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Lucchini A, Villa M, Giani M, Andreossi M, Alessandra V, Vigo V, Gatti S, Ferlicca D, Teggia Droghi M, Rezoagli E, Foti G, Pozzi M, Irccs San Gerardo Follow-Up Group. Long term outcome in patients treated with veno-venous extracorporeal membrane oxygenation: A prospective observational study. Intensive Crit Care Nurs 2024; 82:103631. [PMID: 38309144 DOI: 10.1016/j.iccn.2024.103631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 01/04/2024] [Accepted: 01/18/2024] [Indexed: 02/05/2024]
Abstract
INTRODUCTION Over the last few decades, the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) support for severe respiratory failure has increased. AIM This study aimed to assess the long-term outcomes of patients treated with VV-ECMO for respiratory failure. METHODS We performed a single-centre prospective evaluation of patients on VV-ECMO who were successfully discharged from the intensive care unit of an Italian University Hospital between January 2018 and May 2021. The enrolled patients underwent follow-up evaluations at 6 and 12 months after ICU discharge. The follow-up team performed psychological and functional assessments using the following instruments: Hospital Anxiety and Depression Scale (HADS), Post-traumatic Stress Disorder Symptom Severity Scale (PTSS-10), Euro Quality Five Domains Five Levels (EQ-5L-5D), and 6-minute walk test. RESULTS We enrolled 33 patients who were evaluated at a follow-up clinic. The median patient age was 51 years (range: 45-58 years). The median duration of VV-ECMO support was 12 (9-19) days and the length of ICU stay was 23 (18-42) days. A HADS score higher than 14 was reported in 8 (24 %) and 7 (21 %) patients at the six- and twelve-month visit, respectively. PTSS-10 total score ≥ 35 points was present in three (9 %) and two (6 %) patients at the six- and twelve-month examination. The median EQ-5L-5D-VAS was respectively 80 (80-90) and 87.5 (70-95). The PTSS-10 score significantly decreased from six to 12 months in COVID-19 survivors (p = 0.024). CONCLUSIONS In this cohort of patients treated with VV-ECMO, cognitive and psychological outcomes were good and comparable to those of patients with Adult Respiratory Distress Syndrome (ARDS) managed without ECMO. IMPLICATIONS FOR CLINICAL PRACTICE The findings of this study confirm the need for long-term follow-up and rehabilitation programs for every ICU survivor after discharge. COVID-19 survivors treated with VV-ECMO had outcomes comparable to those reported in non-COVID patients.
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Affiliation(s)
- Alberto Lucchini
- Direction of health and social professions - General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza; University of Milano-Bicocca, Via Pergolesi 33, Monza (MB), Italy.
| | - Marta Villa
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza.
| | - Marco Giani
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza; University of Milano-Bicocca, Via Pergolesi 33, Monza (MB), Italy.
| | - Mara Andreossi
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza.
| | - Valentino Alessandra
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza.
| | - Veronica Vigo
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza.
| | - Stefano Gatti
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza.
| | - Daniela Ferlicca
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza.
| | - Maddalena Teggia Droghi
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza.
| | - Emanuele Rezoagli
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza; University of Milano-Bicocca, Via Pergolesi 33, Monza (MB), Italy.
| | - Giuseppe Foti
- General Adult and Pediatric Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori - Monza; University of Milano-Bicocca, Via Pergolesi 33, Monza (MB), Italy.
| | - Matteo Pozzi
- University of Milano-Bicocca, Via Pergolesi 33, Monza (MB), Italy; Cardiosurgical ICU Fondazione IRCCS San Gerardo dei Tintori - Monza.
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Takeshita Y, Onozawa S, Katase S, Shirakawa Y, Yamashita K, Shudo J, Nakanishi A, Akahori S, Yokoyama K. Evaluation of an artificial intelligence U-net algorithm for pulmonary nodule tracking on chest computed tomography images. J Int Med Res 2024; 52:3000605241230033. [PMID: 38321885 PMCID: PMC10851735 DOI: 10.1177/03000605241230033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/13/2024] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVES To apply image registration in the follow up of lung nodules and verify the feasibility of automatic tracking of lung nodules using an artificial intelligence (AI) method. METHODS For this retrospective, observational study, patients with pulmonary nodules 5-30 mm in diameter on computed tomography (CT) and who had at least six months follow-up were identified. Two radiologists defined a 'correct' cuboid circumscribing each nodule which was used to judge the success/failure of nodule tracking. An AI algorithm was applied in which a U-net type neural network model was trained to predict the deformation vector field between two examinations. When the estimated position was within a defined cuboid, the AI algorithm was judged a success. RESULTS In total, 49 lung nodules in 40 patients, with a total of 368 follow-up CT examinations were examined. The success rate for each time evaluation was 94% (345/368) and for 'nodule-by-nodule evaluation' was 78% (38/49). Reasons for a decrease in success rate were related to small nodules and those that decreased in size. CONCLUSION Automatic tracking of lung nodules is highly feasible.
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Affiliation(s)
- Yuhei Takeshita
- Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shimorenjaku, Mitaka-shi, Tokyo, Japan 181-8611 Japan
| | - Shiro Onozawa
- Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shimorenjaku, Mitaka-shi, Tokyo, Japan 181-8611 Japan
| | - Shichiro Katase
- Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shimorenjaku, Mitaka-shi, Tokyo, Japan 181-8611 Japan
| | - Yuya Shirakawa
- Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shimorenjaku, Mitaka-shi, Tokyo, Japan 181-8611 Japan
| | - Kouji Yamashita
- Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shimorenjaku, Mitaka-shi, Tokyo, Japan 181-8611 Japan
| | - Jun Shudo
- Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shimorenjaku, Mitaka-shi, Tokyo, Japan 181-8611 Japan
| | - Akihito Nakanishi
- Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shimorenjaku, Mitaka-shi, Tokyo, Japan 181-8611 Japan
| | - Sadato Akahori
- FUJIFILM Corporation, 2-26-30 Nishiazabu, Minato-ku, Tokyo, Japan
| | - Kenichi Yokoyama
- Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shimorenjaku, Mitaka-shi, Tokyo, Japan 181-8611 Japan
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Kurppa K, Mulder C, Stordal K, Kaukinen K. Celiac Disease Affects 1% of Global Population-Who Will Manage All These Patients? What Are Criteria to Prioritize Along Risk for Complications? Gastroenterology 2024:S0016-5085(24)00066-0. [PMID: 38290622 DOI: 10.1053/j.gastro.2023.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024]
Abstract
Celiac disease is a common gastrointestinal condition with an estimated global prevalence of up to 1%. Adequate long-term surveillance of patients is imperative to ensure strict adherence to treatment with a gluten-free diet and the ensuing clinical and histologic recovery. Traditionally, this has been accomplished by means of regular on-site attendance at specialist health care facilities, accompanied for most patients by follow-up endoscopic and laboratory tests. However, the rapidly increasing prevalence of celiac disease and the limited health care resources challenge the current centralized and nonindividualized follow-up strategies. The improved noninvasive surveillance tools and online health care services are further changing the landscape of celiac disease management. There is a clear need for more personalized and on-demand follow-up based on early treatment response and patient-related factors associated with long-term prognosis. Additional scientific evidence on the optimal implementation of follow-up for pediatric and adulthood celiac disease is nevertheless called for.
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Affiliation(s)
- Kalle Kurppa
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Tampere Center for Child, Adolescent, and Maternal Health Research, Tampere University, Tampere, Finland; Department of Pediatrics, Tampere University Hospital, Tampere, Finland; University Consortium of Seinäjoki, Seinäjoki, Finland.
| | - Chris Mulder
- Department of Gastroenterology, Amsterdam University Medical Center, Amsterdam, The Netherlands; Location Vrije Universiteit, Amsterdam, The Netherlands
| | - Ketil Stordal
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Department of Paediatric Research, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Katri Kaukinen
- Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
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Harutyunyan M, Hnath JC, Jacobson X, Le J, Shah MD, Kleene J, Darling RC. Trauma bypass performed by vascular surgeons demonstrate excellent long-term outcomes and limb preservation. J Vasc Surg 2023; 78:779-787. [PMID: 37330703 DOI: 10.1016/j.jvs.2023.05.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/25/2023] [Accepted: 05/25/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE Long-term outcomes in civilian trauma patients requiring upper or lower extremity revascularization is poorly studied secondary to limitations of certain large databases and the nature of the patients in this specific vascular subset. This study reports on the experience and outcomes of a Level 1 trauma center that serves both an urban and a large rural population over a 20-year period to identify bypass outcomes and surveillance protocols. METHODS Database of a single vascular group at an academic center was queried for trauma patients requiring upper or lower extremity revascularization between January 1, 2002, and June 30, 2022. Patient demographics, indications, operative details, operative mortality, 30-day nonoperative morbidity, revisions, subsequent major amputations, and follow-up data were analyzed. RESULTS A total of 223 revascularizations were performed, 161 (72%) lower and 62 (28%) upper extremities. One hundred sixty-seven patients (74.9%) were male, with a mean age of 39 years (range, 3-89 years). Comorbidities included hypertension (n = 34; 15.3%), diabetes (n = 6; 2.7%), and tobacco use (n = 40; 17.9%). Mean follow-up time was 23 months (range, 1-234 months), with 90 patients (40.4%) lost to follow-up. Mechanisms included blunt trauma (n = 106; 47.5%), penetrating trauma (n = 83; 37.2%), and operative trauma (n = 34; 15.3%). Bypass conduit was reversed vein (n= 171; 76.7%), prosthetic (n = 34; 15.2%), and orthograde vein (n = 11; 4.9%). Bypass inflow artery was superficial femoral (n = 66; 41.0%), above-knee popliteal (n = 28; 17.4%), and common femoral (n = 20; 12.4%) in the lower extremity, and brachial (n = 41; 66.1%), axillary (n = 10; 16.1%), and radial (n = 6; 9.7%) in the upper extremity. Lower extremity outflow artery was posterior tibial (n = 47; 29.2%), below-knee popliteal (n = 41; 25.5%), superficial femoral (n = 16; 9.9%), dorsalis pedis (n = 10; 6.2%), common femoral (n = 9; 5.6%), and above-knee popliteal (n = 10; 6.2%). Upper extremity outflow artery was brachial (n = 34; 54.8%), radial (n = 13; 21.0%), and ulnar (n = 13; 21.0%). Total operative mortality was nine patients (4.0%), all involving lower extremity revascularization. Thirty-day non-fatal complications included immediate bypass occlusion (n = 11; 4.9%), wound infection (n = 8; 3.6%), graft infection (n = 4; 1.8%), and lymphocele/seroma (n = 7; 3.1%). All major amputations (n = 13; 5.8%) were early and in the lower extremity bypass group. Late revisions in the lower and upper extremity groups were 14 (8.7%) and four (6.4%), respectively. CONCLUSIONS Revascularization for extremity trauma can be performed with excellent limb salvage rates and has demonstrated long-term durability with low limb loss and bypass revision rates. The poor compliance with long-term surveillance is concerning and may require adjustment in patient retention protocols; however, emergent returns for bypass failure are extremely low in our experience.
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Affiliation(s)
- Misak Harutyunyan
- Division of Vascular Surgery, Department of Surgery, Albany Medical Center Hospital, Albany, NY
| | - Jeffrey C Hnath
- Division of Vascular Surgery, Department of Surgery, Albany Medical Center Hospital, Albany, NY
| | - Xander Jacobson
- Division of Vascular Surgery, Department of Surgery, Albany Medical Center Hospital, Albany, NY
| | - Jeremy Le
- Division of Vascular Surgery, Department of Surgery, Albany Medical Center Hospital, Albany, NY
| | - Melissa D Shah
- Division of Vascular Surgery, Department of Surgery, Albany Medical Center Hospital, Albany, NY
| | - Julia Kleene
- Division of Vascular Surgery, Department of Surgery, Albany Medical Center Hospital, Albany, NY
| | - R Clement Darling
- Division of Vascular Surgery, Department of Surgery, Albany Medical Center Hospital, Albany, NY.
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Yamasaki Y, Uedo N, Akamatsu T, Kagawa T, Higashi R, Dohi O, Furukawa M, Takahashi Y, Inoue T, Tanaka S, Takenaka R, Iguchi M, Kawamura T, Tsuzuki T, Yamasaki T, Yamashina T, Nasu J, Mannami T, Yamauchi A, Matsueda K, Aizawa S, Mitsuhashi T, Okada H. Nonrecurrence Rate of Underwater EMR for ≤20-mm Nonampullary Duodenal Adenomas: A Multicenter Prospective Study (D-UEMR Study). Clin Gastroenterol Hepatol 2022; 20:1010-1018.e3. [PMID: 34217879 DOI: 10.1016/j.cgh.2021.06.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Endoscopic resection of nonampullary duodenal adenoma is often challenging, and its technique has not yet been standardized. To overcome the practical difficulty of conventional endoscopic mucosal resection, underwater endoscopic mucosal resection (UEMR) was recently developed; therefore, we investigated the effectiveness and safety of UEMR for nonampullary duodenal adenoma. METHODS A multicenter, prospective cohort study was conducted at 21 institutions in Japan. We enrolled patients with no more than 2 nonampullary duodenal adenomas ≤20 mm in size, who were planned to undergo UEMR. After UEMR, follow-up endoscopies were scheduled at 2 and 12 months after the procedure, and biopsy specimens were taken from the post-UEMR scars. The primary endpoint was the proportion of patients with histologically proven nonrecurrence at follow-up endoscopy and biopsy. RESULTS A total of 155 patients with 166 lesions underwent UEMR. One patient with a non-neoplastic lesion in the resected specimen and 10 patients with 10 lesions who were lost to follow-up were excluded. Finally, 144 patients with 155 lesions who received all follow-up endoscopies were analyzed for the primary endpoint. The proportion of patients with proven nonrecurrence was 97.2% (n = 140 of 144; 95% confidence interval, 92.8%-99.1%) which exceeded the predefined threshold value (92%). Two cases of delayed bleeding (1.2%) occurred and they were successfully managed by clips. All recurrences were successfully treated by additional endoscopic treatment. CONCLUSIONS This multicenter, prospective cohort study demonstrated effectiveness and safety of UEMR for nonampullary duodenal adenomas ≤20 mm in size. (University Hospital Medical Network Clinical Trials Registry, Number: UMIN000030414).
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Affiliation(s)
- Yasushi Yamasaki
- Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.
| | - Takuji Akamatsu
- Department of Gastroenterology and Hepatology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan
| | - Tomo Kagawa
- Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - Reiji Higashi
- Department of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Osamu Dohi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masanori Furukawa
- Division of Endoscopy, Nara Medical University Hospital, Nara, Japan
| | - Yu Takahashi
- Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Takuya Inoue
- Department of Gastroenterology and Hepatology, Osaka General Medical Center, Osaka, Japan
| | - Shouichi Tanaka
- Department of Gastroenterology, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Ryuta Takenaka
- Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama, Japan
| | - Mikitaka Iguchi
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takuji Kawamura
- Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | - Takao Tsuzuki
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Tomoaki Yamasaki
- Department of Gastroenterology, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Yamashina
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Junichiro Nasu
- Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Tomohiko Mannami
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Atsushi Yamauchi
- Department of Gastroenterology and Hepatology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Kazuhiro Matsueda
- Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Shigeyuki Aizawa
- Department of Gastroenterology, Nara Prefecture Seiwa Medical Center, Nara, Japan
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
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Dang H, Dekkers N, le Cessie S, van Hooft JE, van Leerdam ME, Oldenburg PP, Flothuis L, Schoones JW, Langers AMJ, Hardwick JCH, van der Kraan J, Boonstra JJ. Risk and Time Pattern of Recurrences After Local Endoscopic Resection of T1 Colorectal Cancer: A Meta-analysis. Clin Gastroenterol Hepatol 2022; 20:e298-e314. [PMID: 33271339 DOI: 10.1016/j.cgh.2020.11.032] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/02/2020] [Accepted: 11/06/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Growing numbers of patients with T1 CRC are being treated with local endoscopic resection only and as a result, the need for optimization of surveillance strategies for these patients also increases. We aimed to estimate the cumulative incidence and time pattern of CRC recurrences for endoscopically treated patients with T1 CRC. METHODS Using a systematic literature search in PubMed, EMBASE, Web of Science and Cochrane Library (from inception till 15 May 2020), we identified and extracted data from studies describing the cumulative incidence of local or distant CRC recurrence for patients with T1 CRC treated with local endoscopic resection only. Pooled estimates were calculated using mixed-effect logistic regression models. RESULTS Seventy-one studies with 5167 unique, endoscopically treated patients with T1 CRC were included. The pooled cumulative incidence of any CRC recurrence was 3.3% (209 events; 95% CI, 2.6%-4.3%; I2 = 54.9%), with local and distant recurrences being found at comparable rates (pooled incidences 1.9% and 1.6%, respectively). CRC-related mortality was observed in 42 out of 2519 patients (35 studies; pooled incidence 1.7%, 95% CI, 1.2%-2.2%; I2 = 0%), and the CRC-related mortality rate among patients with recurrence was 40.8% (42/103 patients). The vast majority of recurrences (95.6%) occurred within 72 months of follow-up. Pooled incidences of any CRC recurrence were 7.0% for high-risk T1 CRCs (28 studies; 95% CI, 4.9%-9.9%; I2 = 48.1%) and 0.7% (36 studies; 95% CI, 0.4%-1.2%; I2 = 0%) for low-risk T1 CRCs. CONCLUSIONS Our meta-analysis provides quantitative outcome measures which are relevant to guidelines on surveillance after local endoscopic resection of T1 CRC.
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Affiliation(s)
- Hao Dang
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Nik Dekkers
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Saskia le Cessie
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeanin E van Hooft
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Monique E van Leerdam
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Philip P Oldenburg
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Louis Flothuis
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan W Schoones
- Walaeus Library, Leiden University Medical Center, Leiden, The Netherlands
| | - Alexandra M J Langers
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - James C H Hardwick
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jolein van der Kraan
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jurjen J Boonstra
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
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Zhao B, Chen Y, Yue Y, Liu D, Wu G, Mao Y, Wang L, Liu Z. Two Cases of COVID-19 with Persistently Positive SARS-CoV-2-Specific IgM During One-Year Follow-Up - Sichuan Province, China, February 2021. China CDC Wkly 2021; 3:983-984. [PMID: 34804632 PMCID: PMC8598541 DOI: 10.46234/ccdcw2021.172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Bennan Zhao
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China.,Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Yuezhu Chen
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Yong Yue
- Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Dafeng Liu
- Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Guihui Wu
- Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Yi Mao
- Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Liang Wang
- Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Zhu Liu
- Chengdu Workstation for Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China.,Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China
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Xie WP, Liu JF, Lei YQ, Wang ZC, Chen Q, Cao H. Application of WeChat Platform in Midterm Clinical Follow-Up of Children Who Underwent Transthoracic Device Closure of VSD. Braz J Cardiovasc Surg 2021; 37:194-199. [PMID: 33656834 PMCID: PMC9054152 DOI: 10.21470/1678-9741-2020-0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction The purpose of this study was to investigate the feasibility and superiority of using the WeChat platform for midterm clinical follow-up of children who underwent transthoracic device closure for ventricular septal defects (VSDs). Methods Ninety children with VSDs who underwent transthoracic device closure were divided into a WeChat follow-up group (WFU group) and an outpatient follow-up group (OFU group). The patients were followed up via WeChat or at an outpatient clinic three months and one year after discharge. The incidences of adverse events, associated complications, costs and time spent, loss to follow-up rate, medication adherence, and overall satisfaction were recorded. Results There was no statistically significant difference in the incidence of adverse events or postoperative complications between the two groups. Also, the loss to follow-up rate was similar between them. Compared with the OFU group, there were significant statistical advantages in the WFU group regarding the total time and cost spent, medication adherence, and satisfaction. Conclusion The use of the WeChat platform in midterm clinical follow-up of children who underwent transthoracic device closure for VSDs has the advantages of reducing financial and time burdens, facilitating high medication adherence, and leading to high satisfaction.
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Affiliation(s)
- Wen-Peng Xie
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, People's Republic of China
| | - Jian-Feng Liu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, People's Republic of China
| | - Yu-Qing Lei
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, People's Republic of China
| | - Zeng-Chun Wang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, People's Republic of China
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Heisser T, Guo F, Niedermaier T, Holleczek B, Hoffmeister M, Brenner H. Low Risk of Advanced Neoplasms for up to 20 Years After Negative Colonoscopy Result: Potential for Personalized Follow-up Screening Intervals. Gastroenterology 2020; 159:2235-2237.e4. [PMID: 32777288 DOI: 10.1053/j.gastro.2020.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/09/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Thomas Heisser
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany.
| | - Feng Guo
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Tobias Niedermaier
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Bernd Holleczek
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Saarland Cancer Registry, Saarbrücken, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center and National Center for Tumor Diseases, Heidelberg, Germany; German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany
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10
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Hesselbrock MN, Hesselbrock VM, Chan G, Del Boca F, Chartier K. Subtypes of Alcohol Dependence and 36-Year Mortality. Alcohol Clin Exp Res 2020; 44:1658-1665. [PMID: 32701168 PMCID: PMC8221267 DOI: 10.1111/acer.14398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/11/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Chronic, heavy alcohol use is associated with multiple health problems, including premature death. Further, the clinical presentation of alcohol dependence may differentially affect and predict the long-term health consequences of affected individuals. Subtypes of alcohol dependence based upon treatment intake information can help identify homogenous groups of patients for treatment purposes, but have not been used to predict long-term outcomes. The current study examined mortality in a 36-year posttreatment interval among 4 subtypes of alcohol-dependent patients based upon their initial intake data. METHODS Extensive baseline data were collected from n = 316 male and female patients receiving inpatient treatment for alcohol dependence between 1980 and 1982. Four alcohol dependent subtypes (Del Boca & Hesselbrock, Alcohol Health Res World, 20:56, 1996) derived from the baseline data were used to examine the 1-year posttreatment drinking status and the risk of death 36 years postdischarge. Public records were used to determine patient deaths in the 36 years since discharge. RESULTS At the 36-year follow-up interval since discharge, 68.4% of the sample had died. The 4 subtypes were found to be associated with different rates of resumption of regular drinking in the first year posttreatment and a differential risk of mortality. An increased risk for returning to regular drinking (once a week or more) and early death were associated with subtypes defined, in part, by conduct problems and externalizing disorders. Regardless of subtype membership, women had the highest risk of death following treatment. CONCLUSIONS This study demonstrates the clinical usefulness of subtypes of alcohol dependence for examining different alcohol use outcomes, including predicting mortality. The increased risks for returning to regular drinking once a week or more and early death posttreatment among subtypes associated with conduct problems and externalizing disorders suggest the need for continued monitoring and possible additional intervention postdischarge.
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Affiliation(s)
- Michie N Hesselbrock
- From the, Department of Psychiatry MC-2103, (MNH, VMH, GC), University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Victor M Hesselbrock
- From the, Department of Psychiatry MC-2103, (MNH, VMH, GC), University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Grace Chan
- From the, Department of Psychiatry MC-2103, (MNH, VMH, GC), University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Frances Del Boca
- Department of Public Health Sciences MC-6325, (FDB), University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Karen Chartier
- School of Social Work, (KC), Virginia Commonwealth University, Richmond, Virginia, USA
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11
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Mortani Barbosa EJ, Kelly K. Statistical modeling can determine what factors are predictive of appropriate follow-up in patients presenting with incidental pulmonary nodules on CT. Eur J Radiol 2020; 128:109062. [PMID: 32422551 DOI: 10.1016/j.ejrad.2020.109062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE To assess the performance of statistical modeling in predicting follow-up adherence of incidentally detected pulmonary nodules (IPN) on CT, based on patient variables (PV), radiology report related variables (RRRV) and physician-patient communication variables (PPCV). METHODS 200 patients with IPN on CT were retrospectively identified and randomly selected. PV (age, gender, smoking status, ethnicity), RRRV (nodule size, patient context, whether follow-up recommendations were provided) and PPCV (whether referring physician documented IPN and ordered follow-up on the electronic medical record) were recorded. Primary outcome was whether patients received appropriate follow-up within +/- 1 month of the recommended time frame. Statistical methods included logistic regression and machine learning (K-nearest neighbors and support vector machine). RESULTS Adherence was low, with or without recommendations provided in the radiology report (23.4 %-27.4 %). Whether the referring physician ordered follow-up was the dominant predictor of adherence in all models. The following variables were statistically significant predictors of whether referring physician ordered follow-up: recommendations provided in the radiology report, smoking status, patient context and nodule size (FDR logworth of respectively 21.18, 11.66, 2.35, 1.63, p < 0.05). Prediction accuracy varied from 72 % (PV) to 93 % (PPCV, all variables). CONCLUSION PPCV are the most important predictors of adherence. Amongst all variables, patient context, smoking status, nodule size, and whether the radiologist provided follow-up recommendations in the report were all statistically significant predictors of patient follow-up adherence, supporting the utility of statistical modeling for analytics, quality assurance and optimization of outcomes related to IPN.
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Affiliation(s)
| | - Kate Kelly
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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12
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Myléus A, Reilly NR, Green PHR. Rate, Risk Factors, and Outcomes of Nonadherence in Pediatric Patients With Celiac Disease: A Systematic Review. Clin Gastroenterol Hepatol 2020; 18:562-573. [PMID: 31173891 DOI: 10.1016/j.cgh.2019.05.046] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/21/2019] [Accepted: 05/24/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The only treatment for celiac disease is strict adherence to a gluten-free diet (GFD). We performed a systematic review to investigate the rate of adherence to a GFD in children with celiac disease, risk factors that affect adherence, and outcomes of non-adherence. METHODS We searched PubMed, Cochrane Library, EBSCO, and Scopus for studies through January 2019. We included observational studies of ≥50 children diagnosed with celiac disease and recommended for placement on a GFD. We collected data on adherence assessment (self-report, serology tests, structured dietary interview, biopsies, or assays for gluten immunogenic peptides), risk factors, and outcomes related to adherence. Findings were presented with medians, range, and a narrative synthesis. RESULTS We identified 703 studies; of these, 167 were eligible for full-text assessment and 49 were included in the final analysis, comprising 7850 children. Rates of adherence to a GFD ranged from 23% to 98%. Comparable rates (median rates of adherence, 75%-87%) were found irrespective of how assessments were performed. Adolescents were at risk of non-adherence and children whose parents had good knowledge about celiac disease adhered more strictly. Non-adherence associated with patient growth, symptoms, and quality of life. CONCLUSION In a systematic review of 49 studies of children with celiac disease, we found substantial variation in adherence to a GFD among patients. Rate of adherence was not associated with method of adherence measurement, so all methods appear to be useful, with lack of consensus on the ideal metric. Studies are needed to determine the best method to ensure adherence and effects on long-term health.
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Affiliation(s)
- Anna Myléus
- Division of Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Norelle R Reilly
- Department of Pediatrics, Celiac Disease Center, Columbia University College of Physicians and Surgeons, Columbia University, New York, New York; Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, Columbia University, New York, New York
| | - Peter H R Green
- Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, Columbia University, New York, New York
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Chan G, Kramer JR, Schuckit MA, Hesselbrock V, Bucholz KK, Edenberg HJ, Acion L, Langbehn D, McCutcheon V, Nurnberger JI, Hesselbrock M, Porjesz B, Bierut L, Marenna BC, Cookman A, Kuperman S. A Pilot Follow-Up Study of Older Alcohol-Dependent COGA Adults. Alcohol Clin Exp Res 2019; 43:1759-1768. [PMID: 31141183 PMCID: PMC6685546 DOI: 10.1111/acer.14116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 05/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol consumption and problems are increasing among older adults, who are at elevated risk for alcohol-related accidents and medical problems. This paper describes a pilot follow-up of older adults with a history of alcohol dependence that was designed to determine the feasibility of conducting a more extensive investigation. METHODS The sample consisted of previously assessed subjects in the Collaborative Studies on the Genetics of Alcoholism who: (i) were age 50+; (ii) had lifetime DSM-IV AD; and (iii) had DNA available. Individuals were located through family contacts, Internet searches, and death registries. A brief telephone interview assessed demographics, health, and alcohol involvement. RESULTS Of the total sample (N = 2,174), 36% were contacted, 24% were deceased, and 40% were not yet located. Most (89%) contacted subjects were interviewed, and 99% of them agreed to future evaluation. Thirty percent of interviewed subjects reported abstinence for 10+ years, 56% reported drinking within the past year, and 14% last drank between >1 and 10 years ago. There were no age-related past-year differences in weekly consumption (overall sample mean: 16 drinks), number of drinking weeks (30.8), maximum number of drinks in 24 hours (8.1), or prevalence of weekly risky drinking (19%). Among those who drank within the past 5 years, the 3 most common alcohol-related problems were spending excessive time drinking or recovering (49%), drinking more/longer than intended (35%), and driving while intoxicated (35%); and about a third (32%) received some form of treatment. CONCLUSIONS Over a 1-year period, we located 60% of individuals last seen an average of 23 years ago. The majority of contacted individuals were interviewed and willing to be evaluated again. Although the proportion of individuals currently drinking diminished with age, subjects exhibited troublesome levels of alcohol consumption and problems. Our findings suggest the importance and feasibility of a more comprehensive follow-up.
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Affiliation(s)
| | - John R. Kramer
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
| | | | | | | | | | - Laura Acion
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
| | - Douglas Langbehn
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
| | | | | | | | | | | | - Bethany C. Marenna
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
| | - Angella Cookman
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Carver College
of Medicine, 200 Hawkins Drive, Iowa City, IA 52242
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Simonsen RK, Hald GM, Kristensen E, Giraldi A. Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death. Sex Med 2016; 4:e60-8. [PMID: 26944779 PMCID: PMC4822482 DOI: 10.1016/j.esxm.2016.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 01/07/2016] [Accepted: 01/13/2016] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgically reassigned transsexual individuals in Denmark. AIMS To investigate somatic morbidity before and after SRS and cause of death and its relation to somatic morbidity after SRS in Danish individuals who underwent SRS from 1978 through 2010. METHODS Somatic morbidity and mortality in 104 sex-reassigned individuals were identified retrospectively by data from the Danish National Health Register and the Cause of Death Register. MAIN OUTCOME MEASURES Somatic morbidity and cause of death. RESULTS Overall, 19.2% of the sample were registered with somatic morbidity before SRS and 23.1% after SRS (P = not significant). In total, 8.6% had somatic morbidity before and after SRS. The most common diagnostic category was cardiovascular disease, affecting 18 individuals, 9 before and 14 after SRS, and 5 of those 14 who were affected after SRS had cardiovascular disease before and after SRS. Ten individuals died after SRS at an average age of 53.5 ± 7.9 years (male to female) and 53.5 ± 7.3 years (female to male). CONCLUSION Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality.
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Affiliation(s)
| | - Gert Martin Hald
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ellids Kristensen
- Sexological Clinic, Psychiatric Center Copenhagen, Copenhagen, Denmark
| | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Center Copenhagen, Copenhagen, Denmark
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15
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Nevins EJ, Das K, Bhojak M, Pinto RS, Hoque MN, Jenkinson MD, Chavredakis E. Incidental Pineal Cysts: Is Surveillance Necessary? World Neurosurg 2016; 90:96-102. [PMID: 26944882 DOI: 10.1016/j.wneu.2016.02.092] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 02/21/2016] [Accepted: 02/22/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The natural history of incidental pineal cysts is poorly understood. Neurosurgeons and neuroradiologists are more frequently faced with this disease in the advent of higher-resolution magnetic resonance imaging (MRI) scanning. We aim to suggest a suitable surveillance strategy for these patients. METHODS All patients who had MRI of the brain between June 2007 and January 2014 (n = 42,099) at The Walton Centre for Neurology and Neurosurgery were included. Radiologic reports containing the terms "pineal" and "cyst" were reviewed to identify patients. RESULTS A total of 281 patients were identified with pineal cysts. The principal indication for head MRI was headache (50.2%), although no symptoms were deemed attributable to pineal disease. A total of 178 patients (63.3%) were female, and the age at diagnosis ranged from 16 to 84 years. The median size of pineal cyst at diagnosis was 10 mm. A total of 181 patients had subsequent follow-up at a median time of 6 months (range, 1-68). Eleven pineal cysts (6%) changed size during the follow-up period. Four patients had a reduction in cyst size; the median change was 2.5 mm. A further 7 pineal cysts increased in cyst size; the median change was 2 mm. No patients developed complications. CONCLUSIONS Incidental pineal cysts typically show a benign course. In the adult population, they do not require long-term neurosurgical follow-up, because pineal cysts tend to remain a stable size. In asymptomatic patients, we recommend a single follow-up MRI scan at 12 months to confirm diagnosis. The patient should then be discharged if the cyst remains stable.
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Affiliation(s)
- Edward J Nevins
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom.
| | - Kumar Das
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Maneesh Bhojak
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Rohan S Pinto
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Mohammed N Hoque
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Michael D Jenkinson
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Emmanuel Chavredakis
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
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Miri M, Ghanaati H, Salamati P, Ebrahimi Nik H, Jalali AH, Saeednejad M, Firouznia K. Coil Embolization of Intracranial Aneurysms: A Six-Month Follow-Up Study. Iran J Radiol 2015; 12:e10986. [PMID: 26535107 PMCID: PMC4623815 DOI: 10.5812/iranjradiol.10986v2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 12/21/2013] [Accepted: 04/26/2014] [Indexed: 11/30/2022]
Abstract
Background: Rupture of the intracranial aneurysms is associated with a high risk of bleeding and a high incidence of mortality if left untreated. Objectives: The aim of this study is to report our experience in managing intracranial aneurysms using coil embolization and to report the 6-month follow-up outcome of the patients. Patients and Methods: From January 2010 to December 2012, a series of 90 nonrandomized consecutive patients (mean age: 44.6 ± 14.9 years) with intracranial aneurysms underwent endovascular coil embolization in our center. We excluded patients with dissecting, blood blister-like, or false aneurysms. All patients were evaluated by four-vessel angiography to determine the shape, size, number and location of the aneurysms. We recommended a six-month follow-up control angiography. However, only 38 of them participated in this follow-up imaging. The data were analyzed by chi-square, fisher exact and t-tests and alpha was considered lower than 5%. Results: Immediately after the procedure, the total occlusion was seen in 76 (86.4%), subtotal occlusion in six (6.8%), and partial occlusion in six patients (6.8%). There was no significant relationship between the aneurysm size, aneurysm neck size, and location of the aneurysm with total or subtotal occlusions. Eleven patients (12.5%) experienced some complication during the procedure including two tears, three focal neurological signs, three vision disturbances, and three bleedings in the aneurysm. Major complications were significantly higher in the posterior aneurysm compared to the anterior ones (55.6% versus 44.4% of the major complications; P value = 0.015). Among patients who underwent control angiography, 34 patients (89.4%) had no change, two (5.3%) had new growth and two (5.3%) had widening of the neck after 6 months follow-up. Although aneurysms that remained unchanged after six months follow-up angiography had total occlusion after the procedure, it was 50% for aneurysms that had any changes in 6 months follow-up angiography (P value = 0.01). Conclusion: Coil embolization showed successful outcomes in the treatment of intracranial aneurysms with a low complication rate.
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Affiliation(s)
- Mojtaba Miri
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ghanaati
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Payman Salamati
- Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hojat Ebrahimi Nik
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Jalali
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Amir Hossein Jalali, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166581579, Fax: +98-2166581578, E-mail:
| | - Mina Saeednejad
- Islamic Azad University, Tehran Medical Branch, Tehran, Iran
| | - Kavous Firouznia
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Fan W, Lv Y, Ying G, Li W, Zhou J. Pilot study of amitriptyline in the prophylactic treatment of medication-overuse headache: a 1-year follow-up. Pain Med 2014; 15:1803-10. [PMID: 25159678 DOI: 10.1111/pme.12517] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aims to evaluate the long-term efficacy of low-dose amitriptyline combined with abrupt withdrawal in outpatients of medication-overuse headache (MOH) in an open-label design. METHODS We evaluated the effectiveness of early introduction of low-dose amitriptyline combined with abrupt withdrawal in outpatients with MOH over a 1-year observational period. The primary outcome measures were the reduction in number of headache days and days with use of acute headache medication after 3 months and after 12 months. A number of secondary outcome measures, as well as safety and tolerability, were assessed. The responders were defined as patients with ≥50% reduction in headache frequency from baseline and being without medication overuse. RESULTS Thirty-three patients completed the study. Significant reductions in headache frequency and medication consumption were observed at both months 3 and 12, compared to baseline (P < 0.05 for all). Neither the primary nor the secondary endpoints differed significantly between months 3 and 12. At the 12-month follow-up, 58% of the patients were considered as responders (N = 19); 73% remained cured of MOH (N = 24); 64% had reverted to episodic headaches (N = 21); 27% had relapsed into MOH (N = 9). CONCLUSION Given these results, early introduction of low-dose amitriptyline combined with abrupt withdrawal could be considered as a choice for patients with MOH.
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Affiliation(s)
- Wen Fan
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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18
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Yaltirik M, GÖKÇEN-RÖHLIG B, OZER S, EVLIOGLU G. Clinical evaluation of small diameter straumann implants in partially edentulous patients: a 5-year retrospective study. J Dent (Tehran) 2011; 8:75-80. [PMID: 21998812 PMCID: PMC3184735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 03/23/2011] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of the present study was to retrospectively evaluate small-diameter (3.3 mm) Straumann® dental implants placed in the maxilla or the mandible over a period of 5 years in function. MATERIALS AND METHODS Twenty-eight partially edentulous patients received a total of 48 implants over a 5-year period. After the standard healing period (3 to 6 months), the implants were restored with single-tooth prostheses or fixed partial dentures. All patients were followed according to a strict maintenance program with regular recalls. The cumulative survival rates of implants were analyzed and prosthetic complications were assessed. RESULTS After 5 years of function, one single 10-mm-long implant in the maxillary premolar region was lost because of recurrent peri-implant infection in a female patient. Two single 10-mm-long maxillary implants placed in the posterior region were lost due to body fracture. The cumulative 5-year survival rate of the implants was 93.75 %. The most common prosthetic complication was loosening of the occlusal screw. CONCLUSION Within the limited observation period and the number of patients included in this study, it may be concluded that the use of small-diameter implants appears to be predictable if clinical guidelines are followed and appropriate prosthetic restorations are provided. However, it should be noted that fatigue fracture may occur.
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Affiliation(s)
- M. Yaltirik
- Associate Professor, Department of Oral Surgery, Faculty of Dentistry, Istanbul University,Corresponding author: M. Yaltirik, Department of Oral Surgery, Istanbul University, Faculty of Dentistry, Istanbul, Turkey,
| | - B. GÖKÇEN-RÖHLIG
- Assistant Professor, Department of Maxillofacial Prosthodontics, Faculty of Dentistry, Istanbul University
| | - S. OZER
- Resident, Department of Oral Surgery, Faculty of Dentistry, Istanbul University
| | - G. EVLIOGLU
- Professor, Department of Maxillofacial Prosthodontics, Faculty of Dentistry, Istanbul University
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Amini P, Parirokh M. The importance of long time follow-up after vital pulp therapy: a case report. Iran Endod J 2008; 3:90-2. [PMID: 24146678 PMCID: PMC3800554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 06/14/2008] [Accepted: 06/30/2008] [Indexed: 11/13/2022]
Abstract
This report describes a case of an eight years old girl who was treated for complicated crown fracture of right maxillary central incisor because of a sport accident. For the tooth total pulpotomy was performed in order to achieve apexogenesis and the tooth was restored with a composite resin. The patient was reviewed over 10 years. At first the tooth showed continued root development and complete apex formation following vital pulp therapy, however, after 10 years the tooth developed pulp necrosis and periapical radiolucency. Following root canal therapy, periapical radiolucency has been healed.
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Affiliation(s)
- Parviz Amini
- Department of Prosthodontics, Oral and Dental Diseases Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Parirokh
- Department of Endodontics, Oral and Dental Diseases Research Center, School of Dentistry, Kerman University of Medical Sciences, Kerman/ Iranian Center for Endodontic Research, Tehran, Iran,Corresponding author at: Masoud Parirokh, Department of Endodontics, School of Dentistry, Shafa St., Jomhori Eslami Blvd., Kerman, Iran. Tel: +98-3412457931, Fax: +98-3412114535, E-mail:
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