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Scharink D, Hunfeld M, Albrecht M, Dulfer K, de Hoog M, van Gils A, de Jonge R, Buysse C. An 18-year, single centre, retrospective study of long-term neurological outcomes in paediatric submersion-related cardiac arrests. Resusc Plus 2024; 18:100632. [PMID: 38646092 PMCID: PMC11026833 DOI: 10.1016/j.resplu.2024.100632] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/23/2024] Open
Abstract
Aim Investigate long-term outcome in paediatric submersion-related cardiac arrests (CA). Methods Children (age one day-17 years) were included if admitted to the Erasmus MC Sophia Children's Hospital, after drowning with CA, between 2002 and 2019. Primary outcome was survival with favourable neurological outcome, defined as a Paediatric Cerebral Performance Category (PCPC) score of 1-3 at longest available follow-up. Secondary outcome were age-appropriate neuropsychological assessments at longest available follow-up. Results Upon hospital admission, 99 children were included (median age at time of CA 3.2 years [IQR 2.0-5.9] and 65% males). Forty children died in-hospital (no return of circulation (45%) or withdrawal of life sustaining therapies (55%)) and 4 children deceased after hospital discharge due to complications following the drowning-incident. Among survivors, with a median follow-up of 2.3 years [IQR 0.2-5.5], 47 children had favourable neurological outcome (i.e. PCPC 1-3) and 8 children unfavourable (unfavourable outcome group total n = 52, i.e. PCPC 4-5 or deceased). Twenty-six (47%) children participated in a neuropsychological assessment (median follow-up 4.0 years [IQR 2.3-8.7]). Compared with normative test data, participants obtained worse general (p = 0.008) and performance (p = 0.003) intelligence scores, processing speed (p = 0.002) and visual motor integration scores (p = 0.0012). Conclusions Although overall outcome in survivors was favourable at longest available follow-up, significant deficits in neuropsychological assessments were found. This study underlines the need for a standardized long term follow-up program as standard of care in paediatric drowning with CA.
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Affiliation(s)
- Denne Scharink
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Maayke Hunfeld
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
- Department of Paediatric Neurology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Marijn Albrecht
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Karolijn Dulfer
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Matthijs de Hoog
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Annabel van Gils
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Rogier de Jonge
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Corinne Buysse
- Department of Neonatal and Paediatric Intensive Care, Division of Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
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Passiatore M, Cilli V, Cannella A, Caruso L, Sassara GM, Taccardo G, De Vitis R. Long-term assessment of collagenase treatment for Dupuytren’s contracture: A 10-year follow-up study. World J Orthop 2024; 15:355-362. [DOI: 10.5312/wjo.v15.i4.355] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/30/2024] [Accepted: 03/18/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum (CCH) has revolutionized the treatment for Dupuytren’s contracture (DC). Despite its benefits, the long-term outcomes remain unclear. This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.
AIM To compare the short-term (12 wk) and long-term (10 years) outcomes on CCH treatment in patients with DC.
METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal (MCP) joint and the proximal interphalangeal (PIP) joint and underwent systematic re-evaluation. The study adhered to multicenter trial protocols, and assessments were conducted at 12 wk, 7 years, and 10 years post-surgery.
RESULTS Thirty-seven patients completed the 10-year follow-up. At 10 years, patients treated at the PIP joint exhibited a 100% recurrence. However, patients treated at the MCP joint only showed a 50% recurrence. Patient satisfaction varied, with a lower satisfaction reported in PIP joint cases. Recurrence exceeding 20 degrees on the total passive extension deficit was observed, indicating a challenge for sustained efficacy. Significant differences were noted between outcomes at the 7-year and 10-year intervals.
CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint. However, caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction. Re-intervention is needed within a decade of treatment.
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Affiliation(s)
- Marco Passiatore
- Department of Bone and Joint Surgery, ASST-Spedali Civili, Brescia 25123, Italy
| | - Vitale Cilli
- Department of Chirurgie de la Main, Centre Hospitalier Interregional Edith Cavell, Bruxelles 1160, Belgium
| | - Adriano Cannella
- Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy
| | - Ludovico Caruso
- Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy
| | - Giulia Maria Sassara
- Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy
| | - Giuseppe Taccardo
- Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy
| | - Rocco De Vitis
- Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy
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Yamamoto S, Kurosaka H, Mihara K, Onoda M, Haraguchi S, Yamashiro T. Long-term follow-up of a patient diagnosed with Crouzon syndrome who underwent Le Fort I and III distraction osteogenesis using a rigid external distractor system. Angle Orthod 2023; 93:736-746. [PMID: 37302140 PMCID: PMC10633798 DOI: 10.2319/011823-40.1] [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: 01/01/2023] [Accepted: 04/01/2023] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE This case report describes the successful treatment of a patient with Crouzon syndrome with severe midfacial deficiency and malocclusion, including reverse overjet. MATERIALS AND METHODS In Phase I treatment, maxillary lateral expansion and protraction were performed. In Phase II treatment, after lateral expansion of the maxilla and leveling of the maxillary and mandibular dentition, an orthognathic approach including simultaneous Le Fort I and III osteotomies with distraction osteogenesis (DO) was used to improve the midfacial deficiency. RESULTS After DO, 12.0 mm of the medial maxillary buttress and 9.0 mm of maxillary (point A) advancement were achieved, which resulted in a favorable facial profile and stable occlusion. CONCLUSION Even after 8 years of retention, the patient's profile and occlusion were preserved without any significant relapse.
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Affiliation(s)
| | - Hiroshi Kurosaka
- Corresponding author: Dr Hiroshi Kurosaka, Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan (e-mail: )
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Cheung A, Chan PK, Fu H, Cheung MH, Chan VWK, Luk MH, Chiu KY. Metal-on-crosslinked polyethylene in total hip arthroplasty - an excellent combination at fifteen to twenty years of follow-up. Int Orthop 2023; 47:2547-2552. [PMID: 37247019 DOI: 10.1007/s00264-023-05844-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE Cross-linked polyethylene (PE) has been used with great clinical success in total hip arthroplasty (THA) since its debut in the late 1990's. However, reports regarding this bearing couple near the end of its second decade of service are still scant. The aim of this study was to first determine the long term clinical and radiological results and second Investigate what factors affect wear rates using a metal-on-crosslinked PE bearing articulation. METHODS 55 THAs using a single brand of cross-linked liner, cementless cup and 28 mm hip ball were performed in 44 patients. Age, sex, Charlson Comorbidity Index (CCI) and need for revision surgery were recorded. Linear and volumetric wear was determined using the Martell method. RESULTS Mean age at operation was 51.2 (29-73 ± 12.1) years. Mean duration of follow-up was 16.9 years (range 15.0-20.1 ± 1.1 years). Osteolysis was not present in the latest follow-up radiographs. Median linear and volumetric wear rate was 0.038 mm/year (95% CI 0.032-0.047) and 7.115mm3/year (95% CI 6.92-17.25) respectively. Acetabular component position was not found to be related to both linear and volumetric wear. No significant difference was found in the linear and volumetric wear rates of thinner and thicker liners (8 mm or below and > 8 mm) (p = 0.849 and p = 0.64 respectively). CONCLUSION Metal-on-crosslinked PE is associated with low linear and volumetric wear rates which has virtually obviated osteolysis and has translated to excellent survivorship even at long term follow up. In-vivo oxidation does not appear to be of clinical concern at this point.
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Affiliation(s)
- Amy Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China.
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
| | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
| | - Vincent Wai Kwan Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
| | - Michelle Hilda Luk
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
| | - Kwong-Yuen Chiu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
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Oktar T, Selvi I, Kart M, Dönmez Mİ, Çetin B, Boyuk A, Ziylan O. Lower Urinary Tract Reconstruction for Ectopic Ureterocele: What Happens in the Long-term Follow-up? J Pediatr Surg 2023; 58:1566-1572. [PMID: 36241446 DOI: 10.1016/j.jpedsurg.2022.09.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/19/2022] [Accepted: 09/11/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND We aimed to analyze the long-term clinical and lower urinary tract function outcomes in children with duplex system ectopic ureterocele who underwent ureteroneocystostomy and ureterocelectomy. METHODS Fifty-one patients (28 females, 23 males) who underwent a series of surgical interventions including lower urinary tract reconstruction in childhood for duplex system ectopic ureterocele in our center between 1998 and 2019, were retrospectively reviewed. The demographic and clinical data, surgical history, and the indication for ureterocelectomy were noted. Lower urinary tract dysfunction (LUTD) status was assessed through dysfunctional voiding symptom scores (DVSS) and uroflowmetry in all patients at the last follow-up. The clinical outcomes, and LUTD were evaluated. RESULTS At the last visit at a mean follow-up of 117.18 ± 57.87 months after ureterocelectomy, ipsilateral persistent lower pole VUR was detected in 5.6% (3/54 renal units, 2 females and 1 male) of the cases, who were treated using the subureteric injection. Abnormal DVSS (median 11, range 9-15) was detected in 27.4% (14/51 pts) of the patients. Out of these, 57.1% (8/14 pts) had storage symptoms, 35.7% (5/14 pts) had voiding symptoms, and 7.1% (1/14 pts) had both storage and voiding symptoms while 71.4%(10/14 pts) had abnormal uroflowmetry findings (plateau shaped flow curve in 2, staccato shaped curve with sustained EMG activity in 3, tower shaped curve in 2, interrupted shaped curve in 3 patients). Five patients had elevated residual volume. Anticholinergics were administered to six patients who had overactive bladder symptoms. In addition, two girls required open bladder neck reconstruction due to stress incontinence caused by bladder neck insufficiency. CONCLUSIONS Our findings showed that clinical success was achieved using the lower urinary tract reconstruction with no need for re-operation in 90.2% of patients with duplex system ectopic ureterocele. However, LUTD was present in 27.4% of our patients in the long-term follow-up. Therefore, LUTD should be carefully assessed in the long-term follow-up of these patients.
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Affiliation(s)
- Tayfun Oktar
- İstanbul University, İstanbul Faculty of Medicine, Department of Urology, Division of Pediatric Urology, Istanbul, Turkey; Koç University, School of Medicine, Department of Urology, Istanbul, Turkey.
| | - Ismail Selvi
- İstanbul University, İstanbul Faculty of Medicine, Department of Urology, Division of Pediatric Urology, Istanbul, Turkey
| | - Mücahit Kart
- İstanbul University, İstanbul Faculty of Medicine, Department of Urology, Division of Pediatric Urology, Istanbul, Turkey
| | - M İrfan Dönmez
- İstanbul University, İstanbul Faculty of Medicine, Department of Urology, Division of Pediatric Urology, Istanbul, Turkey
| | - Bilal Çetin
- İstanbul University, İstanbul Faculty of Medicine, Department of Urology, Division of Pediatric Urology, Istanbul, Turkey
| | - Abubekir Boyuk
- İstanbul University, İstanbul Faculty of Medicine, Department of Urology, Division of Pediatric Urology, Istanbul, Turkey
| | - Orhan Ziylan
- İstanbul University, İstanbul Faculty of Medicine, Department of Urology, Division of Pediatric Urology, Istanbul, Turkey
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Golwala ZM, Bhat NG, Xu-Bayford J, Stankova T, Adams S, Morris EC, Qasim W, Booth C, Worth A, Kusters MA, Elfeky R. Non-osteopenic Bone Pathology After Allo-hematopoietic Stem Cell Transplantation in Patients with Inborn Errors of Immunity. J Clin Immunol 2023; 43:1019-1031. [PMID: 36930409 PMCID: PMC10276082 DOI: 10.1007/s10875-023-01465-z] [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: 10/17/2022] [Accepted: 03/03/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE There is a lack of data on post-HSCT non-osteopenic bone pathology specifically for children with inborn errors of immunity (IEI). We collected data on non-osteopenic bone pathology in children with IEI post-HSCT over two decades in a large tertiary pediatric immunology center. METHODS Descriptive study with data analysis of bone pathology in allo-HSCT for IEI was performed between 1/1/2000 to 31/12/2018 including patients alive at follow-up to July 2022. Records were analyzed for bone pathology and risk factors. Exclusion criteria included isolated reduced bone density, fractures, and skeletal anomalies due to underlying IEI and short stature without other bone pathology. Bone pathologies were divided into 5 categories: bone tumors; skeletal dysplasia; avascular necrosis; evolving bone deformities; slipped upper femoral epiphysis. RESULTS A total of 429 children received HSCT between 2000 and 2018; 340 are alive at last assessment. Non-osteopenic bone pathology was observed post-HSCT in 9.4% of patients (32/340, mean 7.8 years post-HSCT). Eleven patients (34%) had > 1 category of bone pathology. Seventeen patients (17/32; 53%) presented with bilateral bone pathology. The majority of patients received treosulfan-based conditioning (26/32; 81.2%). Totally, 65.6% (21/32) of patients had a history of prolonged steroid use (> 6 months). Pain was the presenting symptom in 66% of patients, and surgical intervention was required in 43.7%. The highest incidence of bone pathologies was seen in Wiskott-Aldrich syndrome (WAS) (n = 8/34; 23.5%) followed by hemophagocytic lymphohistiocytosis patients (n = 3/16; 18.8%). CONCLUSION Non-osteopenic bone pathology in long-term survivors of allo-HSCT for IEI is not rare. Most patients did not present with complaints until at least 5 years post-HSCT highlighting the need for ongoing bone health assessment for patients with IEI. Children presenting with stunted growth and bone pathology post-HSCT should undergo skeletal survey to rule out development of post-HSCT skeletal dysplasia. Increased rates and complexity of bone pathology were seen amongst patients with Wiskott-Aldrich syndrome.
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Affiliation(s)
- Zainab M Golwala
- Department of Immunology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Nikita Gireesh Bhat
- Department of Immunology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - Jinhua Xu-Bayford
- Department of Immunology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - Tanja Stankova
- Department of Immunology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - Stuart Adams
- SIHMDS-Haematology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Emma C Morris
- Department of Immunology, Institute of Immunity and Transplantation, University College London, London, UK
| | - Waseem Qasim
- Department of Immunology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Claire Booth
- Department of Immunology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Austen Worth
- Department of Immunology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Maaike A Kusters
- Department of Immunology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Reem Elfeky
- Department of Immunology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
- UCL Great Ormond Street Institute of Child Health, London, UK.
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Brooks G, Gazzaneo M, Bertozzi M, Riccipetitoni G, Raffaele A. Systematic review of long term follow-up and transitional care in adolescents and adults with esophageal atresia - why is transitional care mandatory? Eur J Pediatr 2023. [PMID: 36905437 DOI: 10.1007/s00431-023-04893-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/07/2023] [Accepted: 02/17/2023] [Indexed: 03/12/2023]
Abstract
PURPOSE to review recent literature concerning long-term health issues and transitional care in esophageal atresia (EA) patients. PubMed, Scopus, Embase and Web of Science databases were screened for studies regarding EA patients aged more than or equal to 11 years, published between August 2014 and June 2022. Sixteen studies involving 830 patients were analyzed. Mean age was 27.4 years (range 11-63). EA subtype distribution was: type C (48.8%), A (9.5%), D (1.9%), E (0.5%) and B (0.2%). 55% underwent primary repair, 34.3% delayed repair, 10.5% esophageal substitution. Mean follow-up was 27.2 years (range 11-63). Long-term sequelae were: gastro-esophageal reflux (41.4%), dysphagia (27.6%), esophagitis (12.4%), Barrett esophagus (8.1%), anastomotic stricture (4.8%); persistent cough (8.7%), recurrent infections (4.3%) and chronic respiratory diseases (5.5%). Musculo-skeletal deformities were present in 36 out of 74 reported cases. Reduced weight and height were detected in 13.3% and 6% cases, respectively. Impaired quality of life was reported in 9% of patients; 9.6% had diagnosis or raised risk of mental disorders. 10.3% of adult patients had no care provider. Meta-analysis was conducted on 816 patients. Estimated prevalences are: GERD 42.4%, dysphagia 57.8%, Barrett esophagus 12.4%, respiratory diseases 33.3%, neurological sequelae 11.7%, underweight 19.6%. Heterogeneity was substantial (> 50%). Conclusion: EA patients must continue follow-up beyond childhood, with a defined transitional-care path by a highly specialized multidisciplinary team due to the multiple long-term sequelae. WHAT IS KNOWN • Survival rates of esophageal atresia patients is now more than 90% thanks to the improvements in surgical techniques and intensive care, therefore patients' needs throughout adolescence and adulthood must be taken into account. WHAT IS NEW • This review, by summarizing recent literature concerning long term sequelae of esophageal atresia, may contribute to raise awareness on the importance of defining standardized protocols of transitional and adulthood care for esophageal atresia patients.
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Bankole NDA, Janot K, Kamounye US, Barrot V, Ifergan H, Bibi R, Boulouis G. Recurrence leading to retreatment in the long-term follow-up after endovascular treatment of carotid-ophthalmic artery aneurysm. J Neuroradiol 2023; 50:50-53. [PMID: 35654286 DOI: 10.1016/j.neurad.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Nourou Dine Adeniran Bankole
- Neuroradiology Department, CHRU Tours, University of Tours, Tours, France; Neurosurgery Department, CHU Ibn Sina, Mohammed V University of Rabat, Rabat, Morocco.
| | - Kevin Janot
- Neuroradiology Department, CHRU Tours, University of Tours, Tours, France
| | | | - Valere Barrot
- Neuroradiology Department, CHRU Tours, University of Tours, Tours, France
| | - Heloise Ifergan
- Neuroradiology Department, CHRU Tours, University of Tours, Tours, France
| | - Richard Bibi
- Neuroradiology Department, CHRU Tours, University of Tours, Tours, France
| | - Gregoire Boulouis
- Neuroradiology Department, CHRU Tours, University of Tours, Tours, France
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Torres-Claramunt R, Morales-Avalos R, Perelli S, Padilla-Medina JR, Monllau JC. Good clinical outcomes can be expected after meniscal allograft transplantation at 15 years of follow-up. Knee Surg Sports Traumatol Arthrosc 2023; 31:272-278. [PMID: 35972520 DOI: 10.1007/s00167-022-07106-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [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: 04/15/2022] [Accepted: 08/03/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of this study was to evaluate graft survivorship and report the functional and radiographic results of Meniscal allograft transplantation (MAT) throughout a minimum 15-year follow-up period. METHODS Fifty-one patients that had undergone an isolated MAT procedure during the period studied were included. The results were assessed with the Lysholm and Tegner scores as well as the Visual Analog Scale. Magnetic resonance imaging and a complete radiographic series were carried out to determine the degree of meniscal extrusion and joint space narrowing. A comparison was made between the radiological findings of the last follow-up, the 5-year mid-term follow-up and those from the preoperative period. RESULTS Thirty-eight patients were available for the final follow-up. The mean follow-up was 17.4 years. There were 23 (60.5%) medial menisci and 15 lateral menisci (39.4%). Meniscal extrusion increased from the 29.7% ± 14.9 obtained at the 5-year follow-up to the 72.5% ± 22.5 seen at the end of the follow-up (p = 0.0001). The joint space distance was almost unchanged from the initial evaluation (3.3 ± 1.5 mm) to the 5-year follow-up measurement (3.1 ± 1.7 mm, n.s.). However, it did decrease at the last follow-up (1.9 ± 1.5 mm, p < 0.05). The functional outcomes improved from the preoperative period to the mid-term follow-up and later worsened at the final follow-up. The mean preoperative Lysholm score at the initial follow-up was 61.5 ± 9.6, 86.9 ± 10.9 for the 5-year evaluation and stood at 77.4 ± 11.5 (p = 0.0001) at the final follow-up. Regarding the Tegner score, those pre-operative scores were compared to the ones at the last follow-up (median: 3; range 0-6 vs. 5.5; 3-6, respectively; p = 0.0001). The VAS went down from 6.6 ± 1.7 at the initial evaluation to 2.5 ± 1.9 at the final follow-up (p = 0.0001). The joint-space width remained unchanged from the initial evaluation (3.35 ± 1.5 mm) up to the 5-year follow-up measurement (3.1 ± 1.7 mm, n.s.). However, this joint-space distance had decreased by the last evaluation in the long-term follow-up (1.9 ± 1.4 mm, p < 0.05). Five patients (13.1%) presented with a MAT failure at 5 years, which was followed by extirpation of the meniscal graft. At the final follow-up, a total of 16 patients (42.1%) presented with a failure. At that time, there were 4 more MAT removals and seven patients that required a total knee replacement. The mean time to failure of the meniscal graft was 206.2 months ± 13.4 (18.0 years). CONCLUSIONS Meniscal allograft transplantation produces good functional results at a minimum 15-year follow-up. However, degenerative arthritis in the affected compartment progressed during that period. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Raúl Torres-Claramunt
- ICATKnee, ICATME, Hospital Universitari Dexeus, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
- Knee Unit, Department of Orthopaedic Surgery and Traumatology, Hospital del Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Rodolfo Morales-Avalos
- Department of Physiology, School of Medicine, Universidad Autonoma de Nuevo León (U.A.N.L.), Av. Francisco I. Madero and Av. Dr. Eduardo Aguirre Pequeño, s/n, Col. Mitras Centro, CP 66460, Monterrey, Nuevo León, Mexico.
- Knee Unit, Department of Orthopedic Surgery and Traumatology, University Hospital "Dr. José Eleuterio González", Universidad Autònoma de Nuevo León (U.A.N.L.), Monterrey, Nuevo León, Mexico.
| | - Simone Perelli
- ICATKnee, ICATME, Hospital Universitari Dexeus, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
- Knee Unit, Department of Orthopaedic Surgery and Traumatology, Hospital del Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - José Ramón Padilla-Medina
- Knee Unit, Department of Orthopedic Surgery and Traumatology, University Hospital "Dr. José Eleuterio González", Universidad Autònoma de Nuevo León (U.A.N.L.), Monterrey, Nuevo León, Mexico
| | - Joan Carles Monllau
- ICATKnee, ICATME, Hospital Universitari Dexeus, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
- Knee Unit, Department of Orthopaedic Surgery and Traumatology, Hospital del Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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Panicucci C, Schiaffino MC, Nesti C, Derchi M, Trocchio G, Severino M, Stagnaro N, Priolo E, Zara F, Santorelli FM, Bruno C. Long term follow-up in two siblings with Sengers syndrome: Case report. Ital J Pediatr 2022; 48:180. [PMID: 36253788 PMCID: PMC9575244 DOI: 10.1186/s13052-022-01370-y] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/28/2022] [Accepted: 09/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background Sengers syndrome is characterized by congenital cataract, hypertrophic cardiomyopathy, mitochondrial myopathy, and lactic acidosis associated with mutations in AGK gene. Clinical course ranges from a severe fatal neonatal form, to a more benign form allowing survival into adulthood, to an isolated form of congenital cataract. Thus far few reported cases have survived the second decade at their latest examination, and no natural history data are available for the disease. Case presentation Here we provide a 20-year follow-up in two siblings with a benign form of Sengers syndrome, expanding the phenotypical spectrum of the disease by reporting a condition of ovarian agenesis. Conclusion To our knowledge, this report provides the first longitudinal data of Sengers syndrome patients. Supplementary information The online version contains supplementary material available at 10.1186/s13052-022-01370-y.
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Affiliation(s)
- Chiara Panicucci
- Center of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Via G. Gaslini, 5, I-16147, Genova, Italy
| | | | - Claudia Nesti
- Molecular Medicine, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Maria Derchi
- Cardiology Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | | | | | - Nicola Stagnaro
- Radiology Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Enrico Priolo
- Ophthalmology Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Federico Zara
- Medical Genetics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.,Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | | | - Claudio Bruno
- Center of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Via G. Gaslini, 5, I-16147, Genova, Italy. .,Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.
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11
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Vitellius G, Donadille B, Decoudier B, Leroux A, Deguelte S, Barraud S, Bertherat J, Delemer B. Unilateral or bilateral adrenalectomy in PPNAD: six cases from a single family followed up over 40 years. Endocrine 2022; 78:201-204. [PMID: 35925470 DOI: 10.1007/s12020-022-03142-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/09/2022] [Indexed: 11/03/2022]
Abstract
The most frequent endocrine Carney complex manifestation is a bilateral primary pigmented nodular adrenocortical disease and bilateral adrenalectomy (BA) is therefore its main treatment. In this study, a 40 years follow-up of six members of the same family with heterozygous PRKAR1A germline mutation, is reported over two generations. The first cases, two sisters with severe hyperandrogenism and Cushing syndrome (CS) diagnosed in 1972 at age 14 and 25, were successfully treated with unilateral adrenalectomy (UA). Their two brothers were then diagnosed, one with a CS-related severe osteoporosis treated with BA and the other with CS treated with UA. The second generation was diagnosed with CS signs at 7 and 21 years of age and were treated with BA and UA respectively. Out of the four patients treated with UA, the only event possibly related to CS was spontaneous episode of pulmonary embolism, 30 years after surgery. Hormonal evaluation revealed either eucortisolism in one patient or partial adrenal deficiency in two and mild hypercortisolism in one patient. For the two patients with BA, one of them accidentally died. The second one, surprisingly, recovered progressively normal cortisol secretion and circadian variation. Steroid substitution was stopped 6 years after her surgery and we demonstrated by iodocholesterol scintigraphy the presence of bilateral adrenal remnants. In conclusion, our results of long term evolution of PPNAD patients show that UA in this subset of patients could be considered to treat CS.
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Affiliation(s)
- G Vitellius
- Service Endocrinologie, Diabète - Nutrition CHU Robert Debré, Reims, France.
| | - B Donadille
- Service Endocrinologie, Diabétologie, et Maladies métaboliques, Saint Antoine, Paris, France
| | - B Decoudier
- Service Endocrinologie, Diabète - Nutrition CHU Robert Debré, Reims, France
| | - A Leroux
- Polyclinique Bezannes, Reims, France
| | - S Deguelte
- Service de Chirurgie Digestive et Endocrinienne, CHU Robert Debré, Reims, France
| | - S Barraud
- Service Endocrinologie, Diabète - Nutrition CHU Robert Debré, Reims, France
- CRESTIC EA 3804, Université de Reims Champagne Ardenne, UFR Sciences Exactes et Naturelles, Moulin de la Housse, BP 1039, 51687, Reims CEDEX 2, France
| | - J Bertherat
- Service d'endocrinologie, Hôpital Cochin, Paris, France
| | - B Delemer
- Service Endocrinologie, Diabète - Nutrition CHU Robert Debré, Reims, France
- CRESTIC EA 3804, Université de Reims Champagne Ardenne, UFR Sciences Exactes et Naturelles, Moulin de la Housse, BP 1039, 51687, Reims CEDEX 2, France
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Berge LI, Gjestad R, Franck J, Javaras KN, Greenfield S, Haver B. Gender specific early treatment for women with alcohol addiction (EWA): Impact on work related outcomes. A 25-year registry follow-up of a randomized controlled trial (RCT). Drug Alcohol Depend 2022; 239:109600. [PMID: 36007448 PMCID: PMC9509484 DOI: 10.1016/j.drugalcdep.2022.109600] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/30/2022] [Accepted: 08/04/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Alcohol contributes to substantial economic burden, at both individual and community levels. We investigated the effect of the Early treatment for Women with Alcohol Addiction (EWA) treatment program on sickness leave, income, unemployment and early retirement pension up to 25 years following intake to treatment. METHODS The EWA RCT included 200 women with alcohol use disorder from 1983 to 1984 at the Karolinska University Hospital, Sweden. Participants were randomized to the EWA program, a two-year specialized woman only treatment including psychiatric, interpersonal and family concerns, or treatment as usual (TAU) in a mixed gender setting. We followed the participants in the RCT from 1985 to 2009 through linkage with a national labor market registry and applied latent growth curve modeling to estimate level and change in sickness leave, income, unemployment and early retirement pension. FINDINGS Relative to TAU, the EWA group had less increase in sickness leave up to 21 years after treatment. Overall, we found no differences in income between treatment groups, yet, a two-year interval analysis showed greater rise in income up to 8 years after treatment for the EWA group. Level and change in unemployment and early retirement pension did not differ between treatment groups. CONCLUSIONS Gender specific treatment emphasizing psychiatric, interpersonal and family issues for women with alcohol addiction had long-term positive effects on sickness leave and income. These findings complement positive clinical outcomes of the EWA treatment program on drinking patterns, mental health and mortality.
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Affiliation(s)
- Line Iden Berge
- NKS Olaviken Gerontopsychiatric Hospital, 5306 Erdal, Norway; Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Årstadveien 19, 5009 Bergen, Norway
| | - Rolf Gjestad
- Research department, Division of Psychiatry, Haukeland University Hospital, Sandviksleitet 1, 5036 Bergen, Norway; Center for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Sandviksleitet 1, 5036 Bergen, Norway
| | - Johan Franck
- Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18 A, 17177 Stockholm, Sweden
| | - Kristin Nicole Javaras
- Division of Women's Mental Health, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States
| | - Shelly Greenfield
- Division of Women's Mental Health, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States; Division of Alcohol, Drugs and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Brit Haver
- Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18 A, 17177 Stockholm, Sweden; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Haukelandsbakken, 5009 Bergen, Norway
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13
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Loberman D, Rinewalt DE, Mallidi HR, Sabe AA, Mohr R, Minha S, Ziv-Baran T. All-cause readmission after transcatheter aortic valve replacement in a community hospital - Long term follow-up: Readmissions after aortic valve replacement. Am J Med Sci 2021:S0002-9629(21)00402-X. [PMID: 34752740 DOI: 10.1016/j.amjms.2021.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/19/2021] [Accepted: 09/28/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Post-procedure readmissions are associated with lower quality of life and increased economic burden. The study aimed to identify predictors for long-term all-cause readmissions in patients who underwent transcatheter aortic valve replacement (TAVR) in a community hospital. METHODS A Historical cohort study of all adults who underwent TAVR at Cape-Cod hospital between June 2015 and December 2017 was performed and data on readmissions was collected up-to May 2020 (median follow up of 3.3 years). Pre-procedure, procedure and in-hospital post-procedure parameters were collected. Readmission rate was evaluated, and univariate and multivariable analyses were applied to identify predictors for readmission. RESULTS The study included 262 patients (mean age 83.7±7.9 years, 59.9% males). The median Society of Thoracic Surgeons (STS) probability of mortality (PROM) score was 4.9 (IQR, 3.1-7.9). Overall, 120 patients were readmitted. Ten percent were readmitted within 1-month, 20.8% within 3-months, 32.0% within 6-months and 44.5% within 1-year. New readmissions after 1-year were rare. STS PROM 5% or above (HR 1.50, p=0.039), pre-procedure anemia (HR 1.63, p=0.034), severely decreased pre-procedure renal function (HR 1.93, p=0.040) and procedural complication (HR 1.65, p=0.013) were independent predictors for all-cause readmission. CONCLUSIONS Elevated procedural risk, anemia, renal dysfunction and procedural complication are important predictors for readmission. Pre-procedure and ongoing treatment of the patient's background diseases and completion of treatment for complications prior to discharge may contribute to a reduction in the rate of readmissions.
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Wang Z, Zhang P, Zhou W, Xia S, Zhou W, Zhou X, Cheng X, Shi Y, Lin Z, Song D, Cheng G. Neonatal hypoxic-ischemic encephalopathy diagnosis and treatment: a National Survey in China. BMC Pediatr 2021; 21:261. [PMID: 34090355 PMCID: PMC8178820 DOI: 10.1186/s12887-021-02737-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/26/2021] [Indexed: 11/28/2022] Open
Abstract
Background Neonatal hypoxic-ischemic encephalopathy (HIE) affects as many as 100,000 infants each year in China. Therapeutic hypothermia reduces HIE related mortality and long-term neurodevelopmental disabilities. National guidelines for HIE management were published a decade ago. This study aimed to investigate the current status of HIE diagnosis and treatment in China. Method This prospective cross-sectional national survey used a questionnaire evaluating practices related to HIE management. Descriptive statistics and Chi-square or Fisher’s exact test were used, and a p-value of < 0.05 was considered significant. Results The 273 hospitals that completed the survey were located in 31 of the 34 provincial districts in China. Eighty-eight percent of the hospitals were Level III hospitals, and 74% treated 10 or more HIE cases annually. Awareness rates of the national guidelines for HIE diagnosis, HIE treatment, and therapeutic hypothermia protocol were 85, 63, and 78%, respectively. Neurological manifestations and blood gas were used as HIE diagnostic criteria by 96% (263/273) and 68% (186/273) of the hospitals, respectively. Therapeutic hypothermia was used in 54% (147/273) of hospitals. The percentage of general hospitals that implemented therapeutic hypothermia (43%, 71/165) was significantly lower than that in maternity and infant hospitals (67%, 49/73) (χ2 = 11.752, p = 0.001) and children’s hospitals (77%, 27/35) (χ2 = 13.446, p < 0.001). Reasons for not providing therapeutic hypothermia included reduction of HIE cases in recent years (39%), high cost of cooling devices and treatment (31%), lack of training (26%), and safety concerns (4%). Among the hospitals that provided therapeutic hypothermia, 27% (39/147) were in full compliance with the recommended protocol. Eighty-one percent (222/273) of the hospitals treated HIE infants with putative neuroprotective agents alone or in combination with cooling. Ninety-one percent of the hospitals had long-term neurodevelopmental follow-up programs for infants with HIE. Conclusions There is significant heterogeneity in HIE diagnosis and treatment in China. Therapeutic hypothermia has not become a standard of care for neonatal HIE nationwide. Unproven agents are widely used for HIE treatment. Nationwide standardization of HIE management and dissemination of therapeutic hypothermia represent the opportunities to reduce mortality and improve long-term neurodevelopmental outcomes of children affected by HIE. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02737-6.
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Affiliation(s)
- Zheng Wang
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 200032, China
| | - Peng Zhang
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 200032, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 200032, China
| | - Shiwen Xia
- Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Hubei, 430070, China
| | - Wei Zhou
- Guangzhou women and children's Medical Center, Guangdong, 510623, China
| | - Xiaoyu Zhou
- Children's Hospital of Nanjing Medical University, Jiangsu, 210093, China
| | - Xiuyong Cheng
- Department of Neonatology, The First Affiliated Hospital of Zhengzhou University, Henan, 450052, China
| | - Yuan Shi
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Zhenlang Lin
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Zhejiang, 325027, China
| | - Dongli Song
- Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA. .,Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Guoqiang Cheng
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 200032, China.
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Gutschmidt K, Musumeci O, Díaz-Manera J, Chien YH, Knop KC, Wenninger S, Montagnese F, Pugliese A, Tavilla G, Alonso-Pérez J, Hwu PW, Toscano A, Schoser B. STIG study: real-world data of long-term outcomes of adults with Pompe disease under enzyme replacement therapy with alglucosidase alfa. J Neurol 2021; 268:2482-92. [PMID: 33543425 DOI: 10.1007/s00415-021-10409-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/11/2020] [Accepted: 01/13/2021] [Indexed: 12/12/2022]
Abstract
Background Pompe disease is one of the few neuromuscular diseases with an approved drug therapy, which has been available since 2006. Our study aimed to determine the real-world long-term efficacy and safety of alglucosidase alfa. Methods This multicenter retrospective study (NCT02824068) collected data from adult Pompe disease patients receiving ERT for at least 3 years. Demographics and baseline characteristics, muscle strength, lung function (FVC), walking capability (6MWT), and safety were assessed once a year. Evaluation was done on the group and individual levels, using quantitative linear models (t test) and general univariate linear models (ANOVA). Findings Sixty-eight adult Pompe disease patients from four countries (Spain, Taiwan, Italy, Germany (STIG)) participated. The mean follow-up was 7.03 years ± 2.98. At group level in all outcome measures, an initial improvement followed by a secondary decline was observed. After 10 years, the 6MWT%pred showed the most sustained positive effect (p = 0.304). The MRC%max remained stable with a mild decline (p = 0.131), however, FVC%pred deteriorated significantly (p < 0.001) by 14.93% over 10 years of ERT. The progression rate of FVC%pred under ERT could be explained in most of the patients (83.5%) by the disease severity at baseline. Furthermore, our study shows a decline in the FVC combined with an increase in non-invasive and invasive ventilation requirements in adult Pompe disease patients over time. Conclusions The STIG real-world study confirms an initial efficacy of ERT in the first years with a secondary sustained decline in multiple outcome measures. Further efforts are required to establish a more valid long-term monitoring and improved therapies. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-021-10409-9.
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İNCESOY ÖZDEMİR S, TAÇYILDIZ N, VARAN A, KEBUDİ R, ZÜLFİKAR B, CELKAN T, ŞAHİN G, ÇORAPÇIOĞLU F, KESKİN YİLDİRİM Z, PINARLI FG, OLGUN N, SARI N, DAĞDEMİR A, ÖZYÖRÜK D, EREN T, ÇAKIR FB, ADAKLI AKSOY B, BOZKURT C, GÜLER E, ÖZGÜVEN AA, ERBEY F, BERBER M, DİNÇASLAN H, ÜNAL E, KANTAR M. Cross-sectional study: long term follow-up care for pediatric cancer survivors in a developing country, Turkey: current status, challenges, and future perspectives. Turk J Med Sci 2020; 50:1916-1921. [PMID: 32628434 PMCID: PMC7775715 DOI: 10.3906/sag-1911-193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 07/04/2020] [Indexed: 11/03/2022] Open
Abstract
Aim The main purpose of this study is to determine the current status of long-term follow-up (LTFU) for childhood cancer survivors and the challenges of LTFU for pediatric cancer survivors at pediatric oncology institutions in Turkey. Material and methods A questionnaire was e-mailed to the directors of 33 pediatric oncology centers (POCs) registered in the Turkish Pediatric Oncology Group (TPOG). Of these 33 active TPOG institutions, 21 participated in the study and returned their completed questionnaires. Results Only 1 of the 21 participating centers had a separate LTFU clinic. The remaining centers provided LTFU care for childhood cancer survivors at the pediatric oncology outpatient clinic. Of these centers, 17 (80.9%) reported difficulty in transition from the pediatric clinic to the adult clinic, 14 (66.6%) reported insufficient care providers, and 12 (57.1%) reported insufficient time and transportation problems. As neglected late effects, 16 (76.1%) centers reported psychosocial and getty job problems and 11 (52.3%) reported sexual and cognitive problems. None of the centers had their own LTFU guidelines for their daily LTFU practice Conclusion This study was the first to gain an overview of the needs of POCs and the gaps in survivorship services in Turkey. The results from this study will help to develop a national health care system and national guidelines for pediatric cancer survivors.
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Affiliation(s)
- Sonay İNCESOY ÖZDEMİR
- Department of Pediatric Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, AnkaraTurkey
| | - Nurdan TAÇYILDIZ
- Department of Pediatric Oncology, Faculty of Medicine, Ankara University, AnkaraTurkey
| | - Ali VARAN
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Rejin KEBUDİ
- Institute of Oncology, İstanbul University, İstanbulTurkey
| | | | - Tiraje CELKAN
- Department of Pediatric Hematology Oncology, Faculty of Medicine, İstanbul University, İstanbulTurkey
| | - Gürses ŞAHİN
- Department of Pediatric Oncology, Dr. Sami Ulus Children’s Hospital, AnkaraTurkey
| | - Funda ÇORAPÇIOĞLU
- Department of Pediatric Oncology, Faculty of Medicine, Kocaeli University, KocaeliTurkey
| | - Zuhal KESKİN YİLDİRİM
- Department of Pediatric Oncology, Faculty of Medicine, Atatürk University, ErzurumTurkey
| | - Faruk Güçlü PINARLI
- Department of Pediatric Oncology, Faculty of Medicine, Celal Bayar University, ManisaTurkey
| | - Nur OLGUN
- Department of Pediatric Oncology, Faculty of Medicine, Dokuz Eylül University, İzmirTurkey
| | - Neriman SARI
- Department of Pediatric Oncology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, AnkaraTurkey
| | - Ayhan DAĞDEMİR
- Department of Pediatric Oncology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
| | - Derya ÖZYÖRÜK
- Department of Pediatric Oncology, Ankara Children’s Hematology and Oncology Training and Research Hospital, AnkaraTurkey
| | - Tuba EREN
- Department of Pediatric Oncology, Faculty of Medicine, Trakya University, EdirneTurkey
| | - Fatma Betül ÇAKIR
- Department of Pediatric Hematology Oncology, Faculty of Medicine, Bezmiâlem Vakıf University, İstanbulTurkey
| | - Başak ADAKLI AKSOY
- Department of Pediatric Hematology Oncology, Faculty of Medicine, Medeniyet University, İstanbulTurkey
| | - Ceyhun BOZKURT
- Department of Pediatric Hematology Oncology, Faculty of Medicine, Istinye University, Bahçelievler Medikal Park Hospital, İstanbulTurkey
| | - Elif GÜLER
- Department of Pediatric Oncology, Faculty of Medicine, Akdeniz University, AntalyaTurkey
| | - Ali Aykan ÖZGÜVEN
- Department of Pediatric Oncology, Faculty of Medicine, Celal Bayar University, ManisaTurkey
| | - Fatih ERBEY
- Department of Pediatric Hematology Oncology, Faculty of Medicine, Koç University, AnkaraTurkey
| | - Melda BERBER
- Department of Pediatric Oncology, Faculty of Medicine, Ankara University, AnkaraTurkey
| | - Handan DİNÇASLAN
- Department of Pediatric Oncology, Faculty of Medicine, Ankara University, AnkaraTurkey
| | - Emel ÜNAL
- Department of Pediatric Oncology, Faculty of Medicine, Ankara University, AnkaraTurkey
| | - Mehmet KANTAR
- Department of Pediatric Oncology, Faculty of Medicine, Ege University, İzmirTurkey
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Skerritt C, DaJusta DG, Fuchs ME, Pohl H, Gomez-Lobo V, Hewitt G. Long-term urologic and gynecologic follow-up and the importance of collaboration for patients with anorectal malformations. Semin Pediatr Surg 2020; 29:150987. [PMID: 33288143 DOI: 10.1016/j.sempedsurg.2020.150987] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Anorectal malformations (ARM) are well recognized to be associated with anomalies in other organ systems. The introduction of screening protocols has increased the diagnosis of these anomalies and greater collaboration with other specialties has influenced the treatment and follow-up of patients with ARMs. Much of the medical literature regarding the treatment of anorectal malformations has focused on technical details of operations and early post-surgical outcomes. Recently, an increase in published data regarding the long-term sequelae of an ARM diagnosis has resulted in an emphasis extended follow up in this population. Patient support groups have highlighted complex issues in ARM patients persist into adulthood have advocated for improved transitional care. This article describes the benefits of long-term follow-up and identifies key issues in ARM patients with respect to urologic and gynecologic health. A collaborative model of care is outlined and suggested timings of screening for potential problems is described.
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Serati M, Salvatore S, Athanasiou S, Scancarello C, Ghezzi F, Braga A; Italian Society of Urodynamics. Ten years' follow-up after iliococcygeus fixation for the treatment of apical vaginal prolapse. Int Urogynecol J 2021; 32:1533-8. [PMID: 33237354 DOI: 10.1007/s00192-020-04598-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/28/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Various surgical techniques have been described for vaginal vault prolapse repair, but the best surgical approach is still to be proven. The aim of this study is to report the long-term objective and subjective outcomes of women who underwent iliococcygeus fixation for the treatment of vaginal vault prolapse with a minimum follow-up of 10 years. METHODS Women with symptomatic vaginal vault prolapse (Pelvic Organ Prolapse Quantification [POP-Q] stage ≥ 2) who had previously undergone hysterectomy for any reason were prospectively enrolled and treated with iliococcygeus fixation. Subjective success was defined as Patient Global Impression of Improvement (PGI-I) ≤ 2 and an absence of bulging symptoms. Objective success was defined as stage of prolapse < 2 in all compartments. Overall success rate was defined as women without prolapse symptoms, PGI-I ≤ 2, stage of prolapse < 2, and no need for other surgery. Prolpase Quality of Life (P-QOL) questionnaires were completed at the preoperative visit and at every follow-up visit. Multiple logistic regression was performed to identify factors involved in the risk of recurrent POP. RESULTS After a median (range) follow-up of 120 (120-132) months, the subjective, objective, and overall cure rates were 82% (32/39), 74.4% (29/39), and 74.4% (29/39), respectively. Only stage IV vault descensus independently predicted POP recurrence after ICG (OR: 7.66 [95% CI: 1.21-9.02]; p < 0.001). CONCLUSION Iliococcygeus fixation seems to be a safe and effective option for the treatment of vaginal vault prolapse at 10 years' follow-up.
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Yoneda K, Takahashi T, Kishi K. Over Ten Years' Follow-Up of Chronic Total Coronary Occlusion Angioplasty. Cardiovasc Revasc Med 2020; 25:44-46. [PMID: 33183984 DOI: 10.1016/j.carrev.2020.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/15/2020] [Revised: 09/21/2020] [Accepted: 10/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES It has been reported that successful percutaneous coronary intervention for chronic total occlusion (CTO-PCI) might be associated with symptom relief, a lower rate of subsequent myocardial infarction and coronary artery bypass graft surgery, and improved long-term survival, compared with unsuccessful PCI for CTO. However, the long-term benefit of percutaneous recanalization of CTO remains unclear. Therefore, we aimed to evaluate the long-term benefit of percutaneous recanalization of CTO. METHODS We analyzed consecutive cases of CTO-PCI performed between January 2000 and December 2006. The health status of all patients on September 2017 was obtained via letter or from medical records. We collected relevant patient information as well as angiographic and procedural characteristics. RESULTS A total of 477 patients (82.8% men, mean age, 65.7 years) underwent CTO-PCI. The procedural was successful in 382 cases (80.3%). Reference vessel diameter, occlusion length and angiographic stump of CTO site were associated with the success of CTO intervention. During the mean follow-up period of 139.8 months, successful CTO-PCI was associated with a higher survival rate when compared with failed CTO-PCI (Log-rank test: P = 0.0147). When categorized by target vessel, successful revascularization of left anterior descending (LAD) -CTO improved long-term survival (Log-rank test: P = 0.0041). On the other hand, successful revascularization of right coronary artery or left circumflex -CTO was not associated with improved long-term survival [Log-rank test: P = 0.5631 (RCA), P = 0.2774 (LCX)]. CONCLUSIONS Successful CTO-PCI, especially the successful revascularization of LAD-CTO, improved long-term survival of patients.
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Affiliation(s)
- Kohei Yoneda
- Tokushima Red Cross Hospital, Department of Cardiology, Tokushima, Japan.
| | - Takefumi Takahashi
- Tokushima Red Cross Hospital, Department of Cardiology, Tokushima, Japan
| | - Koichi Kishi
- Tokushima Red Cross Hospital, Department of Cardiology, Tokushima, Japan
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Bilet T, Olsen T, Andersen JR, Martinsen EW. Cognitive behavioral group therapy for panic disorder in a general clinical setting: a prospective cohort study with 12 to 31-years follow-up. BMC Psychiatry 2020; 20:259. [PMID: 32448206 PMCID: PMC7247216 DOI: 10.1186/s12888-020-02679-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/18/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The long-term prognosis after cognitive behavioral therapy (CBT) in outpatient groups for panic disorder and agoraphobia is not well known. The purpose of this study was to assess long-term outcomes in terms of psychological health, health-related quality of life (HRQoL), quality of life (QoL) and treatment satisfaction after CBT for panic disorder and agoraphobia. METHODS The sample consisted of 68 patients (61% response rate), who were assessed at pretreatment; at the start and end of treatment; and after 3 months, after 1 year, and over the long term (M = 24 years; SD = 5.3; range: 12 to 31 years). The main outcome was the total score on the Phobic Avoidance Rating Scale (PARS-total). At long-term follow-up, HRQoL was measured with the RAND-12 questionnaire, and QoL was measured with two questions from the "Study on European Union Statistics on Income and Living Conditions". Patient experiences and treatment satisfaction were assessed by the Generic Short Patient Experiences Questionnaire. A marginal longitudinal model was applied to study the main outcome. RESULTS The effect size of the long-term change (mean change/ pooled SD) in the PARS-total score was (- 1.6, p < 0.001) and was stable over time. A PARS-total score reduction of 50% was found in 98% of patients at the long-term follow-up. The patients' HRQoL and QoL were similar to the expected scores for the general Norwegian population. Of the patients, 95% reported high to very high satisfaction with the CBT, and 93% reported large treatment benefits. CONCLUSIONS To the best of our knowledge, this study has the longest follow-up after group CBT for panic disorder and agoraphobia, showing a good prognosis in ≥93% of the participating patients.
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Affiliation(s)
- Truls Bilet
- Division of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Torbjørn Olsen
- Division of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - John Roger Andersen
- Centre of Health Research, Førde Hospital Trust, Førde, Norway. .,Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway.
| | - Egil W. Martinsen
- grid.55325.340000 0004 0389 8485Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Murphy P, Levine A, Lerma T, Young S, Hwang J, Goldsby R. A portable survivorship care plan: a tool that helps educate and improve knowledge in childhood cancer survivors. Support Care Cancer 2020; 29:169-177. [PMID: 32328773 PMCID: PMC7686177 DOI: 10.1007/s00520-020-05422-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/17/2020] [Indexed: 01/29/2023]
Abstract
PURPOSE There is a growing population of survivors of childhood cancer at risk for late effects that can affect their overall quality of life. There is evidence that they have inadequate knowledge about their diagnosis, treatment, and subsequent late effects. A randomized study was conducted to determine if a portable credit card-sized plastic card, the "Survivor Healthcare Passport," improved the survivor's knowledge of diagnosis, treatment, risks, and follow-up care. The study included 126 patients 2 years post-end of cancer treatment and took place at the UCSF Benioff Children's Hospital Survivorship Clinic. METHODS Patients attending the UCSF Survivorship clinic were randomized to receive or not receive a passport at their first survivorship clinic visit. Each groups' knowledge of diagnosis, treatment history, and follow-up needs was assessed at three time points with a questionnaire. RESULTS Patients who received the passport distributed immediately after their visit demonstrated improved and sustained knowledge compared with survivors who did not receive the passport until more than 4 months later. CONCLUSION Enhancing a survivor's knowledge is an important endeavor and a continual challenge for practitioners in survivorship clinics. This portable educational tool helps improve patient knowledge of their cancer, therapy, and follow-up needs. By providing a tangible card that is quick and easy to access, survivors have access to their treatment late effects and follow-up needs that can also be shared with other healthcare providers.
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Affiliation(s)
- Patricia Murphy
- Pediatric Oncology, UCSF Benioff Children's Hospital, 550 16th Street, 4th Floor, San Francisco/Oakland, CA, 94158, USA.
| | - Alyssa Levine
- Pediatric Oncology, UCSF Benioff Children's Hospital, 550 16th Street, 4th Floor, San Francisco/Oakland, CA, 94158, USA
| | - Tanya Lerma
- Pediatric Oncology, UCSF Benioff Children's Hospital, 550 16th Street, 4th Floor, San Francisco/Oakland, CA, 94158, USA
| | - Sabrina Young
- Pediatric Oncology, UCSF Benioff Children's Hospital, 550 16th Street, 4th Floor, San Francisco/Oakland, CA, 94158, USA
| | - Jimmy Hwang
- Pediatric Oncology, UCSF Benioff Children's Hospital, 550 16th Street, 4th Floor, San Francisco/Oakland, CA, 94158, USA
| | - Robert Goldsby
- Pediatric Oncology, UCSF Benioff Children's Hospital, 550 16th Street, 4th Floor, San Francisco/Oakland, CA, 94158, USA
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Laddaga FE, Moschetta M, Perrone T, Perrini S, Colonna P, Ingravallo G, D'abbicco D, Specchia G, Gaudio F. Long-term Hodgkin Lymphoma Survivors: A Glimpse of What Happens 10 Years After Treatment. Clin Lymphoma Myeloma Leuk 2020; 20:e506-e512. [PMID: 32381398 DOI: 10.1016/j.clml.2020.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION This retrospective study was focused on 96 patients (median age at diagnosis, 35 years) with newly diagnosed Hodgkin lymphoma (HL) treated at the University Hospital of Bari (Italy) between 2005 and 2008, to evaluate the outcome and the long-term toxicity. PATIENTS AND METHODS First-line chemotherapy was ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in all patients; 49 (51%) patients had undergone radiotherapy. At the end of treatment, 75 (78%) patients were in complete remission (CR); 18 (24%) of 75 patients relapsed after first-line treatment; 20 (21%) underwent autologous hematopoietic stem cell transplantation, and 3 (3%) underwent allogeneic stem cell transplantation. RESULTS After a median follow-up of 12 years, 85 (88%) patients are alive in CR, and 11 (14%) have died (2 of a second neoplasia, 1 of infection, and 8 of the disease). The 140-month Kaplan-Meier survival estimates were 86%. Three women became pregnant and each gave birth to a healthy child. The most prevalent chronic conditions at last follow-up were: a reduction in lung transfer factor for carbon monoxide (40%), fatigue (31%), hypothyroidism (30%), and infertility (16%). CONCLUSIONS Results of this study offer indications about how long after the initial treatment excess deaths from causes other than HL begin to occur. However, challenges remain, namely establishing the optimal time to begin screening for potential late complications and developing better surveillance guidelines. Further work is needed to identify risk factors that may predict specific late effects.
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Affiliation(s)
| | - Marco Moschetta
- Department of Emergency and Organ Transplantation (D.E.T.O.), Breast Unit, University of Bari, Bari, Italy
| | - Tommasina Perrone
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy
| | - Sebastio Perrini
- Department of Emergency and Organ Transplantation (D.E.T.O.), Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari, Bari, Italy
| | - Paolo Colonna
- Department of Cardiology, University Hospital Policlinico, Bari, Italy
| | - Giuseppe Ingravallo
- Department of Emergency and Organ Transplantation (D.E.T.O.), Pathology Section, University of Bari, Bari, Italy
| | - Dario D'abbicco
- Department of Emergency and Organ Transplantation (D.E.T.O.), Institute of General Surgery "G Marinaccio," University of Bari, Bari, Italy
| | - Giorgina Specchia
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy
| | - Francesco Gaudio
- Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy.
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Lopez Gordo S, Busquets J, Peláez N, Secanella L, Martinez-Carnicero L, Ramos E, Fabregat J. Long-term results of resection of the head of the pancreas due to chronic pancreatitis: Pancreaticoduodenectomy or duodenum-preserving cephalic pancreatectomy? Cir Esp 2019; 98:267-273. [PMID: 31848016 DOI: 10.1016/j.ciresp.2019.10.009] [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] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 10/12/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Chronic pain in chronic pancreatitis is difficult to manage. The objective of our study is to assess the control of pain that is refractory to medical treatment in patients with an inflammatory mass in the head of the pancreas, as well as to compare the two surgical techniques. METHODS A retrospective study included patients treated surgically between 1989 and 2011 who had been refractory to medical treatment with inflammation of the head of the pancreas. An analysis of the short and long-term results was done to compare patients who had undergone pancreaticoduodenectomy (PD) and/or resection of the head of the pancreas with duodenal preservation (RHPDP). RESULTS 22 PD and 12 RHPDP were performed. Postoperative complications were observed in 14% of patients, the most frequent being delayed gastric emptying (14.7%) and pancreatic fistula (11.7%). No statistically significant differences were found in terms of surgical technique. Pain control was satisfactory in 85% of patients, 43% presented de novo diabetes mellitus, and 88% returned to their work activities. Fourteen patients died during follow-up, 7 due to malignancies, and some were related to tobacco use and alcohol consumption. The overall 5 and 10 year survival rates were 88% and 75% respectively. CONCLUSION Cephalic resection in patients with intractable pain in chronic pancreatitis is an effective therapy that provides good long-term results in terms of pain control, with no significant differences between the two surgical techniques. Patients with chronic pancreatitis have a high mortality rate associated with de novo malignancies.
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Affiliation(s)
- Sandra Lopez Gordo
- Consorcio Sanitario Alt Penedés-Garraf, Sant Pere de Ribes, Barcelona, España
| | - Juli Busquets
- Unitat de Cirurgia Hepatobiliopancreàtica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España.
| | - Nuria Peláez
- Unitat de Cirurgia Hepatobiliopancreàtica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Lluís Secanella
- Unitat de Cirurgia Hepatobiliopancreàtica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Laura Martinez-Carnicero
- Servei de Radiodiagnòstic, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Emilio Ramos
- Unitat de Cirurgia Hepatobiliopancreàtica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Joan Fabregat
- Unitat de Cirurgia Hepatobiliopancreàtica, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
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Insulander M, Lindh G, Stenkvist J, Samuelson A, Fischler B. Long-term follow-up of a vaccination program for infants born to HBsAg-positive mothers in Stockholm County, Sweden. Vaccine 2019; 38:790-793. [PMID: 31740095 DOI: 10.1016/j.vaccine.2019.10.100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/24/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 01/30/2023]
Abstract
We investigated the long-term antibody response to hepatitis B virus (HBV) vaccination in babies born to chronically infected mothers. They received one dose of monovalent HBV vaccination at birth and one month of age, followed by 3 doses of hexavalent vaccine including an HBV component at ages 3, 5, and 12 months, respectively, with a very high percentage of protective anti-HBs levels at 13 months. At the age of 8-12 years, 56 out of 68 children (82%) had protective levels of anti-HBs, two had signs of anti-HBc seroconversion without any history of clinical disease and none had ongoing infection. A small subgroup was retested after one booster dose, in all resulting in increase in anti-HBs from below 10 IU/L to levels corresponding to protective immunity. We conclude that this vaccination strategy is effective throughout the first decade of life in avoiding chronic infection and in maintaining a good serological response.
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Affiliation(s)
- Mona Insulander
- Department of Communicable Disease Control and Prevention, Stockholm County Council, Sweden
| | - Gudrun Lindh
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Sweden
| | - Jenny Stenkvist
- Department of Communicable Disease Control and Prevention, Stockholm County Council and Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Sweden
| | - Agneta Samuelson
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet and Department of Clinical Microbiology, Karolinska University Hospital, Sweden
| | - Björn Fischler
- Department of Pediatrics, CLINTEC, Karolinska Institutet, Karolinska University Hospital, Sweden.
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Labbé D, Guerreschi P. [Facial paralysis sequelae: Long term follow-up revision surgery, redo, continuing care]. ANN CHIR PLAST ESTH 2019; 64:531-539. [PMID: 31492441 DOI: 10.1016/j.anplas.2019.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 11/17/2022]
Abstract
Facial paralysis sequelae have an intense psycho-social impact which imposes an optimal care in the long run. The surgical challenges are numerous, and the therapeutic weapons are multiple. We propose an analysis of these treatments by the prism of their pitfalls and their limits. The complications of the main surgical procedures are described as well as the details of the rework necessary to cope with them or to quickly correct the defects. Moreover, the result limits are detailed with suggestions to improve them. Finally, we develop the necessary iterative treatments or new therapeutic proposals that are essential for the long-term care of these patients whose sequelae of facial paralysis evolve with time and aging. The surgery of facial paralysis is not unequivocal. It requires humility, patience and tenacity to support the patient throughout his life.
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Affiliation(s)
- D Labbé
- Hôpital privé Saint-Martin, 18, rue des Roquemonts, 14000 Caen, France
| | - P Guerreschi
- Service de chirurgie plastique et reconstructrice, CHU de Lille, hôpital Roger Salengro, 59000 Lille, France.
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Lenderink T, Balkestein EJM. First time referral reasons, diagnoses and 10-year follow-up of patients seen at a Dutch fast lane outpatient cardiology clinic. Neth Heart J 2019; 27:354-61. [PMID: 30953280 DOI: 10.1007/s12471-019-1266-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose To describe reasons for referral, diagnostic procedures, diagnoses and long-term follow-up of first-time referred patients to a fast lane outpatient cardiology clinic (FLOCC). Methods A descriptive report of results obtained in a newly organised outpatient clinic. Data up to final diagnosis were recorded from electronic medical records. Follow-up data were obtained from electronic medical records, contacting patients and/or their general practitioners. Results During the first 3 months of 2007, 419 patients were seen at the FLOCC. Of these patients, 360 were referred by general practitioners, 55 by other specialists and four were self-referrals. The largest referral groups were: chest complaints (44%), palpitations (19%) and dyspnoea (12%). In 65% of the 419 patients, cardiovascular disease was ruled out and they were discharged. Of these, 41% of the diagnoses were made on the same day, with a further 44% after additional investigations, mostly Holter registration. During 10 years of follow-up, 49 patients died: 17 of cardiac, 29 of non-cardiac, mainly cancer, and three of unknown causes. Of the initially discharged patients, 35% were referred again after an average of 4 years (1,443 days), with 47% reporting similar complaints. Conclusion Of the patients referred to our FLOCC, most had chest pain. In one-third of all patients, cardiac disease was ruled out on the same day. Of all the patients discharged, 85% were diagnosed after basic investigations that could be ordered by a general practitioner. Holter registration was the most frequently requested additional investigation. These results support the development of less expensive, easily accessible extramural cardiology clinics.
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Pels A, Knaven OC, Wijnberg-Williams BJ, Eijsermans MJC, Mulder-de Tollenaer SM, Aarnoudse-Moens CSH, Koopman-Esseboom C, van Eyck J, Derks JB, Ganzevoort W, van Wassenaer-Leemhuis AG. Neurodevelopmental outcomes at five years after early-onset fetal growth restriction: Analyses in a Dutch subgroup participating in a European management trial. Eur J Obstet Gynecol Reprod Biol 2019; 234:63-70. [PMID: 30660941 DOI: 10.1016/j.ejogrb.2018.12.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/23/2018] [Accepted: 12/28/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The objective of this study is to explore developmental outcomes at five years after early-onset fetal growth restriction (FGR). STUDY DESIGN Retrospective data analysis of prospective follow-up of patients of three Dutch centres, who participated in a twenty centre European randomized controlled trial on timing of delivery in early-onset FGR. Developmental outcome of very preterm infants born after extreme FGR is assessed at (corrected) age of five. RESULTS Seventy-four very preterm FGR children underwent follow-up at the age of five. Mean gestational age at birth was 30 weeks and birth weight was 910 g, 7% had a Bayley score <85 at two years. Median five years' FSIQ was 97, 16% had a FSIQ < 85, and 35% had one or more IQ scores <85. Motor score ≤ 7 on movement ABC-II (M-ABC-II-NL) was seen in 38%. Absent or reversed end-diastolic flow, gestational age at delivery, birthweight and neonatal morbidity were related to an FSIQ < 85. Any abnormal IQ scale score was related to birthweight, male sex and severity of FGR, and abnormal motor score to male sex and bronchopulmonary dysplasia (BPD). CONCLUSIONS Overall, median cognitive outcome at five years was within normal range, but 35% of the children had any abnormal IQ score at age five, depending on the IQ measure, and motor impairment was seen in 38% of the children. GA at delivery, birthweight, EDF prior to delivery and neonatal morbidity were the most important risk factors for cognitive outcomes.
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van Elten TM, Karsten MDA, Geelen A, Gemke RJBJ, Groen H, Hoek A, van Poppel MNM, Roseboom TJ. Preconception lifestyle intervention reduces long term energy intake in women with obesity and infertility: a randomised controlled trial. Int J Behav Nutr Phys Act 2019; 16:3. [PMID: 30621789 PMCID: PMC6325811 DOI: 10.1186/s12966-018-0761-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 12/05/2018] [Indexed: 12/16/2022] Open
Abstract
Background The preconceptional period may be an optimal window of opportunity to improve lifestyle. We previously showed that a 6 month preconception lifestyle intervention among women with obesity and infertility was successful in decreasing the intake of high caloric snacks and beverages, increasing physical activity and in reducing weight in the short term. We now report the effects of the preconception lifestyle intervention on diet, physical activity and body mass index (BMI) at 5.5 years (range = 3.7–7.0 years) after the intervention. Methods We followed women who participated in the LIFEstyle study, a multicentre RCT in which women with obesity and infertility were assigned to a six-month lifestyle intervention program or prompt infertility treatment (N = 577). Diet and physical activity 5.5 years later were assessed with an 173-item food frequency questionnaire (N = 175) and Actigraph triaxial accelerometers (N = 155), respectively. BMI was calculated from self-reported weight and previously measured height (N = 179). Dietary intake, physical activity, and BMI in the intervention and control group were compared using multivariate regression models. Additionally, dietary intake, physical activity and BMI of women allocated to the intervention arm with successful weight loss during the intervention (i.e. BMI < 29 kg/m2 or ≥ 5% weight loss), unsuccessful weight loss and the control group were compared with ANCOVA. Results Although BMI did not differ between the intervention and control group 5.5 years after the intervention (− 0.5 kg/m2 [− 2.0;1.1]; P = 0.56), the intervention group did report a lower energy intake (− 216 kcal/day [− 417;-16]; P = 0.04). Women in the intervention arm who successfully lost weight during the intervention had a significantly lower BMI at follow-up compared to women in the intervention arm who did not lose weight successfully (− 3.4 kg/m2 [− 6.3;-0.6]; P = 0.01), and they reported a significantly lower energy intake compared to the control group (− 301 kcal [− 589;-14]; P = 0.04). Macronutrient intake, diet quality, and physical activity did not differ between the intervention and control group, irrespective of successful weight loss during the intervention. Conclusions In our study population, a preconception lifestyle intervention led to reduced energy intake 5.5 years later. Additionally, women allocated to the intervention group who were successful in losing weight during the intervention also had a lower BMI at follow-up. This shows the potential sustainable effect of a preconception lifestyle intervention. Trial registration This trial was registered on 16 November 2008 in the Dutch trial register; clinical trial registry number NTR1530. Electronic supplementary material The online version of this article (10.1186/s12966-018-0761-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- T M van Elten
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University medical centre, de Boelelaan 1117, Amsterdam, The Netherlands. .,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands. .,Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands. .,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. .,Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
| | - M D A Karsten
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands. .,Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands. .,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. .,Amsterdam Reproduction and Development, Amsterdam, The Netherlands. .,Department of Obstetrics and Gynaecology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.
| | - A Geelen
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands
| | - R J B J Gemke
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development, Amsterdam, The Netherlands.,Department of Paediatrics, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University medical centre, de Boelelaan 1117, Amsterdam, The Netherlands
| | - H Groen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - A Hoek
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - M N M van Poppel
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University medical centre, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,University of Graz, Institute of Sport Science, Graz, Austria
| | - T J Roseboom
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands.,Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development, Amsterdam, The Netherlands
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Beks RB, de Jong MB, Houwert RM, Sweet AAR, De Bruin IGJM, Govaert GAM, Wessem KJP, Simmermacher RKJ, Hietbrink F, Groenwold RHH, Leenen LPH. Long-term follow-up after rib fixation for flail chest and multiple rib fractures. Eur J Trauma Emerg Surg 2019; 45:645-54. [PMID: 30229337 DOI: 10.1007/s00068-018-1009-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/12/2018] [Indexed: 11/18/2022]
Abstract
Purpose Rib fixation for flail chest has been shown to improve in-hospital outcome, but little is known about treatment for multiple rib fractures and long-term outcome is scarce. The aim of this study was to describe the safety, long-term quality of life, and implant-related irritation after rib fixation for flail chest and multiple rib fractures. Methods All adult patients with blunt thoracic trauma who underwent rib fixation for flail chest or multiple rib fractures between January 2010 and December 2016 in our level 1 trauma facility were retrospectively included. In-hospital characteristics and implant removal were obtained via medical records and long-term quality of life was assessed over the telephone. Results Of the 864 patients admitted with ≥ 3 rib fractures, 166 (19%) underwent rib fixation; 66 flail chest patients and 99 multiple rib fracture patients with an ISS of 24 (IQR 18–34) and 21 (IQR 16–29), respectively. Overall, the most common complication was pneumonia (n = 58, 35%). Six (9%) patients with a flail chest and three (3%) with multiple rib fractures died, only one because of injuries related to the thorax. On average at 3.9 years, follow-up was obtained from 103 patients (62%); 40 with flail chest and 63 with multiple rib fractures reported an EQ-5D index of 0.85 (IQR 0.62–1) and 0.79 (0.62–0.91), respectively. Forty-eight (48%) patients had implant-related irritation and nine (9%) had implant removal. Conclusions We show that rib fixation is a safe procedure and that patients reported a relative good quality of life. Patients should be counseled that after rib fixation approximately half of the patients will experience implant-related irritation and about one in ten patients requires implant material removal. Electronic supplementary material The online version of this article (10.1007/s00068-018-1009-5) contains supplementary material, which is available to authorized users.
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Galler M, Zellner M, Roll C, Bäuml C, Füchtmeier B, Müller F. A prospective study with ten years follow-up of two-hundred patients with proximal femoral fracture. Injury 2018; 49:841-845. [PMID: 29510856 DOI: 10.1016/j.injury.2018.02.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 11/18/2017] [Revised: 02/19/2018] [Accepted: 02/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The proximal femoral fracture is one of the most common injuries in the elderly. Nevertheless, no results beyond the second year post surgery have been reported in the literature. Therefore, the purpose of this study was to evaluate any revision and mortality within 10 years follow-up as well as the walking ability of still alive patients. METHODS A total of 200 consecutive patients were included. A prospective database was first used to collect the demographic data. Exactly ten years after the surgery, a final evaluation was conducted by telephone for every patient. Any revision, any contralateral as well as other fractures and the date of death were recorded. For all patients who were still alive, the mobility score according to Parker was also surveyed. RESULTS The average age was 79.0 years (SD: 12.5); women were affected at higher numbers (73.5%). The total surgical revision rate was 17.5% (35/200), due in particular to hematoma (9×) or infection (7×). A surgical revision later than two years was only needed in three patients (1.5%). The risk of another fracture caused by a fall was 19% (38/200), most often a contralateral femoral fracture (22/200; 11%) that happened on average 51.9 months (1-97) after the initial surgery. The risk of a contralateral femoral fracture was 15.4% (22/143) in patients who survived the first year post surgery. The postoperative mortality was 1, 2, 5 and 10 years or 23.5%, 32.5%, 55% as well as 81.5%, respectively. An average Parker's mobility score of 6.3 points (0-9) was determined for the 37 patients (18.5%) who were still alive at the time of the follow-up. CONCLUSION The long-term study showed that revision surgery was only required in 3/200 patients (1.5%) beyond the second year of that surgery. On the other hand, more than half of all patients had already passed away five years after the initial surgery. The exact incidence of a contralateral femoral fracture was 11.9%, climbing to 15.4% if the patient survived at least one year. Nearly every fifth patient experienced another fall resulting in a severe fracture requiring treatment during the long-term course.
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Affiliation(s)
- M Galler
- Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, Prüfeninger Str. 86, 93049, Regensburg, Germany
| | - M Zellner
- Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, Prüfeninger Str. 86, 93049, Regensburg, Germany
| | - C Roll
- University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93055, Regensburg, Germany
| | - C Bäuml
- Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, Prüfeninger Str. 86, 93049, Regensburg, Germany
| | - B Füchtmeier
- Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, Prüfeninger Str. 86, 93049, Regensburg, Germany
| | - F Müller
- Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, Prüfeninger Str. 86, 93049, Regensburg, Germany.
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Kowalewski PK, Olszewski R, Kwiatkowski A, Gałązka-Świderek N, Cichoń K, Paśnik K. Life with a Gastric Band. Long-Term Outcomes of Laparoscopic Adjustable Gastric Banding-a Retrospective Study. Obes Surg 2017; 27:1250-1253. [PMID: 27787760 PMCID: PMC5403836 DOI: 10.1007/s11695-016-2435-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background Laparoscopic adjustable gastric banding (LAGB) is the third most popular bariatric procedure worldwide. Various authors present ambivalent long-term follow up results. Methods We revised records of the patients who underwent LAGB between 2003 and 2006 along with history of additional check-ins. Patients with outdated details were tracked with the national health insurance database and social media (Facebook). An online survey was sent. The patients who did not have their band removed were included in this study. We calculated the percent total weight loss (%TWL) and percent excess weight loss (%EWL), along with changes in body mass index (ΔBMI). Satisfactory weight loss was set at >50% EWL (for BMI = 25 kg/m2). Since eight patients gained weight, we decided to include negative values of %TWL, %EWL, and ΔBMI. Results One hundred seven patients underwent LAGB from 2003 to 2006. The mean follow-up time was 11.2 (±1.2) years. Eleven percent of patients were lost to follow up (n = 12). There was one perioperative death. Fifty-four of the patients (n = 57) had their band removed. Thirty-seven patients still have the band (39%) and were included in the study. The mean %EWL was 27% (−56–112%) and %TWL was 11% (−19–53%). Twelve patients achieved %EWL > 50% (32%). Thiry-two patients still suffer from obesity, with BMI over 30 kg/m2. Eight patients (22%) gained additional weight. Patients with %EWL > 50% suffered less from gastroesophageal reflux disease symptoms than those with EWL < 50% (p < 0.05). Conclusions Out of 107 cases, only 11.2% of patients with gastric band (n = 12) achieved satisfactory %EWL. Twenty–two percent of patients regained their weight or even exceeded it. Overall results suggest that LAGB is not an effective bariatric procedure in long term observation.
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Affiliation(s)
- Piotr K Kowalewski
- Department of General Surgery, Military Institute of Medicine, Szaserów 128, 04-141, Warsaw, Poland.
| | - Robert Olszewski
- Department of Cardiology, Military Institute of Medicine, Warsaw, Poland
| | - Andrzej Kwiatkowski
- Department of General Surgery, Military Institute of Medicine, Szaserów 128, 04-141, Warsaw, Poland
| | | | - Krzysztof Cichoń
- Department of Internal Medicine, Regional Hospital, Łęczna, Poland
| | - Krzysztof Paśnik
- Department of General Surgery, Military Institute of Medicine, Szaserów 128, 04-141, Warsaw, Poland
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Inokuchi H, Mizowaki T, Norihisa Y, Takayama K, Ikeda I, Nakamura K, Hiraoka M. Correlation between urinary dose and delayed radiation cystitis after 78 Gy intensity-modulated radiotherapy for high-risk prostate cancer: A 10-year follow-up study of genitourinary toxicity in clinical practice. Clin Transl Radiat Oncol 2017; 6:31-6. [PMID: 29594221 DOI: 10.1016/j.ctro.2017.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/12/2017] [Accepted: 09/16/2017] [Indexed: 11/21/2022] Open
Abstract
Purpose To investigate the factors associated with the risk of long-term genitourinary (GU) toxicity among high-risk prostate cancer (PC) patients treated with high-dose intensity-modulated radiotherapy (IMRT). Methods and materials Between 2000 and 2011, PC patients treated with 78 Gy in 39 fractions delivered by IMRT combined with neo-adjuvant hormonal therapy were selected from among our database. GU toxicities and clinical factors, as well as separate anatomical urinary structures, were evaluated in terms of their associations. Results A total of 309 patients was included in this study. The median follow-up was 104 months (range: 24-143 months). The most frequently observed late grade ≥2 GU toxicity was hematuria (11.2%: 10-year actuarial risk) with radiation cystitis observed in the majority of patients. In univariate analysis, late grade ≥2 hematuria was associated with the exposure to doses >75 Gy (V75) of the bladder neck and V70 of the bladder wall, as well as with T stage. V75 of the bladder neck remained significant in multivariate analysis (p = 0.049). Conclusions At the 10-year follow up of high-dose IMRT, a major concern was proved to be delayed cystitis related to the higher volume of bladder neck dose exposed excess over 75 Gy.
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Czimbalmos C, Csecs I, Polos M, Bartha E, Szucs N, Toth A, Maurovich-Horvat P, Becker D, Sapi Z, Szabolcs Z, Merkely B, Vago H. Uncommon presentation of a rare tumour - incidental finding in an asymptomatic patient: case report and comprehensive review of the literature on intrapericardial solitary fibrous tumours. BMC Cancer 2017; 17:612. [PMID: 28865431 PMCID: PMC5581469 DOI: 10.1186/s12885-017-3574-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 08/21/2017] [Indexed: 11/17/2022] Open
Abstract
Background A solitary fibrous tumour is a rare, mainly benign spindle cell mesenchymal tumour most commonly originating from the pleura. An intrapericardial location of a solitary fibrous tumour is extremely unusual. We present a case of an asymptomatic patient with a slow-growing massive benign cardiac solitary fibrous tumour. Case presentation A 37-year-old asymptomatic female patient was referred to our hospital with an enlarged cardiac silhouette found on her screening chest X-ray. The echocardiographic examination revealed pericardial effusion and an inhomogeneous mobile mass located in the pericardial sac around the left ventricle. Cardiac magnetic resonance (MRI) examination showed an intrapericardial, semilunar-shaped mass attached to the pulmonary trunk with an intermediate signal intensity on proton density-weighted images and high signal intensity on T2-weighted spectral fat saturation inversion recovery images. First-pass perfusion and early and late gadolinium-enhanced images showed a vascularized mass with septated, patchy, inhomogeneous late enhancement. Coronary computed tomography angiography revealed no invasion of the coronaries. Based on the retrospectively analysed screening chest X-rays, the mass had started to form at least 7 years earlier. Complete resection of the tumour with partial resection of the pulmonary trunk was performed. Histological evaluation of the septated, cystic mass revealed tumour cells forming an irregular patternless pattern; immunohistochemically, the cells tested positive for vimentin, CD34, CD99 and STAT6 but negative for keratin (AE1-AE3), CD31 and S100. Thus, the diagnosis of an intrapericardial solitary fibrous tumour was established. There has been no recurrence for 3 years based on the regular MRI follow-up. Conclusion Intrapericardial SFTs, showing slow growth dynamics, can present with massive extent even in completely asymptomatic patients. MRI is exceedingly useful for characterizing intrapericardial masses, allowing precise surgical planning, and is reliable for long-term follow up. Electronic supplementary material The online version of this article (10.1186/s12885-017-3574-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Csilla Czimbalmos
- Heart and Vascular Center, Semmelweis University, 68 Varosmajor St, Budapest, H-1122, Hungary
| | - Ibolya Csecs
- Heart and Vascular Center, Semmelweis University, 68 Varosmajor St, Budapest, H-1122, Hungary
| | - Miklos Polos
- Heart and Vascular Center, Semmelweis University, 68 Varosmajor St, Budapest, H-1122, Hungary
| | - Elektra Bartha
- Heart and Vascular Center, Semmelweis University, 68 Varosmajor St, Budapest, H-1122, Hungary
| | - Nikolette Szucs
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Attila Toth
- Heart and Vascular Center, Semmelweis University, 68 Varosmajor St, Budapest, H-1122, Hungary
| | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Semmelweis University, Budapest, Hungary
| | - David Becker
- Heart and Vascular Center, Semmelweis University, 68 Varosmajor St, Budapest, H-1122, Hungary
| | - Zoltan Sapi
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Zoltan Szabolcs
- Heart and Vascular Center, Semmelweis University, 68 Varosmajor St, Budapest, H-1122, Hungary
| | - Bela Merkely
- Heart and Vascular Center, Semmelweis University, 68 Varosmajor St, Budapest, H-1122, Hungary
| | - Hajnalka Vago
- Heart and Vascular Center, Semmelweis University, 68 Varosmajor St, Budapest, H-1122, Hungary.
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Lalone E, MacDermid J, Grewal R, King G. Patient Reported Pain and Disability Following a Distal Radius Fracture: A Prospective Study. Open Orthop J 2017; 11:589-599. [PMID: 28979578 PMCID: PMC5620403 DOI: 10.2174/1874325001711010589] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 05/11/2017] [Accepted: 05/14/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Fractures of the distal radius are common. Few studies investigating the extended long term outcomes of participants following a distal radius fracture (especially beyond 2 years) and they have relied on subjective measures or single objective tests to measure participant's final outcome. OBJECTIVES The objective of this study was to describe the pain and disability in long-term follow-up of participants after a distal radius fracture. Participants who had previously participated in a prospective study, where baseline and standardized one-year follow-up were performed, were contacted to volunteer to participate in this follow-up (FU) study. Sixty-five participants (17 males, 48 females) with an average age of 57 (SD 13) years at the time of injury and 67 (SD 13 years) at follow-up were evaluated at an average of 11(SD 6) years (range 2-20 years). RESULTS The majority of patients (85%) participants reported no change or had less pain and disability (PRWE) (<5 point difference) at their long-term follow-up compared to their one year PRWE scores. One year PRWE scores were found to be predictive (19.1%) of the variability in long term PRWE score (p=0.02). Age, gender, and mechanism of fall were not significant predictors of worsened outcome. CONCLUSION The majority of people that are experiencing no or low patient reported pain and disability one year following a DRF can expect to retain their positive outcome 10-20 years later. This study did not identify how to predict worsened outcome.
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Affiliation(s)
- Emily Lalone
- Western Univeristy - Mechanical and Materials Engineering, 1151 Richmond Street, London, Ontario N6A 5B9, Canada
| | - Joy MacDermid
- McMaster University - School of Rehabilitation Science, Rm 429, IAHS Victoria, Hamilton, Ontario L8S 1C7, Canada
| | - Ruby Grewal
- The University of Western Ontario - Roth
- McFarlane Hand and Upper Limb Center, St Joseph's Health Center 268 Grosvenor Street, London, Ontario N6A 4L6, Canada
| | - Graham King
- Roth
- McFarlane Hand and Upper Limb Centre - Orthopedic Surgery, London, Ontario, Canada
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Piloni D, Morosini M, Magni S, Balderacchi A, Scudeller L, Cova E, Oggionni T, Stella G, Tinelli C, Antonacci F, D'Armini AM, Meloni F. Analysis of long term CD4+CD25highCD127- T-reg cells kinetics in peripheral blood of lung transplant recipients. BMC Pulm Med. 2017;17:102. [PMID: 28720146 PMCID: PMC5516333 DOI: 10.1186/s12890-017-0446-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 07/14/2017] [Indexed: 12/26/2022] Open
Abstract
Background The role of CD4+CD25highCD127− T-reg cells in solid-organ Transplant (Tx) acceptance has been extensively studied. In previous studies on kidney and liver recipients, peripheral T-reg cell counts were associated to graft survival, while in lung Tx, there is limited evidence for similar findings. This study aims to analyze long term peripheral kinetics of T-reg-cells in a cohort of lung recipients and tests its association to several clinical variables. Methods From jan 2009 to dec 2014, 137 lung Tx recipients were submitted to an immunological follow up (median: 105.9 months (6.7–310.5)). Immunological follow up consisted of a complete blood peripheral immuno-phenotype, inclusive of CD4+CD25highCD127− T and FOXP3+ cells. We tested the association between T-reg and relevant variables by linear OR regression models for repeated measures, adjusting for time from Tx. Also, by ordered logistic models for panel data, the association between Chronic Lung Allograft Dysfuncton (CLAD) onset/progression and T-reg counts in the previous 3 months was tested. Results Among all variables analyzed at multivariate analysis: Bronchiolitis Obliterans Syndrome (OR −6.51, p < 0.001), Restrictive Allograft Syndrome (OR −5.19, p = 0.04) and Extracorporeal photopheresis (OR −5.65, p < 0.001) were significantly associated to T-reg cell. T-reg cell counts progressively decreased according to the severity of CLAD. Furthermore, patients with higher mean T-reg counts in a trimester had a significantly lower risk (OR 0.97, p = 0.012) of presenting CLAD or progressing in the graft dysfunction in the following trimester. Conclusions Our present data confirm animal observations on the possible role of T-reg in the evolution of CLAD.
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Gori M, Canova P, Calabrese A, Cioffi G, Trevisan R, De Maria R, Grosu A, Iacovoni A, Fontana A, Ferrari P, Greene SJ, Gheorghiade M, Parati G, Gavazzi A, Senni M. Strategy to identify subjects with diabetes mellitus more suitable for selective echocardiographic screening: The DAVID-Berg study. Int J Cardiol 2017; 248:414-420. [PMID: 28709699 DOI: 10.1016/j.ijcard.2017.06.101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 04/14/2017] [Revised: 06/15/2017] [Accepted: 06/26/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Despite the burden of pre-clinical heart failure (HF) among diabetes mellitus (DM) patients, routine screening echocardiography is not currently recommended. We prospectively assessed risk prediction for HF/death of a screening strategy combining clinical data, electrocardiogram, NTproBNP, and echocardiogram, aiming to identify DM patients more suitable for selective echocardiography. METHODS Among 4047 screened subjects aged≥55/≤80years, the DAVID-Berg Study prospectively enrolled 623 outpatients with DM, or hypertension, or known cardiovascular disease but with no HF history/symptoms. The present analysis focuses on data obtained during a longitudinal follow-up of the 219 patients with DM. RESULTS Mean age was 68years, 61% were men, and median DM duration was 4.9years. During a median follow-up of 5.2years, 50 subjects developed HF or died. A predictive model using clinical data demonstrated moderate predictive power, which significantly improved by adding electrocardiogram (C-statistic 0.75 versus 0.70; p<0.05), but not NTproBNP (C-statistic 0.72, p=0.20). Subjects with normal clinical variables or abnormal clinical variables but normal electrocardiogram had low events rate (1.3 versus 2.4events/100-person-years, p=NS). Conversely, subjects with both clinical and electrocardiogram abnormalities (47%) carried higher risk (9.0events/100-person-years, p<0.001). The predictive power for mortality/HF development increased when echocardiography was added (13.6events/100-person-years, C-statistic 0.80, p<0.05). CONCLUSIONS Our prospective study found that a selective echocardiographic screening strategy guided by abnormal clinical/electrocardiogram data can reliably identify DM subjects at higher risk for incident HF and death. This screening approach may hold promise in guiding HF prevention efforts among DM patients.
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Affiliation(s)
- Mauro Gori
- CardioVascular Department, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Paolo Canova
- CardioVascular Department, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Alice Calabrese
- CardioVascular Department, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Giovanni Cioffi
- Department of Cardiology, Villa Bianca Hospital, Trento, Italy
| | - Roberto Trevisan
- Diabetology Unit, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Renata De Maria
- CNR Institute of Clinical Physiology, CardioThoracic and Vascular Department, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Aurelia Grosu
- CardioVascular Department, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Attilio Iacovoni
- CardioVascular Department, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Alessandra Fontana
- CardioVascular Department, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Paola Ferrari
- CardioVascular Department, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Stephen J Greene
- Duke Clinical Research Institute and Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Mihai Gheorghiade
- Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, St. Luke Hospital, Istituto Auxologico Italiano, Milan and Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Antonello Gavazzi
- FROM Research Foundation, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Michele Senni
- CardioVascular Department, Ospedale Papa Giovanni XXIII Hospital, Bergamo, Italy.
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Nam SY, Jeon SW, Lee HS, Kwon YH, Park H, Choi JW. Long-term follow-up of pepsinogen I/II ratio after eradication of Helicobacter pylori in patients who underwent endoscopic mucosal resection for gastric cancer. Dig Liver Dis 2017; 49:500-506. [PMID: 28057446 DOI: 10.1016/j.dld.2016.12.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 08/15/2016] [Revised: 12/06/2016] [Accepted: 12/09/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although the pepsinogen I/II (PGI/II) ratio after Helicobacter pylori eradication is recovered at short-term follow-up, long-term follow-up studies of PGI/II are rare. METHODS A total of 773 patients with gastric cancer who underwent endoscopic resection and pepsinogen and H. pylori tests were enrolled. H. pylori was eradicated in these patients. Endoscopic and pepsinogen tests were performed every year. A low PGI/II ratio was defined as ≤3. RESULTS The PGI/II ratio was higher in non-infected patients (n=275, 4.99) than infected patients (n=498, 3.53). After H. pylori eradication, the PGI/II ratio increased to 5.81 and 5.63 after 1 and 2 years (each p<0.05). The PGI/II ratio in the non-eradication group decreased to 3.94 and 2.75 after 1 and 2 years. The PGI/II ratio in the H. pylori eradication group became similar to that of the H. pylori-negative group at 3 (4.48 vs. 4.34), 4 (4.88 vs. 4.34), and 5 years (4.89 vs. 4.23). The adjusted odds ratios for a lower PG I/II ratio in the non-eradication group compared to the eradication group were 4.78 (95% CI 2.15-10.67) after 1year and 8.13 (95% CI 2.56-25.83) after 2 years. CONCLUSIONS After H. pylori eradication, the PGI/II ratio increased and was similar to that of H. pylori-negative controls for up to 5 years of follow-up.
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Affiliation(s)
- Su Youn Nam
- Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Seong Woo Jeon
- Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, South Korea.
| | - Hyun Seok Lee
- Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Yong Hwan Kwon
- Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Haeyoon Park
- Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Jin Woo Choi
- Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, South Korea
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Papaspyrou G, Linxweiler M, Knöbber D, Schick B, Al Kadah B. Laser CO 2 tonsillotomy versus argon plasma coagulation (APC) tonsillotomy: A retrospective study with 10-year follow-up. Int J Pediatr Otorhinolaryngol 2017; 92:56-60. [PMID: 28012534 DOI: 10.1016/j.ijporl.2016.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 06/09/2016] [Revised: 11/04/2016] [Accepted: 11/07/2016] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Tonsillotomy is increasingly gaining acceptance as the treatment for tonsillar hyperplasia resulting in obstructive symptoms. The aim of this study was to compare the long-term results of CO2 laser tonsillotomy with those of argon plasma coagulation (APC) tonsillotomy. METHODS The data of 64 children, aged 2-10 years (mean 4.7 years), treated in the Department of Otolaryngology, Head and Neck Surgery, in Homburg, Germany with APC (36 patients) or CO2 laser (28 patients) for tonsillar hyperplasia between June 2004 and December 2004 were available for analysis. RESULTS Forty-five (APC: 26 patients, CO2: 19 patients) of the 64 patients (70.3%) could be contacted and were available for follow-up in a telephone survey conducted 10 years after surgery. The mean operation time was 17 min (range 10-25 min) in the APC group and 23 min (range 13-32 min) in the CO2 group (p = 0.0003). No case of intra- or postoperative bleeding was documented. One minor intraoperative complication in the form of a superficial lip burn was documented in the APC group. During the minimum 10 years of follow-up, 1 patient treated with APC underwent a surgical revision because of tonsillar regrowth, whereas in the group of patients treated with CO2, no surgical revision was needed. Regarding the parents' assessment of their children's symptoms, 89.4% of the parents of the CO2 laser group and 84.6% of the parents of the APC group reported that the overall long-term operation results of their children to be "very satisfying." Regarding complications, the need for secondary tonsillectomy, and parents' satisfaction, no statistically significant differences were found. CONCLUSIONS Both CO2 laser tonsillotomy and APC tonsillotomy are safe procedures leading to very satisfying results with respect to intra- and postoperative complications.
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Affiliation(s)
- Giorgos Papaspyrou
- Department of Otorhinolaryngology, University Medical Centre, Homburg, Saar, Germany.
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, University Medical Centre, Homburg, Saar, Germany
| | - Dirk Knöbber
- Department of Otorhinolaryngology, University Medical Centre, Homburg, Saar, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, University Medical Centre, Homburg, Saar, Germany
| | - Basel Al Kadah
- Department of Otorhinolaryngology, University Medical Centre, Homburg, Saar, Germany
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Alió JL, Plaza-Puche AB, Cavas F, Yébana Rubio P, Sala E. An angle-supported foldable phakic intraocular lens for correction of myopia: A five-year follow-up. ACTA ACUST UNITED AC 2016; 92:4-11. [PMID: 27453580 DOI: 10.1016/j.oftal.2016.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 04/13/2016] [Revised: 05/27/2016] [Accepted: 05/30/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of an angle-supported foldable phakic intraocular lens (pIOL) for the correction of moderate to high myopia after 5 years follow-up. METHODS Prospective and retrospective, observational, longitudinal, non-randomised consecutive series of cases conducted on a total of 100 eyes of 67 patients with moderate to high myopia implanted with an Acrysof Cachet pIOL (Alcon Laboratories Inc.) with the aim of minimising the refractive error. The ages ranged between 18 to 60years. Uncorrected distance visual acuity (UDVA), manifest refraction, corrected distance visual acuity (CDVA), endothelial cells density, pIOL position, intraocular pressure, and complications were recorded preoperatively and during the 5 year follow-up. RESULTS Five years after implantation, the mean manifest spherical equivalent refraction reduced significantly from -11.62±3.35 dioptres (D) to -0.33±0.85D. UDVA was 20/20 or better in 5 of 25 cases (20%), and 20/40 or better in 22 cases (88%). CDVA was 20/20 or better in 17 cases (68%), and 20/32 or better in 23 cases (92%) of eyes. The residual refractive error was within ±0.50D of emmetropia in 12 cases (48%), and within ±1.00D in 19 cases (76%). Mean endothelial cell loss at 5 years was 11.8% central, and 13.7% peripheral. Mean endothelium-pIOL distance was 2.11±0.18mm, and mean pIOL-crystalline distance was 0.88±0.20mm. CONCLUSIONS This angle supported pIOL provided a favourable refractive correction and predictability, as well as acceptable safety in patients with moderate to high myopia. Although endothelial cell density decreased over 5years, the results are within the range reported in previous studies with other pIOLs.
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Affiliation(s)
- J L Alió
- Vissum Alicante, Departamento de Investigación, Desarrollo e Innovación, Alicante, España; División de Oftalmología, Departamento de Patología y Cirugía, Universidad Miguel Hernández, Alicante, España.
| | - A B Plaza-Puche
- Vissum Alicante, Departamento de Investigación, Desarrollo e Innovación, Alicante, España
| | - F Cavas
- Departamento de Expresión Gráfica, Universidad Politécnica de Cartagena, Cartagena, Murcia, España
| | - P Yébana Rubio
- Vissum Alicante, Departamento de Investigación, Desarrollo e Innovación, Alicante, España
| | - E Sala
- Vissum Alicante, Departamento de Investigación, Desarrollo e Innovación, Alicante, España
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Kubota A, Yamakawa S, Yamamoto E, Kosugi M, Hirano S, Shiraishi J, Kitajima H, Yoneda A, Taduke Y, Mitani Y, Watanabe T, Takifuji K, Yamaue H. Major neonatal surgery: psychosocial consequence of the patient and mothers. J Pediatr Surg 2016; 51:364-7. [PMID: 26589187 DOI: 10.1016/j.jpedsurg.2015.09.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 03/04/2015] [Revised: 07/19/2015] [Accepted: 09/15/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE Our previous studies of long-term QOL after major neonatal surgery revealed an unexpectedly high incidence of mental retardation as well as emotional and psychosocial problems, and the patients' QOL correlated with maternal QOL and post-traumatic stress disorder (PTSD). The main purpose of this study was to clarify the risk factors affecting long-standing maternal PTSD. MATERIALS AND METHODS Sixty-eight patients, aged between 6 and 17years, and their mothers were enrolled in this study. The underlying diseases included congenital diaphragmatic hernia in 21, anorectal anomalies in 25 and esophageal atresia in 22. Psychoanalysts carried out intelligence tests, the Child Behavior Checklist and QOL evaluation in the patients. QOL was evaluated with WHOQOL26 and PTSD with IES-R questionnaires in their mothers. The mothers were divided into two groups; low- and high-risk groups according to PTSD score. RESULTS Patient QOL scores correlated positively with maternal QOL (p<0.05) and negatively with maternal PTSD scores (p<0.05). There were significant differences in total number of hospital admissions (p<0.05), feeling of economic burden (p<0.05), and satisfaction with husband's help (p<0.01) between the two groups. CONCLUSION Risk factors for maternal PTSD include repeated hospitalization, a feeling of economic burden, and lack of satisfaction with husband's help.
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Affiliation(s)
- Akio Kubota
- Second Department of Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan; Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan.
| | - Sakiko Yamakawa
- Department of Developmental Pediatrics, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan
| | - Etsuyo Yamamoto
- Department of Developmental Pediatrics, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan
| | - Megumi Kosugi
- Department of Developmental Pediatrics, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan
| | - Shinya Hirano
- Department of Developmental Pediatrics, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan
| | - Jun Shiraishi
- Department of Neonatology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan
| | - Hiroyuki Kitajima
- Department of Neonatology, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan
| | - Akihiro Yoneda
- Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan
| | - Yuko Taduke
- Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, 594-1101, Japan
| | - Yasuyuki Mitani
- Second Department of Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan
| | - Takashi Watanabe
- Second Department of Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan
| | - Katsunari Takifuji
- Second Department of Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan
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Krause D, Gabriel B, Herborn G, Braun J, Rau R. Response to methotrexate predicts long-term patient-related outcomes in rheumatoid arthritis. Clin Rheumatol 2016; 35:1123-7. [PMID: 26920753 DOI: 10.1007/s10067-016-3216-y] [Citation(s) in RCA: 4] [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: 08/03/2015] [Revised: 01/25/2016] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
Abstract
This study was conducted to investigate the predictive value of the initial response to methotrexate (MTX) on long-term patient-related outcomes (PROs) in rheumatoid arthritis (RA). All RA patients starting MTX treatment between 1980 and 1987 in our department were enrolled in a prospective observational study. After an average of 18 years, patient-related outcomes were assessed in three dimensions according to the International Classification of Functioning, Disability and Health (ICF). Statistical analyses employed multivariable models with baseline values for age, gender, disease duration, rheumatoid factor positivity, disease activity, response to MTX after 1 year and continuous use of MTX as covariates. The 271 patients enrolled had a mean disease duration of 8.5 years, a mean number of swollen joints of 18 (out of 32), and a mean erythrocyte sedimentation rate of 55 mm/h. After 18 years, PRO was available in 89 patients (33 %). A clinical improvement of at least 20 % 1 year after the initiation of MTX was associated with a favourable outcome in all three dimensions of the ICF, independent of continuation of MTX (p < 0.05). The initial response to MTX is an independent predictor of PRO in RA as assessed after an average of 18 years.
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Affiliation(s)
- Dietmar Krause
- Department of Medical Informatics, Biometry and Epidemiology, Ruhr-University, Bochum, Germany.
| | | | - Gertraud Herborn
- Department of Rheumatology, Evangelisches Fachkrankenhaus, Ratingen, Germany
| | | | - Rolf Rau
- Department of Rheumatology, Evangelisches Fachkrankenhaus, Ratingen, Germany
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Tancredi A, Muscarella LA, la Torre A, Scaramuzzi R, Valori VM, Fazio VM, Scaramuzzi G. The Post-Surgical Long-Term Behaviour of Lung Carcinoid Tumours. Indian J Surg 2015; 77:481-5. [PMID: 26884654 DOI: 10.1007/s12262-015-1290-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 05/20/2015] [Indexed: 10/23/2022] Open
Abstract
Here, we report a retrospective evaluation of long-term behaviour of lung carcinoids after surgery. A total of 23 patients (17 with typical pulmonary carcinoids and 6 with atypical pulmonary carcinoids) were enrolled in our hospital from April 1994 to July 2009. All patients underwent intervention at the Unit of Surgery and then were followed at the Unit of Oncology. The standard protocol for patient monitoring consisted of follow-up at 3 months after surgery, 6 months after first control and annually for 5 years. The follow-up evaluations consisted in blood tests, imaging of chest and abdomen, bone scintigraphy, and brain computed tomography. In case of disease recurrence, patients underwent chemotherapy (etoposide, carboplatin) and radiotherapy. All patients were followed for a mean of follow-up period of 100 months, ranging between 20 and 203 months. In the group of typical carcinoid, the observed recurrence rate at 5 years was zero, at 10 years was 5.8 %, whereas the observed mortality rate at 5 and 10 years was zero. In the group of atypical carcinoid, both the recurrence rate and the mortality rate at 5 and 10 years were 16.6 %. A statistical significant difference (p = 0.002) in the recurrence rate between stage I and stage II was observed. The overall prognosis of pulmonary carcinoids was favourable, and the typical carcinoids presented a better prognosis than the atypical ones. The stage at time of diagnosis could be considered as a predictive prognostic factor.
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Nohara A, Kawakami N, Seki K, Tsuji T, Ohara T, Saito T, Kawakami K. The Effects of Spinal Fusion on Lumbar Disc Degeneration in Patients with Adolescent Idiopathic Scoliosis: A Minimum 10-Year Follow-Up. Spine Deform 2015; 3:462-468. [PMID: 27927532 DOI: 10.1016/j.jspd.2015.04.001] [Citation(s) in RCA: 35] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Revised: 03/23/2015] [Accepted: 04/07/2015] [Indexed: 10/23/2022]
Abstract
STUDY DESIGN Retrospective study. OBJECTIVES This study focused on patients with adolescent idiopathic scoliosis (AIS) who were followed up for more than 10 years, and assessed the influence of spinal balance on lumbar degenerative changes at distal unfused segments (DUS). SUMMARY OF BACKGROUND DATA Previous studies suggested that longer fusion segments may result in higher rates of occurrence of disc degeneration (DD) at unfused segments adjacent to the distal fused area. However, there are no existing studies that correlate the degree of DD to the location of lower instrumented vertebra (LIV) and the amount of the residual lumbar curve during the follow-up period. METHODS Radiologic measurements were recorded at the time of surgery, immediately after surgery, and 10 years after surgery. The Pfirrmann grading scale was used to rate the MR images of these patients. The presence of vertebral DD was also used to classify patients into DD+ and DD- groups. RESULTS 93 patients with AIS participated in this study. The average age at the time of surgery was 15.2 years; the average follow-up time was 154 months. DD was found in 45 patients (48%) and L5/S1 was the most common (40%) location in those patients. The L1 group experienced DD at a frequency of 34%, whereas the frequency increased with lower LIV placement. There was a significant difference between DD+ and DD- in age at the time of operation, the L4 tilt (pre Op. and post. 10 years), and the number of mobile segments. CONCLUSIONS Disc degeneration occurred in 48% of the patients at the time of postop. 10 years. Disc degeneration had a tendency to occur in patients with greater preoperative and postoperative 10 years L4 tilt angle and fewer mobile segments in the lower lumbar spine. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Ayato Nohara
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Naka-ku, Nagoya City, Aichi Prefecture 460-0001, Japan
| | - Noriaki Kawakami
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Naka-ku, Nagoya City, Aichi Prefecture 460-0001, Japan.
| | - Kenji Seki
- Department of Orthopedics, Tenriyorozu Soudanzyo Hospital, 200 Misima-cho, Tenri, Nara prefecture 632-8552, Japan
| | - Taichi Tsuji
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Naka-ku, Nagoya City, Aichi Prefecture 460-0001, Japan
| | - Tetsuya Ohara
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Naka-ku, Nagoya City, Aichi Prefecture 460-0001, Japan
| | - Toshiki Saito
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Naka-ku, Nagoya City, Aichi Prefecture 460-0001, Japan
| | - Kazuki Kawakami
- Department of Orthopedics and Spine Surgery, Meijo Hospital, Naka-ku, Nagoya City, Aichi Prefecture 460-0001, Japan
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Hoffart A, Øktedalen T, Svanøe K, Hedley LM, Sexton H. Predictors of short- and long-term avoidance in completers of inpatient group interventions for agoraphobia. J Affect Disord 2015; 181:33-40. [PMID: 25917291 DOI: 10.1016/j.jad.2015.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 12/19/2014] [Revised: 03/14/2015] [Accepted: 04/06/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little is currently known about predictors of follow-up outcome of psychological treatment of agoraphobia. In this study, we wished to examine predictors of short- and long-term avoidance after inpatient group interventions for agoraphobia. METHODS Ninety-six (68%) of 141 agoraphobic patients (74% women) who had completed treatment in two open and one randomized controlled trial (RCT) were followed up 13 to 21 years after start of treatment. RESULTS Major depression at pre-treatment predicted less short-term (up to one year after end of treatment) improvement in agoraphobic avoidance. Working and being married/cohabiting at pre-treatment predicted greater long-term (across one-year, two-year, and 13-21 years follow-up) improvement. In contrast, the duration of agoraphobia, amount of Axis I and II co-morbidity, being diagnosed with avoidant, dependent, and obsessive-compulsive personality disorder, and the use of antidepressants and benzodiazepines the month before intake to treatment, were unrelated to short-term as well as long-term outcome. LIMITATIONS As many as 31.9% of the included patients did not attend long-term follow-up and the power of the study was limited. The long time period between the two and 13-21 year follow-ups is a limitation, in which it is difficult to assess what actually happened. Although all the patients received some form of CBT, there was variability among the treatments. CONCLUSIONS The only short-term predictor identified represented a clinical feature, whereas the long-term predictors represented features of the patients' life situation. The limited power of the study precludes the inference that non-significant predictors are unrelated to follow-up outcome.
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Affiliation(s)
- Asle Hoffart
- Research Institute, Modum Bad, N-3370 Vikersund, Norway; Department of Psychology, University of Oslo, PB 1094, Blindern, N-0317 Oslo, Norway.
| | - Tuva Øktedalen
- Research Institute, Modum Bad, N-3370 Vikersund, Norway; Department of Psychology, University of Oslo, PB 1094, Blindern, N-0317 Oslo, Norway
| | - Karol Svanøe
- Buskerud and Vestfold University College, PB 2243, N-3103 Tønsberg, Norway
| | - Liv M Hedley
- Research Institute, Modum Bad, N-3370 Vikersund, Norway
| | - Harold Sexton
- Research Institute, Modum Bad, N-3370 Vikersund, Norway
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Gonzalez P, Hildesheim A, Herrero R, Katki H, Wacholder S, Porras C, Safaeian M, Jimenez S, Darragh TM, Cortes B, Befano B, Schiffman M, Carvajal L, Palefsky J, Schiller J, Ocampo R, Schussler J, Lowy D, Guillen D, Stoler MH, Quint W, Morales J, Avila C, Rodriguez AC, Kreimer AR. Rationale and design of a long term follow-up study of women who did and did not receive HPV 16/18 vaccination in Guanacaste, Costa Rica. Vaccine 2015; 33:2141-51. [PMID: 25796338 PMCID: PMC4390538 DOI: 10.1016/j.vaccine.2015.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 10/28/2014] [Revised: 03/02/2015] [Accepted: 03/06/2015] [Indexed: 10/23/2022]
Abstract
The Costa Rica Vaccine Trial (CVT) was a randomized clinical trial conducted between 2004 and 2010, which randomized 7466 women aged 18 to 25 to receive the bivalent HPV-16/18 vaccine or control Hepatitis-A vaccine. Participants were followed for 4 years with cross-over vaccination at the study end. In 2010 the long term follow-up (LTFU) study was initiated to evaluate the 10-year impact of HPV-16/18 vaccination, determinants of the immune response, and HPV natural history in a vaccinated population. Herein, the rationale, design and methods of the LTFU study are described, which actively follows CVT participants in the HPV-arm 6 additional years at biennial intervals (3 additional study visits for 10 years of total follow-up), or more often if clinically indicated. According to the initial commitment, women in the Hepatitis-A arm were offered HPV vaccination at cross-over; they were followed 2 additional years and exited from the study. 92% of eligible CVT women accepted participation in LTFU. To provide underlying rates of HPV acquisition and cervical disease among unvaccinated women to compare with the HPV-arm during LTFU, a new unvaccinated control group (UCG) of women who are beyond the age generally recommended for routine vaccination was enrolled, and will be followed by cervical cancer screening over 6 years. To form the UCG, 5000 women were selected from a local census, of whom 2836 women (61% of eligible women) agreed to participate. Over 90% of participants complied with an interview, blood and cervical specimen collection. Evaluation of comparability between the original (Hepatitis-A arm of CVT) and new (UCG) control groups showed that women's characteristics, as well as their predicted future risk for cervical HPV acquisition, were similar, thus validating use of the UCG. LTFU is poised to comprehensively address many important questions related to long-term effects of prophylactic HPV vaccines.
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Affiliation(s)
- Paula Gonzalez
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica; International Agency for Research on Cancer, Lyon, France.
| | - Allan Hildesheim
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Hormuzd Katki
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Sholom Wacholder
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Carolina Porras
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
| | - Mahboobeh Safaeian
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Silvia Jimenez
- International Agency for Research on Cancer, Lyon, France
| | - Teresa M Darragh
- University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Bernal Cortes
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
| | - Brian Befano
- Information Management Services (IMS), Calverton, MD, USA
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Loreto Carvajal
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
| | - Joel Palefsky
- University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - John Schiller
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Rebeca Ocampo
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
| | - John Schussler
- Information Management Services (IMS), Calverton, MD, USA
| | - Douglas Lowy
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Diego Guillen
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
| | - Mark H Stoler
- Department of Pathology, University of Virginia, Charlottesville, VA, USA
| | - Wim Quint
- DDL Diagnostic Laboratory, Rijswijk, The Netherlands
| | - Jorge Morales
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
| | - Carlos Avila
- Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Guanacaste, Costa Rica
| | | | - Aimée R Kreimer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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Bonneau J, Dugas K, Louis A, Morel L, Toughza J, Frappaz D. [Educational and social outcome after childhood cancer]. Bull Cancer 2015; 102:691-7. [PMID: 25917346 DOI: 10.1016/j.bulcan.2015.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 03/18/2015] [Accepted: 03/22/2015] [Indexed: 11/26/2022]
Abstract
The survival rate improvement of childhood cancer survivors lead to question about their educational and social outcome. Authors suggest an international review in order to find risk factors of school or social failure after cancer experience. Principal cohort is studied in USA (the Children Cancer Survivor Study). Nevertheless, European studies are also published. The results vary, depending on subpopulation studied and on control choice (siblings or general population). Treatment improvement and supportive care make difficult to compare studies with current situations. Moreover, there are not international standard of education or social outcome. School and social behaviour are influenced by: types of tumor (cerebral tumor but also sometimes hemopathy and osteosarcoma), age at diagnosis (very young children and adolescent), treatments (neurotoxical treatments, hematopoietic stem cell transplant), and social or educational status of the parents.
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Affiliation(s)
- Jacinthe Bonneau
- CHU, hôpital Sud, unité d'hématologie oncologie pédiatrique, 35203 Rennes, France.
| | - Karyn Dugas
- CHU de Pellegrin, maison Aquitaine ressources pour les adolescents et jeunes adultes (MARADJA), 33000 Bordeaux, France
| | - Aurélien Louis
- Centre hospitalier de Chalon-sur-Saône, unité de Pédiatrie, 71321 Chalon-sur-Saone, France
| | - Laëtitia Morel
- CHU, hôpital Sud, unité d'hématologie oncologie pédiatrique, 35203 Rennes, France
| | - Jihane Toughza
- Institut hématologie oncologie pédiatrique (IHOP), oncologie pédiatrique, 69008 Lyon, France
| | - Didier Frappaz
- Institut hématologie oncologie pédiatrique (IHOP), oncologie pédiatrique, 69008 Lyon, France
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Abstract
This literature review discusses the growing trend toward multidisciplinary long term follow-up for congenital diaphragmatic hernia.
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Affiliation(s)
- Sarah Tracy
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Catherine Chen
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA.
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Sechi A, Deroma L, Dardis A, Ciana G, Bertin N, Concolino D, Linari S, Perria C, Bembi B. Long term effects of enzyme replacement therapy in an Italian cohort of type 3 Gaucher patients. Mol Genet Metab 2014; 113:213-8. [PMID: 25127542 DOI: 10.1016/j.ymgme.2014.07.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 05/12/2014] [Revised: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The chronic neuropathic form of Gaucher disease (GD3) is characterised by hepatosplenomegaly, anaemia, thrombocytopenia, bone alterations and central neurological involvement. Enzyme replacement therapy (ERT) has been demonstrated to be effective in non neuropathic Gaucher disease, but long term results in patients with GD3 are still limited and contrasting. A possible role of genotype in determining the response to ERT has been hypothesised. PATIENTS AND METHODS All patients affected by GD3, treated with ERT, and followed-up in 4 different Italian centres (Udine, Catanzaro, Sassari and Florence) were included. Data on clinical conditions, laboratory values, neurological and neuropsychological examinations, radiological and electrophysiological features were collected retrospectively from clinical records. RESULTS Ten patients (6 females, 4 males) with four different genotypes (L444P/L444P, L444P/F231I, P159T/unknown, C.115+1G>A/N188S) were identified. They received ERT infusions from 3 to 21years. Haematological parameters and organomegaly improved/normalised in all patients. Three patients showed severe progressive skeletal deformities. 6/10 patients were neurologically asymptomatic when they started ERT for systemic symptoms. During the follow-up, 2/6 developed an important central nervous system disease; 2/6 developed mild central symptoms; and 2/6 did not show any neurological symptom after 5, and 20years of treatment respectively, despite the presence of epileptiform abnormalities at the electroencephalogram. Overall, neurological involvement worsened over time in 6/10 patients, 3 of whom developed progressive myoclonic encephalopathy and died. CONCLUSIONS ERT improved the systemic manifestations in patients with GD3, but was not able to counteract the progression of neurological symptoms in the long term.
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Affiliation(s)
- Annalisa Sechi
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy.
| | - Laura Deroma
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Andrea Dardis
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Giovanni Ciana
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Nicole Bertin
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Daniela Concolino
- Department of Paediatrics, University Magna Graecia, Catanzaro, Italy
| | - Silvia Linari
- Regional Reference Centre for Inherited Bleeding Disorders, University Hospital of Florence, Florence, Italy
| | - Chiara Perria
- Section of Childhood and Adolescence Neuropsychiatry, Department Experimental and Clinical Medicine, University of Sassari, Sassari, Italy
| | - Bruno Bembi
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
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Ten Tusscher GW, Leijs MM, de Boer LCC, Legler J, Olie K, Spekreijse H, van Dijk BW, Vulsma T, Briët J, Ilsen A, Koppe JG. Neurodevelopmental retardation, as assessed clinically and with magnetoencephalography and electroencephalography, associated with perinatal dioxin exposure. Sci Total Environ 2014; 491-492:235-9. [PMID: 24656404 DOI: 10.1016/j.scitotenv.2014.02.100] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/21/2014] [Accepted: 02/22/2014] [Indexed: 05/04/2023]
Abstract
UNLABELLED In 1980s Western Europe, human perinatal exposure to background levels of dioxins was rather high. We therefore evaluated the neurodevelopment of our cohort during the prepubertal period and in adolescence. At prepubertal age (7-12 years) 41 children were tested. Both neuromotor functioning and psychological testing were performed (Dutch version of the Wechsler Intelligence Scale for Children (WISC-R) and the Dutch version of the Child Behavior Checklist for ages 4-18 years (CBCL 4-18) and the Teacher Report Form (TRF)). Neurophysiological tests were performed using magnetoencephalography and electroencephalography. In adolescence (14-18 years) the behavior of 33 children was studied again (CBCL and TRF). And the levels of dioxins and dioxin-like PCBs (dl-PCBs) were measured in serum. RESULTS At prepubertal age no association was found between perinatal dioxin exposure and verbal, performal and total IQ or with the Touwen's test for neuromotor development. There were behavioral problems associated with both prenatal and postnatal dioxin exposure. In adolescence there were problems associated with the current dioxin levels and dioxin-like-PCBs. Neurophysiological tests revealed clear negative dysfunction. An increase in latency time after a motion stimulus (N2b) of 13 ms (= a delay of 10%) is associated with the higher prenatal dioxin exposure. A similar delay was measured in testing cognitive ability by analyzing the odd ball measurements, N200 and P300, together with an amplitude decrease of 12 %. The delay is indicative of a defective myelinisation and the decrease in amplitude of a loss of neurons. CONCLUSION We found effects on behavior in association with the perinatal dioxin exposure and in adolescence in association with the current dioxin levels. Neurophysiological testing is instrumental in the detection of effects of perinatal background levels of chemicals on brain development in normal, healthy children. The clinical, neurological and psychological tests commonly used are not sensitive enough to detect important effects.
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Affiliation(s)
- G W Ten Tusscher
- Department of Paediatrics and Neonatology, Westfriesgasthuis, Maelsonstraat 3, 1624 NP Hoorn, Netherlands
| | - M M Leijs
- University Hospital Aachen, Department of Dermatology, 52074 Aachen, Germany; Department of Paediatrics and Neonatology, Emma Children's Hospital Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - L C C de Boer
- Department of Paediatrics and Neonatology, Westfriesgasthuis, Maelsonstraat 3, 1624 NP Hoorn, Netherlands
| | - J Legler
- Institute for Environmental Studies (IVM) VU University, De Boelelaan 1105, 1081 HV Amsterdam, Netherlands
| | - K Olie
- IBED/ESS, University of Amsterdam, Science Park 904, 1098 XH, Netherlands
| | - H Spekreijse
- Department of Medical Physics and Visual System Analysis, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - B W van Dijk
- Department FMT, VU Medical Center, De Boelelaan 1105, 1081 HV Amsterdam, Netherlands
| | - T Vulsma
- Department of Paediatrics and Neonatology, Emma Children's Hospital Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - J Briët
- Department of Child Psychiatry, GGZ Maelsonstraat 9, 1624 NP Hoorn, Netherlands
| | - A Ilsen
- Department of Paediatrics and Neonatology, Emma Children's Hospital Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - J G Koppe
- Department of Paediatrics and Neonatology, Emma Children's Hospital Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands; Ecobaby Foundation, Hollandstraat 6, 3634 AT Loenersloot, Netherlands
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Skar AMS, von Tetzchner S, Clucas C, Sherr L. The long-term effectiveness of the International Child Development Programme (ICDP) implemented as a community-wide parenting programme. Eur J Dev Psychol 2014; 12:54-68. [PMID: 25431603 PMCID: PMC4241648 DOI: 10.1080/17405629.2014.950219] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 07/27/2014] [Indexed: 11/29/2022]
Abstract
Short-term effectiveness of the International Child Development Programme (ICDP) for parents in the general population has been studied. The aim of this paper was to investigate the longer term impact of the ICDP programme on parents looking for sustained changes 6–12 months after the programme. For this, a non-clinical caregiver group attending the ICDP programme (N = 79) and a non-attending comparison group (N = 62) completed questionnaires on parenting, psychosocial functioning, and child difficulties before, on completion and 6–12 months after the ICDP programme. Analyses compare changes in scores over time. The results revealed that the ICDP group showed significantly improved scores on parenting measures, less loneliness, and trends towards improved self-efficacy compared to the comparison group 6–12 months after programme completion. The ICDP group also reported that their children spent significantly less time on television and computer games and a trend towards fewer child difficulties. Key positive effects sustained over time but at a somewhat lower level, supporting community-wide implementation of ICDP as a general parenting programme. It is concluded that more intensive training with follow-up sessions should be considered to sustain and boost initial gains.
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Affiliation(s)
| | | | - Claudine Clucas
- Department of Infection & Population Health, University College London , London , UK
| | - Lorraine Sherr
- Department of Infection & Population Health, University College London , London , UK
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