWEB)

    Vieira, R.L.V.; Amaral, D.T. [Federal University of Sao Paulo, Department of Radiology, Sao Paulo (Brazil); Jesus-Garcia, Filho R. [Federal University of Sao Paulo, Department of Orthopedic Surgery, Sao Paulo (Brazil); Saraiva, G. [Federal University of Sao Paulo, Department of Endocrinology, Sao Paulo (Brazil); Fernandes, A.R.C. [University of California San Diego, Department of MSK Radiology, San Diego, CA (United States); Resnick, D.

    2006-06-15

    We report a case of hyperplastic callus formation that occurred in both femurs in a patient with type V osteogenesis imperfecta (OI), with 4-year follow-up and resolution. The clinical, histological and imaging aspects of this condition are discussed. Recognition of the hyperplastic callus formation in this particular type of OI is important in order to avoid misdiagnosis. (orig.)

  16. Development of Fatigue in Cancer Survivors : A Prospective Follow-Up Study From Diagnosis Into the Year After Treatment

    NARCIS (Netherlands)

    Goedendorp, Martine M.; Gielissen, Marieke F. M.; Verhagen, Constans A. H. H. V. M.; Bleijenberg, Gijs

    2013-01-01

    Context. There is a lack of longitudinal studies investigating fatigue from before cancer treatment to long after successful cancer treatment. Objectives. This prospective follow-up study aimed to determine the prevalence and predictors of persistent fatigue in cancer survivors in the first year aft

  17. Up to 10-year follow-up of the Oxford medial partial knee arthroplasty - 695 cases from a single institution

    DEFF Research Database (Denmark)

    Wagner Kristensen, Per; Holm, Henriette A; Varnum, Claus

    2013-01-01

    Partial knee arthroplasty (PKA) has shown obvious advantages compared to total knee arthroplasty, but survival of PKA from different institutions and registries has differed. In our institution, 695 consecutive Oxford medial PKAs were performed from 2002 to 2011 with mean follow-up of 4.6 years. ...

  18. Antithrombotic treatment and outcomes of splanchnic vein thrombosis in an international prospective registry: Results of 2-year follow-up

    NARCIS (Netherlands)

    Ageno, Walter; Riva, Nicoletta; Schulman, Sam; Beyer-Westendorf, Jan; Bang, Soo-Mee; Senzolo, Marco; Grandone, Elvira; Barillari, Giovanni; Di Minno, Matteo; Duce, Rita; Malato, Alessandra; Santoro, Rita; Poli, Daniela; Verhamme, Peter; Martinelli, Ida; Kamphuisen, Pieter W.; Dentali, Francesco

    2014-01-01

    Background: Little information is available on the long-term clinical outcome of patients with splanchnic vein thrombosis (SVT). We aimed to assess incidence rates of bleeding, recurrence, and mortality in a large prospective cohort of SVT patients after a 2-year follow-up. Methods: Consecutive SVT

  19. Disaster and primary health care utilization: a 4 year follow-up.

    NARCIS (Netherlands)

    Dorn, T.; Yzermans, J.; Kerssens, J.; Veen, P. ten

    2005-01-01

    Background: Although crucial for the management of the post-disaster phase, the impact of disasters on primary health care utilization is largely unknown. Often, pre-disaster base-line data is lacking. The current study quantified primary health care utilization after a major fire disaster in The Ne

  20. How Satisfied Are Patients with Arthroscopic Bankart Repair? A 2-Year Follow-up on Quality-of-Life Outcome.

    Science.gov (United States)

    Saier, Tim; Plath, Johannes E; Waibel, Sabrina; Minzlaff, Philipp; Feucht, Matthias J; Herschbach, Peter; Imhoff, Andreas B; Braun, Sepp

    2017-06-29

    To report general life and health satisfaction after arthroscopic Bankart repair in patients with post-traumatic recurrent anterior glenohumeral instability and to investigate postoperative time lost to return to work at 2-year follow-up. Between 2011 and 2013 patients treated with arthroscopic Bankart repair in the beach chair position for acute shoulder instability were included in this study. Questions on Life Satisfaction Modules (FLZ(M)) and the Short Form 12 (SF-12) were used as quality-of-life outcome scales. Oxford Instability Score (OIS), Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), and self-reported American Shoulder and Elbow Surgeons (ASES) shoulder index were used as functional outcome scales. Return to work (months) was monitored and analyzed depending on physical workload. Data were assessed the day before surgery and prospectively monitored until 24 months postoperatively. Quality-of-life outcome was correlated with functional shoulder outcome and compared with normative age-adjusted data. Paired t-test, Wilcoxon test, Mann-Whitney U-Test, and Spearman's correlation coefficient were used for statistical analysis. Fifty-three patients were prospectively included. The mean age at surgery was 29.4 years. Satisfaction with general life and satisfaction with health (FLZ(M)) as well as physical component scale (SF-12) improved significantly to values above normative data within 6 to 12 months after surgery (each P return to work was 2 months (range, 0-10; standard deviation, 1.9), with significantly longer time intervals observed in patients with heavy physical workload (3.1 months; range, 0 to 10; standard deviation, 2.4; P = .002). Following arthroscopic Bankart repair, quality of life was impaired during early course after surgery and increased significantly above preoperative levels within 6 to 12 months after the procedure. A steady state of excellent quality-of-life and functional outcomes was noted after 12

  1. Hypertension Screening and Follow-up Management by Primary Health Care System among Chinese Population Aged 35 Years and Above

    Institute of Scientific and Technical Information of China (English)

    FENG Ya Jing; WANG Hui Cheng; LI Yi Chong; ZHAO Wen Hua

    2015-01-01

    Objective To describe hypertension screening and follow-up management among Chinese population aged 35 years and above within the primary health care system. Methods Data from 2010 China Chronic Disease and Risk Factor Surveillance System were used. We investigated previous hypertension diagnosis, screening, and follow-up assessments within the primary health care system. The prevalence of self-reported and criterion-based hypertension, screening rates, demographic and socioeconomic characteristics associated with screening, and patterns of follow-up assessments were recorded. The SAS software system was used for statistical analyses. Results About 17.1% reported a previous hypertension diagnosis. The rate difference between the two measures of prevalence was 27.2%. Among those without self-reported hypertension, 27.7%reported never visiting a clinic during the past 1 year and 60.4%of those attending a clinic reported ever being screened. Younger age group was associated with lower screening proportion;odds ratios of 35-, 45-, 55-, and≥65 years were 1.7 (95%CI:1.5-1.9), 1.5 (95%CI:1.3-1.7), 1.3 (95%CI:1.2-1.4), and 1.0, respectively. About 35.1% of the patients had undergone follow-up assessments four or more times during the past 1 year. Conclusion Majority of the Chinese population aged 35 years and above, particularly the less educated, elderly population, and rural residents were unaware of that they were suffering from hypertension. Most patients did not receive enough management services by the primary health care system. Thus, strengthening both the screening and follow-up management is needed.

  2. Vitamin D Status Does Not Affect Disability Progression of Patients with Multiple Sclerosis over Three Year Follow-Up.

    Directory of Open Access Journals (Sweden)

    Anne-Hilde Muris

    Full Text Available The risk of developing multiple sclerosis (MS as well as MS disease activity is associated with vitamin D (25(OHD status. The relationship between the main functional disability hallmark of MS, disability progression, and 25(OHD status is less well established though, especially not in MS patients with progressive disease.This retrospective follow-up study included 554 MS patients with a serum baseline 25(OHD level and Expanded Disability Status Scale (EDSS with a minimum follow-up of three years. Logistic regressions were performed to assess the effect of baseline 25(OHD status on relapse rate. Repeated measures linear regression analyses were performed to assess the effect on disability and disability progression.Baseline deseasonalized 25(OHD status was associated with subsequent relapse risk (yes/no, but only in the younger MS patients (≤ 37.5 years; OR = 0.872, per 10 nmol/L 25(OHD, p = 0.041. Baseline 25(OHD status was not significantly associated with either disability or disability progression, irrespective of MS phenotype.Within the physiological range, 25(OHD status is just significantly associated with the occurrence of relapses in younger MS patients, but is not associated with disability or disability progression over three years follow-up. Whether high dose supplementation to supra physiological 25(OHD levels prevents disability progression in MS should become clear from long term follow-up of supplementation studies.

  3. Early hematopoietic stem cell transplantation in a patient with severe mucopolysaccharidosis II: A 7 years follow-up

    Directory of Open Access Journals (Sweden)

    Anneliese L. Barth

    2017-09-01

    Full Text Available Mucopolysaccharidosis type II (MPS II - Hunter syndrome is an X-linked lysosomal storage disorder caused by a deficiency in the enzyme iduronate-2 sulfatase (I2S, leading to the accumulation of the glycosaminoglycans, affecting multiple organs and systems. Enzyme replacement therapy does not cross the blood brain barrier, limiting results in neurological forms of the disease. Another option of treatment for severe MPS, hematopoietic stem cell transplantation (HSCT has become the treatment of choice for the severe form of MPS type I, since it can preserve neurocognition when performed early in the course of the disease. To date, only few studies have examined the long-term outcomes of HSCT in patients with MPS II. We describe the seven-year follow-up of a prenatally diagnosed MPS II boy with positive family history of severe MPS form, submitted to HSCT with umbilical cord blood cells at 70 days of age. Engraftment after 30 days revealed mixed chimerism with 79% donor cells; after 7 years engraftment remains at 80%. I2S activity 30 days post-transplant was low in plasma and normal in leukocytes and the same pattern is observed to date. At age 7 years growth charts are normal and he is very healthy, although mild signs of dysostosis multiplex are present, as well as hearing loss. The neuropsychological evaluation (Wechsler Intelligence Scale for Children - Fourth Edition - WISC-IV, disclosed an IQ of 47. Despite this low measured IQ, the patient continues to show improvements in cognitive, language and motor skills, being quite functional. We believe that HSCT is a therapeutic option for MPS II patients with the severe phenotype, as it could preserve neurocognition or even halt neurodegeneration, provided strict selection criteria are followed.

  4. Proximal Junctional Kyphosis in Adolescent Idiopathic Scoliosis Following Segmental Posterior Spinal Instrumentation and Fusion; Minimum 2 Years Follow-Up

    Directory of Open Access Journals (Sweden)

    Mohammad Khaki Nahad

    2009-11-01

    Full Text Available Background:To evaluate proximal junctional segment changes in Adolescent Idiopathic Scoliosis(AIS the posterior spinal fusion and also instrumentation also and finding of probable risk factors, were all considered in this study.Methods: We retrospectively reviewed radiographs of 121 consecutive patients who underwent posterior spinal fusion for AIS from T3 or below, with a mean follow-   up of 32.8 months(range,24-83. All coronal and sagittal measurements including the proximal junctional kyphosis (PJKangle recorded on standing anteroposterior and lateral radiographs preoperative, early postoperative and on follow-up radiographs.The data were analyzed using the Spss 10.0 software.Dependent(paired samples student t-test was used for analysis between the groups Results: There was PJK angle above normal for the same junctional segment preoperatively in 13 patients (10.7% and the incidence of the PJK postoperatively was   7.4% (9 patients, 7 female and 2 male, all detected until 2 years postoperation.The mean increase in the PJK angle from pre-operation until 6 weeks postoperation was 5.9° (range,0-13°(P=0.02 and until 2 years post operation was 14.3° (range, 2- 16°(p=0.000.The mean proximal junctional angle increased 1.6° until 2 years postoperation in non-PJK group(n=112.Conclusion: The prevalence of Proximal Junctional Kyphosis was low and a silent radiographic problem. In some cases is preventable with perfect pre-operative planning. There is no specific demographic or radiographic variables or instrumentation types associated with developing PJK .

  5. Hepatitis B viral infection in maintenance hemodialysis patients: A three year follow-up

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To observe the prevalence of hepatitis B virus (HBV)infection in maintenance hemodialysis patients.METHODS: Eighty-eight hemodialysis patients who had been receiving hemodialysis regularly for an average of 39.45 ± 7.57 (range from 36 to 49) mo were enrolled in this study. HBV markers were measured in these patients before hemodialysis and in 100 healthy controls by the chemiluminescent microparticle immunoassay(CMI) method in order to compare the incidence of HBV infection in hemodialysis patients versus normal healthy people. All patients were then divided into two groups:patients positive for HBV markers (I.e. Those positive for HBsAg, anti-HBc, HBeAg, anti-Hbe, with or without positive anti-HBs) (n = 33), and patients negative for HBV markers (including those only positive anti-HBs)(n = 55). The following information was obtained for all patients: socio-demographic data, number of blood transfusions and some laboratory investigations. After 39.45± 7.57 mo follow-up, HBV markers were measured in these patients by CMI.RESULTS: The incidence of HBV infection in maintenance hemodialysis patients was 37.5%, which was higher than in controls (9%). In the patients positive for HBV markers, there were 13 patients (39.4%) who had a history of blood transfusion, which was more than the number [12 (21.8%), P = 0.04] of patients negative for HBV markers. Eight of the 88 patients negative for HBV markers turned out to be positive, while three of the 33 patients positive for HBV markers turned out to be negative. There was no cirrhosis of the liver or hepatoma occurring in these patients.CONCLUSION: Maintenance hemodialysis patients have a higher risk of HBV infection than the average population. The number of blood transfusions is associated with an increased prevalence of HBV. While it is hard for hemodialysis patients to eliminate HBV, the prognosis of patients with positive HBV markers is good.

  6. Ten-Year Follow-Up of a Patient with Metastatic Ewing's Sarcoma of the Pelvis

    Directory of Open Access Journals (Sweden)

    Robert U. Ashford

    2002-01-01

    Full Text Available Patient: We report a 32-year-old women with a pelvic Ewing's sarcoma, who developed skeletal metastases within 20 months of diagnosis but following treatment remains disease-free at 10 years.

  7. Participation in Treatment and Alcoholics Anonymous: A 16-Year Follow-Up of Initially Untreated Individuals

    Science.gov (United States)

    Moos, Rudolf H.; Moos, Bernice S.

    2007-01-01

    This study focused on the duration of participation in professional treatment and Alcoholics Anonymous (AA) for previously untreated individuals with alcohol use disorders. These individuals were surveyed at baseline and 1 year, 3 years, 8 years, and 16 years later. Compared with individuals who remained untreated, individuals who obtained 27 weeks or more of treatment in the first year after seeking help had better 16-year alcohol-related outcomes. Similarly, individuals who participated in AA for 27 weeks or more had better 16-year outcomes. Subsequent AA involvement was also associated with better 16-year outcomes, but this was not true of subsequent treatment. Some of the association between treatment and long-term alcohol-related outcomes appears to be due to participation in AA.* PMID:16538654

  8. Developing COPD: a 25 year follow up study of the general population

    DEFF Research Database (Denmark)

    Løkke, Anders; Lange, Peter; Scharling, H

    2006-01-01

    population. METHODS: As part of the Copenhagen City Heart Study, 8045 men and women aged 30-60 years with normal lung function at baseline were followed for 25 years. Lung function measurements were collected and mortality from COPD during the 25 year observation period was analysed. RESULTS: The percentage...

  9. Five-year follow-up of a one-year self-management program for patients with COPD

    Directory of Open Access Journals (Sweden)

    Steinsbekk A

    2012-02-01

    Full Text Available Borghild K Lomundal1,2, Aslak Steinsbekk1,21Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU, Trondheim, Norway; 2St Olavs Hospital, Trondheim, NorwayObjective: Investigate long-term effects 4 years after the end of a 1-year self-management program (SMP with 30 hours of education and 16 hours of physical activity in patients with chronic obstructive pulmonary disease (COPD.Methods: Prospective observational outcome study. SMP focused on improving disease related self-care skills. Main outcome measures were health-related quality of life, HRQoL, (St Georges Respiratory Questionnaire, SGRQ total and exercise capacity (6-minute walk test, 6MWT.Results: Thirty patients participated, 47% women. Baseline mean age was 67 years and mean pre-bronchodilator FEV1 (forced expiratory volume in 1 second percentage predicted was 41.3. HRQoL showed a statistical significant improvement during the 1-year intervention. Four years after the end of the program SGRQ total was similar to baseline value, 1.4 points (95% CI: –3.6 to 6.3, P = 0.580. Also 6MWT was similar to baseline value at the same test point, –10 m (95% CI: –27 to 8, P = 0.262, and 63% reported having continued to exercise regularly a minimum of three times per week during the follow-up period.Conclusion: The participants in a 1-year self-management program with additional training had maintained their pre-intervention level of HRQoL and exercise capacity 4 years after the end of the program. Two out of three participants had continued to exercise regularly.Keywords: chronic obstructive pulmonary disease, outpatient, patient education, self-care ability, self-management

  10. A follow-up study on post myocardial infarction depression in a tertiary healthcare centre of Assam

    Directory of Open Access Journals (Sweden)

    Hemanta Dutta

    2016-01-01

    Full Text Available Background: Major depressive disorder is widely prevalent in post myocardial infarction (MI period. Various studies have reported a significant relationship between these two major disease states. Aim: To examine depression after MI and its socio-demographic variation. Methods: The study was a follow up study on patients of acute MI (n=50 attending cardiology outpatient department of the Assam Medical College Hospital in four to six weeks after the index event. Screening was done by the Primary Care Evaluation of Mental Disorders and diagnoses of major depressive disorder were established according to the text revision of the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders criteria. Severity of the depression was assessed by the Beck Depression Inventory. Study populations were again reassessed after eight weeks from the index event. Statistical software packages like SPSS-20, XLSTAT, and Microsoft Office Access were used for analysis. Results: Twenty eight and 32% of the study subjects were depressed on their first and second visit respectively. Conclusion: Similar pattern of post MI depression is found in our state likewise in correlation to western and Indian studies which were conducted in different states. So we recommend vigilance from the clinician’s side while handling cases of MI.

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

    Energy Technology Data Exchange (ETDEWEB)

    Balderi, Alberto, E-mail: balders@libero.it; Antonietti, Alberto, E-mail: antonietti.a@ospedale.cuneo.it; Pedrazzini, Fulvio, E-mail: pedrazzini.f@ospedale.cuneo.it; Sortino, Davide, E-mail: davide.sortino@hotmail.it; Vinay, Claudia, E-mail: claudia.vinay@gmail.com; Grosso, Maurizio, E-mail: grosso.m@ospedale.cuneo.it [AO Santa Croce e Carle Hospital, Department of Radiology (Italy)

    2013-10-15

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

  12. Efficacy of three treatment protocols for adolescents with social anxiety disorder: a 5-year follow-up assessment.

    Science.gov (United States)

    Garcia-Lopez, Luis-Joaquin; Olivares, Jose; Beidel, Deborah; Albano, Anne-Marie; Turner, Samuel; Rosa, Ana I

    2006-01-01

    Few studies have reported long-term follow-up data in adults and even fewer in adolescents. The purpose of this work is to report on the longest follow-up assessment in the literature on treatments for adolescents with social phobia. A 5-year follow-up assessment was conducted with subjects who originally received either Cognitive Behavioral Group Therapy for Adolescents (CBGT-A), Social Effectiveness Therapy for Adolescents--Spanish version (SET-Asv), or Intervención en Adolescentes con Fobia Social--Treatment for Adolescents with Social Phobia (IAFS) in a controlled clinical trial. Twenty-three subjects completing the treatment conditions were available for the 5-year follow-up. Results demonstrate that subjects treated either with CBGT-A, SET-Asv and IAFS continued to maintain their gains after treatments were terminated. Either the CBGT-A, SET-Asv and IAFS can provide lasting effects to the majority of adolescents with social anxiety. Issues that may contribute to future research and clinical implications are discussed.

  13. Nine-Year Follow-Up of Intacs Implantation for Keratoconus

    OpenAIRE

    Kymionis, George D.; Grentzelos, Michael A; Diakonis, Vasilios F.; Pallikaris, Aristofanis I; Pallikaris, Ioannis G.

    2009-01-01

    Purpose: To present a case of nine- year bilateral Intacs (Addition Technology, Inc, Fremont, California, USA) implantation for early stage keratoconus. Methods: A 25-year-old male underwent bilateral Intacs implantation for the management of keratoconus and hardcontact-lens intolerance (stage 1) in 1999. Results: Nine years postoperatively, spherical equivalent refraction changed from preoperative -0.75 and -2.25 to +0.75 and –1.25 for the right and the left eye, respectively. UCVA was impro...

  14. Transit-time flow measurement as a predictor of coronary bypass graft failure at one year angiographic follow-up

    DEFF Research Database (Denmark)

    Lehnert, Per; Møller, Christian H; Damgaard, Sune

    2015-01-01

    BACKGROUND: Transit-time flow measurement (TTFM) is a commonly used intraoperative method for evaluation of coronary artery bypass graft (CABG) anastomoses. This study was undertaken to determine whether TTFM can also be used to predict graft patency at one year postsurgery. METHODS: Three hundred...... forty-five CABG patients with intraoperative graft flow measurements and one year angiographic follow-up were analyzed. Graft failure was defined as more than 50% stenosis including the "string sign." Logistic regression analysis was used to analyze the risk of graft failure after one year based...... on graft vessel type, anastomatic configuration, and coronary artery size. RESULTS: Nine hundred eighty-two coronary anastomoses were performed of which 12% had signs of graft failure at one year angiographic follow-up. In internal mammary arteries (IMAs), analysis showed a 4% decrease in graft failure...

  15. What physical performance measures predict incident cognitive decline among intact older adults? A 4.4year follow up study.

    Science.gov (United States)

    Veronese, Nicola; Stubbs, Brendon; Trevisan, Caterina; Bolzetta, Francesco; De Rui, Marina; Solmi, Marco; Sartori, Leonardo; Musacchio, Estella; Zambon, Sabina; Perissinotto, Egle; Crepaldi, Gaetano; Manzato, Enzo; Sergi, Giuseppe

    2016-08-01

    Reductions in physical performance, cognitive impairment (CI) and decline (CD), are common in older age, but few prospective cohort studies have considered the relationship between these domains. In this study we investigated whether reduced physical performance and low handgrip/lower limbs strength, could predict a higher incidence of CI/CD during a 4-year follow-up among a cohort of elderly individuals. From 3099 older community-dwelling individuals initially enrolled in the Progetto Veneto Anziani (PRO.V.A.) study, 1249 participants without CI at the baseline were included (mean age 72.2years, 59.5% females). Physical performance measures included the Short Physical Performance Battery (SPPB), 4m gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), categorized in gender-specific tertiles. CI was defined as a Mini-Mental State Examination (MMSE) score below 24; CD a decline of 3 or more points in the MMSE without CI. At baseline, participants developing CI during follow-up scored significantly worse across all physical performance measures compared to those that retained normal cognitive status. After adjusting for potential confounders, a significant trend for MMSE changes was noted for all physical performance tests, except for the SPPB and chair stands time. Multinomial logistic regression revealed that slow gait speed at baseline significantly predicted CD at follow up. Poor SPPB performance and slower gait speed predicted the onset of CI at the follow-up. In conclusion, slow walking speed appears to be the best independent predictor of poor cognitive status over a 4.4-year follow-up, while other items of SPPB were also significantly associated with CI.

  16. Natural History of Thyroid Function in Adults with Down Syndrome--10-Year Follow-Up Study

    Science.gov (United States)

    Prasher, V.; Gomez, G.

    2007-01-01

    Background: The natural history of thyroid function in adults with Down syndrome (DS) is unknown. Method: This study investigated annual thyroid function tests in 200 adults with DS over a 10-year period. Results: Transient and persistent thyroid dysfunction was common. The 5- and 10-year incidence of definite hypothyroidism was 0.9%-1.64% and…

  17. Developing COPD: a 25 year follow up study of the general population

    DEFF Research Database (Denmark)

    Løkke, Anders; Lange, Peter; Scharling, H

    2006-01-01

    BACKGROUND: Smokers are more prone to develop chronic obstructive pulmonary disease (COPD) than non-smokers, but this finding comes from studies spanning 10 years or less. The aim of this study was to determine the 25 year absolute risk of developing COPD in men and women from the general populat...

  18. Sustaining Research-Based Practices in Reading: A 3-Year Follow-Up.

    Science.gov (United States)

    Klingner, Janette K.; Vaughn, Sharon; Hughes, Marie Tejero; Arguelles, Maria Elena

    1999-01-01

    Three years after seven teachers had participated in an intensive year-long professional development experience in three multilevel reading practices (partner reading, collaborative strategic reading, and making words), all but one teacher sustained one or more of the practices at a high rate, as determined by classroom observation and interviews.…

  19. Cognitive and Psychiatric Predictors to Psychosis in Velocardiofacial Syndrome: A 3-Year Follow-Up Study

    Science.gov (United States)

    Antshel, Kevin M.; Shprintzen, Robert; Fremont, Wanda; Higgins, Anne Marie; Faraone, Stephen V.; Kates, Wendy R.

    2010-01-01

    Objective: To predict prodromal psychosis in adolescents with velocardiofacial syndrome (VCFS). Method: A total of 70 youth with VCFS, 27 siblings of youth with VCFS, and 25 community controls were followed from childhood (mean age = 11.8 years) into mid-adolescence (mean age = 15.0 years). Psychological tests measuring intelligence, academic…

  20. Osteosynthesis of medial humeral epicondyle fractures in children. 8-year follow-up of 33 cases

    DEFF Research Database (Denmark)

    Duun, P S; Ravn, Pernille; Hansen, L B;

    1994-01-01

    33 children with a mean age of 12 (7-15) years had open reduction and osteosynthesis for a displaced fracture of the medial humeral epicondyle. 8 (2-15) years after the operation a clinical and radiographic examination was performed. 22/33 had a prominent scar. No patients had symptoms from...

  1. Depressed mood: changes during a five-year follow-up in 75-year-old men and women in three Nordic localities

    DEFF Research Database (Denmark)

    Heikkinen, Riitta-Liisa; Berg, Stig; Avlund, Kirsten

    2002-01-01

    if they predicted depressed mood in this study. The study is a part of a 5-year follow-up of the Nordic comparative NORA study on functional capacity. A 5-year follow-up was carried out with the survivors in 1994. Depressive symptomatology was assessed by the Center for Epidemiologic Studies Depression Scale (CES...

  2. Successful treatment of a radicular groove by intentional replantation and Emdogain therapy: four years follow-up.

    Science.gov (United States)

    Al-Hezaimi, Khalid; Naghshbandi, Jafar; Simon, James H S; Rotstein, Ilan

    2009-03-01

    Radicular groove is an anatomical malformation that often causes severe periodontal defects. Treatments of such an anomaly present a clinical challenge to the operator. Presented is a case of successful treatment of radicular groove associated with a maxillary lateral incisor of a 15-year-old girl. A combination of endodontics, intentional replantation, and Emdogain therapy was used. At 4-year follow-up, the patient was comfortable and complete resolution of the periapical pathology was evident.

  3. [Local complications of papaverine-induced erection: follow-up at 7 years].

    Science.gov (United States)

    De Rose, A F; Oppezzi, G F; Scotto, S

    1993-06-01

    127 patients whose age was from 36 to 68 years old, affected by coeundi impotence, have been started to pharmaco-injection. 44 of these patients practised self-injection for 3 years: 25% once a week, 60% fortnightly and 15% once a month. The 60% of first group patients showed a certain fibrotic plaque between the 11th and the 13th month. At the end of the first year two patients with significative penile deviation underwent to corporoplasty. The 40% (6 patients) that made injection every 15-20 days showed fibrotic plaque between the 22nd and the 32nd month. At the third year two more patients underwent to corporoplasty. The 9 patients that made pharmacoerection monthly, showed plaque after almost 38 months. Only 11 patients have been using self-injection from about 7 years. At the half of the fifth year all patients presented multiple plaques and the 95% showed significant bends. At the end of the sixth year, 3 patients with serious bend, not to permit sexual intercourses, underwent to corporoplasty, having refused prosthesis. The anatomo-pathologic situation of the cavernous bodies has showed an heavy fibrosis, hipertrophy of smooth muscle and many perivascular phlogistic infiltrates.

  4. Back posture education in elementary schoolchildren: a 2-year follow-up study

    National Research Council Canada - National Science Library

    Geldhof, Elisabeth; Cardon, Greet; De Bourdeaudhuij, Ilse; De Clercq, Dirk

    2007-01-01

    ... years, on back posture knowledge, fear-avoidance beliefs and self-reported pain. An additional purpose was to evaluate which aspects of postural behavior were integrated in youngsters’ lifestyle...

  5. Management of hereditary gingival fibromatosis: A 2 years follow-up case report

    OpenAIRE

    Amitandra Kumar Tripathi; Gopal Dete; Charanjeet Singh Saimbi; Vivek Kumar

    2015-01-01

    Hereditary gingival fibromatosis (HGF) is a rare hereditary condition characterized by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva due to increase in sub-mucosal connective tissue component. This paper presents a case report of an 18-year-old female suffering from HGF with positive family history. Her 42-year-old mother also have enlargement of the gums. After through clinical examination of both the patients, routine blood investigation was advised. All the investigatio...

  6. Maturogenesis of a complicated crown fracture: a case report with 8 years follow-up.

    Science.gov (United States)

    Parirokh, Masoud; Kakoei, Shahla; Eskandarizadeh, Ali

    2007-01-01

    This report describes a case of a 7 years old girl who suffered from complicated crown fracture of right mandibular central incisor because of a bicycle accident. For the tooth partial pulpotomy with calcium hydroxide, capping was performed in order to achieve apexogenesis and the tooth was restored with a double-seal of glass ionomer cement and composite resin. The patient was reviewed over 8 years. The tooth showed continued root development and complete apex formation.

  7. Patients With Chronic Three-Vessel Disease in a 15-Year Follow-Up Study

    OpenAIRE

    2014-01-01

    Abstract Genetic and non-genetic predictors of 15-year survival in patients with chronic three-vessel disease (3VD) were investigated. Coronary angiography was performed on 810 subjects with symptoms of stable ischemic heart disease in 1998. The patients with 3VD were genotyped for 23 candidate polymorphisms covering the PPAR-RXR pathway, matrix metalloproteinase-2, renin–angiotensin–aldosterone system, endothelin-1, cytokine genes, MTHFR and APO E variants. Fifteen-year survival data were ob...

  8. Increased risk for stroke in burn patients: a population-based one-year follow-up study.

    Science.gov (United States)

    Chung, Shiu-Dong; Chen, Chin-Shyan; Lin, Herng-Ching; Kang, Jiunn-Horng

    2014-02-01

    The study aimed to explore the frequency and risk of stroke following hospitalization for burn through the analysis of a population-based dataset in Taiwan. We identified 692 hospitalized subjects who had received a diagnosis of burn. We randomly selected 2768 comparison subjects to match the study subjects by sex and age group. We individually tracked each subject for one year identifying all those who received a diagnosis of stroke during that period. Cox proportional hazards regressions were performed to calculate the longitudinal hazard of stroke between the two cohorts. We found that the incidence rate of stroke during the one-year follow-up period was 6.65 (95% CI: 4.92-8.79) per 100 person-years and 2.75 (95% CI: 2.18-3.42) per 100 person-years for study cohort and comparison cohort, respectively. After adjusting for urbanization level, monthly income, geographic region, hypertension, diabetes, coronary heart disease, heart failure, atrial fibrillation, hyperlipidemia, and chronic kidney disease, and censoring the cases that died from non-stroke causes, the hazard ratio (HR) for stroke during the one-year follow-up period for study cohort was 2.52 (95% CI=1.73-3.68, Pburned body surface area (29%). We found that there was no significant difference in the risk of stroke during the one-year follow-up period among these three groups of subjects. We found that burn victims were at higher risk for subsequent stroke that matched comparison subjects during one-year follow-up. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  9. Cytogenetic effects of radioiodine therapy: a 20-year follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Livingston, Gordon K. [Oak Ridge Institute for Science and Education, Radiation Emergency Assistance Center/Training Site, Oak Ridge, TN (United States); Khvostunov, Igor K. [Medical Radiological Research Center, Obninsk, Kaluga Region (Russian Federation); Gregoire, Eric [Institut de Radioprotection et de Surete Nucleaire, PRP-HOM/SRBE/LDB, BP 17, Fontenay aux roses Cedex (France); Barquinero, Joan-Francesc [Universtitat Autonoma de Barcelona, Facultat de Biociencies, Cerdanyola del Valles (Spain); Shi, Lin; Tashiro, Satoshi [Hiroshima University, Department of Cellular Biology, Research Institute for Radiation Biology and Medicine, Hiroshima (Japan)

    2016-05-15

    The purpose of this study was to compare cytogenetic data in a patient before and after treatment with radioiodine to evaluate the assays in the context of biological dosimetry. We studied a 34-year-old male patient who underwent a total thyroidectomy followed by ablation therapy with {sup 131}I (19.28 GBq) for a papillary thyroid carcinoma. The patient provided blood samples before treatment and then serial samples at monthly intervals during the first year period and quarterly intervals for 5 years and finally 20 years after treatment. A micronucleus assay, dicentric assay, FISH method and G-banding were used to detect and measure DNA damage in circulating peripheral blood lymphocytes of the patient. The results showed that radiation-induced cytogenetic effects persisted for many years after treatment as shown by elevated micronuclei and chromosome aberrations as a result of exposure to {sup 131}I. At 5 years after treatment, the micronucleus count was tenfold higher than the pre-exposure frequency. Shortly after the treatment, micronucleus counts produced a dose estimate of 0.47 ± 0.09 Gy. The dose to the patient evaluated retrospectively using FISH-measured translocations was 0.70 ± 0.16 Gy. Overall, our results show that the micronucleus assay is a retrospective biomarker of low-dose radiation exposure. However, this method is not able to determine local dose to the target tissue which in this case was any residual thyroid cells plus metastases of thyroidal origin. (orig.)

  10. A Polylactide Bioresorbable Scaffold Eluting Everolimus for Treatment of Coronary Stenosis: 5-Year Follow-Up.

    Science.gov (United States)

    Serruys, Patrick W; Ormiston, John; van Geuns, Robert-Jan; de Bruyne, Bernard; Dudek, Dariusz; Christiansen, Evald; Chevalier, Bernard; Smits, Pieter; McClean, Dougal; Koolen, Jacques; Windecker, Stephan; Whitbourn, Robert; Meredith, Ian; Wasungu, Luc; Ediebah, Divine; Veldhof, Susan; Onuma, Yoshinobu

    2016-02-23

    Long-term benefits of coronary stenosis treatment with an everolimus-eluting bioresorbable scaffold are unknown. This study sought to evaluate clinical and imaging outcomes 5 years after bioresorbable scaffold implantation. In the ABSORB multicenter, single-arm trial, 45 (B1) and 56 patients (B2) underwent coronary angiography, intravascular ultrasound (IVUS), and optical coherence tomography (OCT) at different times. At 5 years, 53 patients without target lesion revascularization underwent final imaging. Between 6 months/1 year and 5 years, angiographic luminal late loss remained unchanged (B1: 0.14 ± 19 mm vs. 0.13 ± 0.33 mm; p = 0.7953; B2: 0.23 ± 0.28 mm vs. 0.18 ± 0.32 mm; p = 0.5685). When patients with a target lesion revascularization were included, luminal late loss was 0.15 ± 0.20 mm versus 0.15 ± 0.24 mm (p = 0.8275) for B1 and 0.30 ± 0.37 mm versus 0.32 ± 0.48 mm (p = 0.8204) for B2. At 5 years, in-scaffold and -segment binary restenosis was 7.8% (5 of 64) and 12.5% (8 of 64). On IVUS, the minimum lumen area of B1 decreased from 5.23 ± 0.97 mm(2) at 6 months to 4.89 ± 1.81 mm(2) at 5 years (p = 0.04), but remained unchanged in B2 (4.95 ± 0.91 mm(2) at 1 year to 4.84 ± 1.28 mm(2) at 5 years; p = 0.5). At 5 years, struts were no longer discernable by OCT and IVUS. On OCT, the minimum lumen area in B1 decreased from 4.51 ± 1.28 mm(2) at 6 months to 3.65 ± 1.39 mm(2) at 5 years (p = 0.01), but remained unchanged in B2, 4.35 ± 1.09 mm(2) at 1 year and 4.12 ± 1.38 mm(2) at 5 years (p = 0.24). Overall, the 5-year major adverse cardiac event rate was 11.0%, without any scaffold thrombosis. At 5 years, bioresorbable scaffold implantation in a simple stenotic lesion resulted in stable lumen dimensions and low restenosis and major adverse cardiac event rates. (ABSORB Clinical Investigation, Cohort B [ABSORB B]; NCT00856856). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  11. Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women.

    Science.gov (United States)

    Sinaki, M; Itoi, E; Wahner, H W; Wollan, P; Gelzcer, R; Mullan, B P; Collins, D A; Hodgson, S F

    2002-06-01

    The long-term protective effect of stronger back muscles on the spine was determined in 50 healthy white postmenopausal women, aged 58-75 years, 8 years after they had completed a 2 year randomized, controlled trial. Twenty-seven subjects had performed progressive, resistive back-strengthening exercises for 2 years and 23 had served as controls. Bone mineral density, spine radiographs, back extensor strength, biochemical marker values, and level of physical activity were obtained for all subjects at baseline, 2 years, and 10 years. Mean back extensor strength (BES) in the back-exercise (BE) group was 39.4 kg at baseline, 66.8 kg at 2 years (after 2 years of prescribed exercises), and 32.9 kg at 10 years (8 years after cessation of the prescribed exercises). Mean BES in the control (C) group was 36.9 kg at baseline, 49.0 kg at 2 years, and 26.9 kg at 10 years. The difference between the two groups was still statistically significant at 10 year follow-up (p = 0.001). The difference in bone mineral density, which was not significant between the two groups at baseline and 2 year follow-up, was significant at 10 year follow-up (p = 0.0004). The incidence of vertebral compression fracture was 14 fractures in 322 vertebral bodies examined (4.3%) in the C group and 6 fractures in 378 vertebral bodies examined (1.6%) in the BE group (chi-square test, p = 0.0290). The relative risk for compression fracture was 2.7 times greater in the C group than in the BE group. To our knowledge, this is the first study reported in the literature demonstrating the long-term effect of strong back muscles on the reduction of vertebral fractures in estrogen-deficient women.

  12. Left ventricular deformation by speckle tracking echocardiography at 2-year follow-up in treatment naive rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Logstrup, B. B.; Masic, D.; Laurberg, T. B.

    2015-01-01

    is unknown. Objectives: To assess the LV function according to the amount of inflammation during a 2-year follow-up period in a cohort of treatment naive RA patients without known CVD. Methods: Thirty-nine patients (21 women) with mean age 59+/-10.7 years and steroid- and disease-modifying antirheumatic drug...... with anti-CCP >340 at baseline and patients who persistently had an anti-CCP >340 at 2-year follow-up (n=10) we saw a significant decrease in deformation compared to patients who did not (n=29); (2.9+/-3.2% vs. -0.6+/-2.7%; p=0.002). Furthermore we observed a significant correlation between the changes...

  13. Corneal Cross-Linking (with a Partial Deepithelization) in Keratoconus with Five Years of Follow-Up

    Science.gov (United States)

    Galvis, Virgilio; Tello, Alejandro; Carreño, Néstor I.; Ortiz, Alvaro I.; Barrera, Rodrigo; Rodriguez, Carlos Julián; Ochoa, Miguel E.

    2016-01-01

    We performed a retrospective interventional case series including 80 eyes of 48 patients with keratoconus (KC) who were treated with modified corneal cross-linking (CXL) for KC (with a partial deepithelization in a pattern of stripes). The average follow-up was 5.8 years (with a minimum of 5 years). At the last follow-up visit, compared with preoperative values, there were no significant changes in spherical equivalent, average keratometry, corneal thickness, corneal hysteresis, or corneal resistance factor. The distance-corrected visual acuity was 20/39 preoperatively and 20/36 postoperatively (P = 0.3). The endothelial cell count decreased by 4.7% (P < 0.005). These findings suggest that this modified corneal CXL technique is a safe and effective alternative to halt the progression of KC up to five years after the procedure. However, some concerns remain as to whether this technique can affect in some degree the corneal endothelial cells. PMID:27199574

  14. Higher levels of psychological distress are associated with a higher risk of incident diabetes during 18 year follow-up

    DEFF Research Database (Denmark)

    Mommersteeg, Paula M C; Herr, Raphael; Zijlstra, Wobbe P

    2012-01-01

    BACKGROUND: Reviews have shown that depression is a risk factor for the development of type 2 diabetes. However, there is limited evidence for general psychological distress to be associated with incident diabetes. The aim of the present study was to test whether persons who report higher levels...... of psychological distress are a risk factor for the development of diabetes during an 18 year follow up period. This association may be potentially mediated by low energy level and impaired health status....... of psychological distress are at increased risk to develop type 2 diabetes during 18 years follow up, adjusted for confounders. METHODS: A prospective analysis using data from 9,514 participants (41 years, SD=14; 44% men) of the British Household Panel Survey. The General Health Questionnaire 12 item version...

  15. Higher ambulatory blood pressure relates to new cerebral microbleeds: 2-year follow-up study in lacunar stroke patients.

    Science.gov (United States)

    Klarenbeek, Pim; van Oostenbrugge, Robert J; Rouhl, Rob P W; Knottnerus, Iris L H; Staals, Julie

    2013-04-01

    Elevated blood pressure (BP) is associated with the presence of cerebral microbleeds (CMBs) in cross-sectional studies. However, longitudinal studies did not show a convincing relationship. We aimed to determine the association between elevated BP levels and the occurrence of new CMBs after a 2-year follow-up in first-ever lacunar stroke patients using ambulatory BP monitoring. Ninety-six first-ever lacunar stroke patients underwent brain MRI and ambulatory BP monitoring at baseline and after 2-year follow-up. We used logistic regression analyses to assess the association of BP levels with new CMBs. We found new CMBs in 17 patients (18%). Higher 24-hour, day and night systolic BP (odds ratio, 2.69; 95% confidence interval, 1.40-5.21 per SD increase for 24-hour BP) and diastolic BP (odds ratio, 2.13; 95% confidence interval, 1.15-3.90 per SD increase for 24-hour BP) at baseline were associated with the development of new CMBs independent of age and sex. BP levels decreased during follow-up in both patients with and without new CMBs. Unlike BP levels at baseline, there was no difference in BP levels at follow-up between patients with and without new CMBs. Both higher systolic and diastolic BP levels were associated with the development of new CMBs in a population of lacunar stroke patients. Decrease of BP levels during follow-up did not halt progression of CMBs; however, it remains to be determined whether (early) intervention with antihypertensive drugs can slow down progression of CMBs.

  16. Cervical disc arthroplasty with ProDisc-C artificial disc: 5-year radiographic follow-up results

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan-bin; SUN Yu; ZHOU Fei-fei; LIU ZHONG-jun

    2013-01-01

    Background Cervical disc arthroplasty is an alternative surgery to standard cervical decompression and fusion for disc degeneration.Different types of cervical disc prosthesis are used in China.The aim of this study was to evaluate the radiographic outcomes of cervical arthroplasty using the ProDisc-C prosthesis.Methods Radiographic evaluation,including static and dynamic flexion-extension lateral images,was performed at baseline and at final follow-up.Results Twenty six patients who had single-level ProDisc-C arthroplasty were followed up for a mean period of 63 months (56-76 months).The range of motion at the operated level was 9.3°±3.7° at baseline and 7.3°±3.5° at final follow-up,with a significant difference (P <0.05).Seventeen of 26 levels (65.4%) developed heterotopic ossification:three were classified as grade Ⅱ,13 were classified as grade Ⅲ,and 1 as grade Ⅳ,according to McAfee's classification.Forty nine adjacent segments were evaluated by lateral Ⅹ-ray and 18 (36.7%) segments developed adjacent segment degenerations.Conclusions ProDisc-C arthroplasty had acceptable radiographic results at 5-year follow-up.The range of motion was preserved.However,more than 60% of the patients developed heterotopic ossification.

  17. Indirect composite restorations luted with two different procedures: A ten years follow up clinical trial

    Science.gov (United States)

    Preti, Alessandro; Vano, Michele; Derchi, Giacomo; Mangani, Francesco; Cerutti, Antonio

    2015-01-01

    Objectives: The aim of this clinical trial was to evaluate posterior indirect composite resin restoration ten years after placement luted with two different procedures. Study Design: In 23 patients 22 inlays/onlays (Group A) were luted using a dual-cured resin composite cement and 26 inlays/onlays (Group B) were luted using a light cured resin composite for a total of 48 Class I and Class II indirect composite resin inlays and onlays. The restorations were evaluated at 2 time points: 1) one week after placement (baseline evaluation) and 2) ten years after placement using the modified USPHS criteria. The Mann-Whitney and the Wilcoxon tests were used to examine the difference between the results of the baseline and 10 years evaluation for each criteria. Results: Numerical but not statistically significant differences were noted on any of the recorded clinical parameters (p>0.05) between the inlay/onlays of Group A and Group B. 91% and 94 % of Group A and B respectively were rated as clinically acceptable in all the evaluated criteria ten years after clinical function. Conclusions: Within the limits of the study the results showed after ten years of function a comparable clinical performance of indirect composite resin inlays/onlays placed with a light cure or dual cure luting procedures. Key words:Light curing composite, dual curing composite, indirect composite restoration, inlays/onlays, clinical trial. PMID:25810842

  18. Occupational allergic contact dermatitis in a 2-year follow-up study

    DEFF Research Database (Denmark)

    Brok, Line; Clemmensen, Kim Katrine Bjerring; Carøe, Tanja Korfitsen

    2016-01-01

    results and the results of natural rubber latex protein allergy after 2 years. METHODS: One hundred and ninety-nine patients diagnosed with relevant occupational epoxy or rubber chemical contact allergy, or allergy to natural rubber latex protein, were invited to participate in a questionnaire study about...... >60 years (p natural rubber latex proteins, 50% remembered this correctly. CONCLUSIONS: The impact of patch testing depends on the patients' ability to understand and remember the results...... their knowledge of contact allergies after 2 years. RESULTS: The response rate was 75%. Of the respondents, 13% did not remember their occupational contact allergy to rubber chemicals or epoxy. Ability to remember was not significantly influenced by sex or Dermatology Life Quality Index, but was decreased by age...

  19. A large tumour of the left atrium – A 10-year follow-up

    Directory of Open Access Journals (Sweden)

    Agnieszka M. Łebek-Szatańska

    2016-11-01

    Full Text Available Benign myxomas are the most common primary tumors in the left atrium of the heart, and they usually require urgent operative management. However, with the constant aging of the population and treatment of patients with severe concomitant diseases, an interesting question is the efficacy of the conservative approach. We present a case of a 75-year-old woman who was previously diagnosed with a left atrial myxoma, underwent an operation to resect it and then developed a recurrent tumor at the site of resection, which was found by control echocardiography 1.5 years later. She has been observed for over 10 years, as she repeatedly refused reoperation. In the setting of this example of a relatively favorable clinical course of left atrium myxoma, we discuss the current knowledge about the natural history of these tumors and the role of echocardiography in predicting their growth and complications.

  20. A randomized controlled 27 years follow up of three resin composites in Class II restorations

    DEFF Research Database (Denmark)

    Pallesen, Ulla; van Dijken, Jan WV

    2015-01-01

    Objective: To evaluate the durability of three conventional resin composites in Class II restorations during 27 years. Methods: Thirty participants, 25 female and 5 male (mean age 38.2 years, range 25–63), received at least three (one set) as similar as possible Class II restorations of moderate...... size. The three cavities were chosen at random to be restored with a chemical-cured (Clearfil Posterior) and two visible light-cured resin composites (Adaptic II, Occlusin). A chemical-cured enamel bonding agent (Clearfil New Bond) was applied after Ca(OH)2 covering of dentin and enamel etch. Marginal......: Class II restorations of the three conventional resin composites showed an acceptable success rate during the 27 year evaluation....

  1. Very Mild to Severe Dementia and Mortality: A 14-Year Follow-up-The Odense Study

    DEFF Research Database (Denmark)

    Kragh-Sørensen, Per; Lolk, Annette; Martinussen, Torben

    2010-01-01

    BACKGROUND/AIMS: To examine the mortality of very mildly to severely demented persons compared to nondemented persons. METHODS: Participants in a randomly drawn population-based cohort study on dementia were followed for 14 years from 1992 to 2006. Participants were examined at baseline (3......,065 nondemented and 234 prevalent demented), after 2 years (2,286 nondemented and 145 incident demented) and again after 5 years (1,669 nondemented and 124 new cases of dementia). Causes of death were ascertained in 884 nondemented and 286 demented participants. Survival for demented compared to nondemented...... persons was analyzed with the Cox proportional hazards model with time-dependent covariates adjusted for gender and age. RESULTS: The hazard ratio of death (95% confidence interval) increased from 1.82 (1.55-2.14) for the very mildly demented to 9.52 (6.60-13.74) for the severely demented subjects...

  2. Five-year follow up of a randomised controlled trial comparing subtotal with total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, L L; Zobbe, V; Ottesen, B;

    2015-01-01

    years after surgery. Complications of hysterectomy were further examined by scrutinising registered discharge summaries following hospitalisation. Intention-to-treat and per-protocol analyses were conducted. Potential bias caused by missing data was handled using multiple imputation. MAIN OUTCOME...... of respondents had urinary incontinence 5 years after SAH 34/113 (30.1%) than TAH 21/119 (17.6%) (RR 1.71, 95% confidence interval 1.06-2.75, P = 0.026). This difference reduced after multiple imputation to account for missing data (RR 1.37, 95% confidence interval 0.99-1.89, P = 0.052). Eleven of the 101 women...

  3. A Fused Maxillary Central Incisor and Its Multidisciplinary Treatment: An 18-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Lluís Brunet-Llobet

    2014-01-01

    Full Text Available Fused teeth may cause aesthetic, spacing, periodontal, eruption, and caries problems. The present case report describes a 7-year-old boy patient with a chief complaint of unerupted maxillary incisor. Radiographic examination indicated a fused tooth which had two fused roots but two independent root canals. A complex management of a fused tooth is really difficult to standardize. In this case an orthodontic, endodontic, and surgical treatment (intentional replantation allowed the tooth to be retained until 18 years following intervention. Maintenance of the root and alveolar bone in young adults at least until full skeletal maturation should be the main treatment objective.

  4. Evaluation of Single-Bundle versus Double-Bundle PCL Reconstructions with More Than 10-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Masataka Deie

    2015-01-01

    Full Text Available Background. Posterior cruciate ligament (PCL injuries are not rare in acute knee injuries, and several recent anatomical studies of the PCL and reconstructive surgical techniques have generated improved patient results. Now, we have evaluated PCL reconstructions performed by either the single-bundle or double-bundle technique in a patient group followed up retrospectively for more than 10 years. Methods. PCL reconstructions were conducted using the single-bundle (27 cases or double-bundle (13 cases method from 1999 to 2002. The mean age at surgery was 34 years in the single-bundle group and 32 years in the double-bundle group. The mean follow-up period was 12.5 years. Patients were evaluated by Lysholm scoring, the gravity sag view, and knee arthrometry. Results. The Lysholm score after surgery was 89.1±5.6 points for the single-bundle group and 91.9±4.5 points for the double-bundle group. There was no significant difference between the methods in the side-to-side differences by gravity sag view or knee arthrometer evaluation, although several cases in both groups showed a side-to-side difference exceeding 5 mm by the latter evaluation method. Conclusions. We found no significant difference between single- and double-bundle PCL reconstructions during more than 10 years of follow-up.

  5. Treatment of gingival recession using enamel matrix proteins: a case report with 4-year follow-up.

    Science.gov (United States)

    Kuru, Bahar; Yilmaz, Selçuk; Noyan, Ulkü

    2007-05-01

    Obtaining predictable and optimal coverage of exposed root surfaces and correction of corresponding gingival recessions have become important goals of periodontal plastic surgery. Various surgical techniques have been proposed for coverage of root surfaces. A therapeutic advantage may be gained if periodontal regeneration is obtained in addition to coverage of root with gingiva. In this case report, surgical recession coverage was performed as the bilaterally pedicled lateral sliding flap technique with the adjunctive use of enamel matrix derivative bioactive material (Emdogain). A female patient with gingival recession on maxillary central incisors is presented with 4-year follow-up observation. The surgical procedure used in this clinical pilot case study produced a marked reduction in gingival recession that was maintained for 4 years. Initial gingival recession averaged 4.25 mm with a probing depth of 1.25 mm. The 4-year follow-up demonstrated no significant changes in the degree of postoperative results obtained after 1 year. At the 4-year follow-up, a mean of 3.75 mm of root coverage was observed (93.8% root coverage). Probing depth averaged 0.75 mm, indicating a total of 4.25 mm gain of clinical attachment. Within the limits of this case, the results demonstrated the possibility of treating human buccal recessions by means of enamel matrix protein derivative together with the laterally repositioned flap technique, with a predictable reduction in recession and clinical gain in attachment.

  6. [More than 10 years of follow up of the stop screw technique].

    Science.gov (United States)

    Calvo Calvo, S; Marti Ciruelos, R; Rasero Ponferrada, M; González de Orbe, G; Viña Fernández, R

    2016-01-01

    Infantile flexible flatfoot does not require treatment in most cases. Symptomatic flexible flat feet are treated orthopaedically and surgery is only indicated when orthosis fails. Cases who underwent surgical treatment with the stop screw technique at the 12 de Octubre Hospital between 1995 and 2002 are reported. Patient progress is also analysed. Six angles are measured on the x-ray prior to surgery and those same x-ray angles are measured again before material extraction. They are then compared to see if the correction achieved is statistically significant. A more reduced sample is currently being assessed with the same radiological measurements and two clinical assessment scales: Lickert, and Smith and Millar. The latest x-rays are analysed by two radiologists to determine if there is subtalar arthrosis. In the short term, statistically significant differences are observed in all angles. The comparison between the post-surgery angles and the current angles does not show differences, except for the Giannestras angle, which has statistically significantly worsened. Clinical results and patient satisfaction is good. Incipient subtalar arthrosis is present in 68.5% of current patient x-rays. Stop screw method is a cheap, simple and effective technique to correct symptomatic flexible flatfoot that has not improved with conservative treatment. This technique provides short-term foot correction which can be maintained over time. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

  7. II. Methods and measures used for follow-up at 15 years of the English and Romanian Adoptee (ERA) study.

    Science.gov (United States)

    2010-04-01

    This chapter covers the methods and measures used in the ERA study, with a special focus on age 15 outcomes. First, we outline the sample participation rate for the 15-year follow-up-the percentages in all cases referring to the numbers at the time of initial sample contact. We then describe the measures used in this monograph, starting with those obtained at first contact with respect to functioning at the time of leaving institutional care. Because the group definitions relevant to the follow-up at age 15 are based on assessments at 6 and 11 years of age, we deal with the measures in those assessments first. At 11 years of age, we used a range of specific cognitive tests that might be of predictive value and those are detailed next. Then we discuss measures employed at the 15-year follow-up and those relevant to possible autism as used by Rutter in the separate assessment at 18-20 years. The monograph is structured around the possibility of deprivation-specific psychological patterns (DSPs), and hence on the strategies needed to test for them (see Rutter et al. in chapter I). Accordingly, the next section of this chapter deals with that strategy and details the measures taken to test the assumption's underlying the strategy. In our published papers concerning the 11-year follow-up, we tested whether outcomes were affected by the fact that some parents adopted mainly for altruistic reasons and others because of infertility-affected outcomes. Here we repeat this analysis in relation to DSPs. Similarly, we report findings on gender differences. The longitudinal study involved obtaining DNA for genotyping to examine the possibility that genetic features moderated the young people's response to institutional deprivation. Accordingly, in the next section of the chapter, we outline our genotyping approach. The final section of this chapter describes the statistical techniques we employed in our analyses.

  8. Can a more detailed evaluation of excision margins refine cytologic follow-up of women post-LLETZ for high-grade dysplasia?

    LENUS (Irish Health Repository)

    Treacy, Ann

    2010-09-01

    The relationship between dysplastic changes in the cervical epithelium and progression to in situ carcinoma and invasive carcinoma has been extensively studied. The removal of dysplastic epithelium through the long loop excision of the transformation zone (LLETZ) in 95% of the cases is curative. About 18% to 37% of LLETZ specimens with dysplasia at the margins have recurrent\\/residual disease. Earlier small studies suggest that the degree of dysplasia at the margins could predict for recurrence and allow a risk-based stratification of follow-up. We tested this hypothesis in a large group of women post-LLETZ for high-grade dysplasia with follow-up histology and cytology over a 12-year period. The cases were divided according to the excision margin status for dysplasia and if positive, low-grade or high-grade dysplasia. The groups were compared to assess whether the LLETZ specimens\\' margin status had an impact on the subsequent cytology or histology results. Positive follow-up results were defined as any grade of dysplasia in cytology or histology. Two thousand three hundred twenty-one women had LLETZs containing high-grade dysplasia over the 12-year period. One thousand five hundred thirty-four (66.1%) women had full histology and cytology follow-up available. Eight hundred twenty (53.4%) LLETZ specimens had positive margins and 714 (46.6%) had negative margins. The grade of dysplasia at the margins was available in 796 cases (97%) with 115 (15%) showing low-grade dysplasia and 680 (85%) high-grade dysplasia. One hundred seventy (20.7%) of the specimens with positive margins had positive follow-up results compared with 105 (14.7%) of the specimens with negative margins. The presence of dysplasia at an LLETZ margin is associated with dysplasia on follow-up cytology and histology (P=0.0021); however, the grade of dysplasia at the excision margin is not predictive of recurrent\\/residual dysplasia.

  9. Emotional and Personality-Related Career Decision-Making Difficulties: A 3-Year Follow-Up

    Science.gov (United States)

    Gati, Itamar; Asulin-Peretz, Lisa; Fisher, Ahinoam

    2012-01-01

    This study tests the temporal stability and the concurrent and predictive validity of the Emotional and Personality-related Career decision-making Difficulties (EPCD) model and questionnaire. Five hundred forty-three participants filled out the EPCD twice, 3 years apart. The Anxiety cluster was the most stable of the three, followed by the…

  10. Unnatural history of tetralogy of fallot: Prospective follow-up of 40 years after surgical correction

    NARCIS (Netherlands)

    J.A.A.E. Cuypers (Judith); M.E. Menting (Myrthe); E.E.M. Konings (Elisabeth); P. Opic (Petra); E.M.W.J. Utens (Elisabeth); W.A. Helbing (Willem); M. Witsenburg (Maarten); A.E. van den Bosch (Annemien); M. Ouhlous (Mohamed); R.T. van Domburg (Ron); D. Rizopoulos (Dimitris); F.J. Meijboom (Folkert); H. Boersma (Eric); A.J.J.C. Bogers (Ad); J.W. Roos-Hesselink (Jolien)

    2014-01-01

    textabstractBackground - Prospective data on long-term survival and clinical outcome beyond 30 years after surgical correction of tetralogy of Fallot are nonexistent. Methods and Results - This longitudinal cohort study consists of the 144 patients with tetralogy of Fallot who underwent surgical rep

  11. Matching Alcoholics to Coping Skills or Interactional Therapies: Two-Year Follow-Up Results.

    Science.gov (United States)

    Cooney, Ned L.; And Others

    1991-01-01

    Assigned 96 inpatients in alcoholism treatment to aftercare group treatment with either coping skills training or interactional therapy. Survival analyses using two-year outcome data provided evidence for durability of matching interaction effects. Individuals scoring high on sociopathy or global psychopathology had better outcomes in coping…