scholarly journals Diagnostic Classification of Bronchopulmonary Dysplasia: A Compromise between Defining Lung Disease versus Long-Term Outcome Prediction

2019 ◽  
Vol 200 (10) ◽  
pp. 1322-1323
Author(s):  
Eduardo Bancalari ◽  
Nelson Claure ◽  
Deepak Jain
Keyword(s):  
Lung Disease ◽  
Bronchopulmonary Dysplasia ◽  
Outcome Prediction ◽  
Diagnostic Classification ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Update on Postnatal Corticosteroids to Prevent or Treat Bronchopulmonary Dysplasia

2019 ◽  
Vol 36 (S 02) ◽  
pp. S58-S62 ◽  
Author(s):  
Marco Filippone ◽  
Daniel Nardo ◽  
Luca Bonadies ◽  
Sabrina Salvadori ◽  
Eugenio Baraldi
Keyword(s):  
Adverse Effects ◽  
Lung Disease ◽  
Bronchopulmonary Dysplasia ◽  
Lung Inflammation ◽  
Inhaled Corticosteroids ◽  
Therapeutic Option ◽  
Term Outcome ◽  
Severe Respiratory Distress ◽  
Long Term Outcome

AbstractBronchopulmonary dysplasia (BPD) is a major complication of premature birth that significantly affects mortality and long-term morbidity in numerous immature infants. Corticosteroids are particularly suitable for treating BPD, as lung inflammation is central to its pathogenesis. Corticosteroids have considerable, fast beneficial effects on lung function in premature infants with lung disease, but they are also associated with several serious adverse effects, which may have a detrimental impact on long-term outcome. Dexamethasone is the most often used corticosteroid for systemic administration. Despite its value in preventing and treating BPD, its use is associated with several alarming short-term effects and, worst of all, with an increased rate of cerebral palsy in the long term. Dexamethasone nonetheless remains an important therapeutic option for infants with severe lung disease beyond the second to third week of life. Hydrocortisone is an important alternative to dexamethasone, as its use does not appear to be associated with any neurotoxic effects. Its efficacy in the prevention and treatment of BPD has yet to be clearly demonstrated, however. Inhaled corticosteroids might reduce lung inflammation with fewer systemic adverse effects; however, a recent, large randomized trial showed that inhaled budesonide was associated with an excess mortality, despite its beneficial respiratory effects. In another study, instilling budesonide together with surfactant in the trachea of intubated infants with severe respiratory distress appeared safe and achieved a significant reduction in the rate of BPD at 36 postmenstrual weeks. This important finding needs to be confirmed in a larger trial currently underway.

scholarly journals Assessment of the Subarachnoid Hemorrhage International Trialists (SAHIT) Models for Dichotomized Long-Term Functional Outcome Prediction After Aneurysmal Subarachnoid Hemorrhage in a United Kingdom Multicenter Cohort Study

Neurosurgery ◽  
2020 ◽  
Author(s):  
Isabel C Hostettler ◽  
Menelaos Pavlou ◽  
Gareth Ambler ◽  
Varinder S Alg ◽  
Stephen Bonner ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Functional Outcome ◽  
Outcome Prediction ◽  
Prediction Models ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Predictive Performance ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Fisher Grade

Abstract BACKGROUND Long-term outcome after subarachnoid hemorrhage, beyond the first few months, is difficult to predict, but has critical relevance to patients, their families, and carers. OBJECTIVE To assess the performance of the Subarachnoid Hemorrhage International Trialists (SAHIT) prediction models, which were initially designed to predict short-term (90 d) outcome, as predictors of long-term (2 yr) functional outcome after aneurysmal subarachnoid hemorrhage (aSAH). METHODS We included 1545 patients with angiographically-proven aSAH from the Genetic and Observational Subarachnoid Haemorrhage (GOSH) study recruited at 22 hospitals between 2011 and 2014. We collected data on age, WNFS grade on admission, history of hypertension, Fisher grade, aneurysm size and location, as well as treatment modality. Functional outcome was measured by the Glasgow Outcome Scale (GOS) with GOS 1 to 3 corresponding to unfavorable and 4 to 5 to favorable functional outcome, according to the SAHIT models. The SAHIT models were assessed for long-term outcome prediction by estimating measures of calibration (calibration slope) and discrimination (area under the receiver-operating characteristic curve [AUC]) in relation to poor clinical outcome. RESULTS Follow-up was standardized to 2 yr using imputation methods. All 3 SAHIT models demonstrated acceptable predictive performance for long-term functional outcome. The estimated AUC was 0.71 (95% CI: 0.65-0.76), 0.73 (95% CI: 0.68-0.77), and 0.74 (95% CI: 0.69-0.79) for the core, neuroimaging, and full models, respectively; the calibration slopes were 0.86, 0.84, and 0.89, indicating good calibration. CONCLUSION The SAHIT prediction models, incorporating simple factors available on hospital admission, show good predictive performance for long-term functional outcome after aSAH.

Layer-Specific Strain for Long-Term Outcome Prediction After First-Onset Myocardial Infarction

2020 ◽  
Vol 46 (6) ◽  
pp. 1435-1441
Author(s):  
Bo Hu ◽  
Qing Zhou ◽  
Xue Yao ◽  
Tuantuan Tan ◽  
Jiarui Lei ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Outcome Prediction ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Specific Strain ◽  
First Onset

scholarly journals Treatment of unstable hips with the Tübingen splint in early postnatal period: radiological mid-term results of 75 hips with mean follow-up of 5.5 years

2020 ◽  
Vol 14 (4) ◽  
pp. 252-258
Author(s):  
Hannes Kubo ◽  
David Latz ◽  
Martin Hufeland ◽  
Erik Schiffner ◽  
Ruediger Krauspe
Keyword(s):  
Postnatal Period ◽  
Level Of Evidence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Type D ◽  
Further Development ◽  
Mid Term Results

Purpose For treatment of unstable hips, the Tübingen splint is a treatment option. After the initial treatment, regular radiological follow-up examinations are recommended but there is a lack of long-term outcome studies. Therefore, the further development of unstable hips treated with the Tübingen splint were evaluated. Methods From 2004 to 2015 116 patients with 161 unstable hips treated with the Tübingen splint were evaluated. Inclusion criteria were: 1) successfully treated unstable hip (type D, III and IV); 2) pelvic radiographs at the age of one to ≤ two, two to ≤ four and four to ≤ eight years. The acetabular index (ACI) of all and the centre-edge angle (CEA) of the third radiograph were measured and classified according to the Tönnis classification. Results A total of 53 patients with 75 unstable hips (type D 34 (45.3%), III 33 (44.0%), IV 8 (10.7%)) were included. In comparison of the first, second and third radiograph, an increase of normal findings was seen in 31 (41.3%) to 53 (70.7%) and 60 (80.0%) hips, respectively. However, a decrease of slightly dysplastic hips from 31 (41.3%) to 19 (25.3%) and 14 (18.7%) respectively and severely dysplastic hips from 13 (17.3%) to three (4.0%) and one (1.3%) hip respectively was detected. In comparison of first to second radiograph, 32 hips improved and five hips deteriorated and of second to third radiograph 16 hips improved and six hips deteriorated. The Tönnis classification of ACI compared with CEA showed no significant differences (p = 0.442). Conclusion This study shows a good development of unstable hips treated with the Tübingen splint with mean follow-up 5.5 years. Nevertheless, unexpected deteriorations could be identified. The CEA is an alternative to the ACI. Level of evidence IV

scholarly journals Long-Term Outcome of WHIM Syndrome in 18 Patients: High Risk of Lung Disease and HPV-Related Malignancies

2019 ◽  
Vol 7 (5) ◽  
pp. 1568-1577 ◽  
Author(s):  
Laura Dotta ◽  
Lucia Dora Notarangelo ◽  
Daniele Moratto ◽  
Rajesh Kumar ◽  
Fulvio Porta ◽  
...  
Keyword(s):  
High Risk ◽  
Lung Disease ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Whim Syndrome
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