scholarly journals Survival following orbital exenteration at a tertiary brazilian hospital

2016 ◽  
Vol 43 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Juliana Mika Kato ◽  
Fabricio Lopes da Fonseca ◽  
Suzana Matayoshi
Keyword(s):  
Survival Rates ◽  
Histological Diagnosis ◽  
Years Of Life Lost ◽  
Orbital Exenteration ◽  
Tertiary Referral Hospital ◽  
Average Survival ◽  
Significant Difference ◽  
The Face ◽  
One Year ◽  
The One

Objective: to analyze the epidemiology, clinical features and survival rate of patients undergoing orbital exenteration (OE) in a tertiary referral hospital. Methods : we conducted a retrospective study of all patients undergoing OE at the Hospital das Clínicas, FMUSP between January 2007 and December 2012. We collected data records related to gender, age, origin, length of stay, duration of the disease, other treatments related to the disease, number of procedures outside of the face related to the disease, follow-up and histological diagnosis. Results : we treated 37 patients in the study period. The average survival in one year was 70%, in two years, 66.1%, and 58.3% in three years. There was no significant difference in the one-year survival related to histological diagnosis (p=0.15), days of hospitalization (p=0.17), gender (p=0.43), origin (p=0.78), disease duration (p=0.27) or the number of operations for the tumor (p=0.31). Mortality was higher in elderly patients (p=0.02). The average years of life lost was 33.9 in patients under 60 years, 14.7 in patients in the 61-80 years range and 11.3 in patients over 80 years. Conclusion : the present series of cases is significant in terms of prevalence of orbital exenteration; on the other hand, it shows one of the lowest survival rates in the literature. This suggests an urgent need for improved health care conditions to prevent deforming, radical resections.

CHEMOTHERAPY OF MILIARY TUBERCULOSIS AND TUBERCULOUS MENINGITIS

PEDIATRICS ◽  
1953 ◽  
Vol 12 (1) ◽  
pp. 38-55
Keyword(s):  
Tuberculous Meningitis ◽  
Survival Rates ◽  
Miliary Tuberculosis ◽  
First Year ◽  
Aminosalicylic Acid ◽  
Duration Of Treatment ◽  
Number Of Patients ◽  
The Face ◽  
One Year ◽  
The One

Two combinations of drugs were compared in a cooperative study of 32 children with acute hematogenous miliary tuberculosis treated at seven different pediatric centers under a common protocol. Eighteen children were given intramuscular streptomycin with oral para-aminosalicylic acid and promizole®; 14 children were given streptomycin and para-aminosalicylic acid without promizole®. A one year follow-up of this small group showed no significant differences in the results due to the use of promizole®. However, 5 of 10 children treated initially with a streptomycin dose of 20 mg./kg. intramuscularly twice a day were either dead or had developed meningitis, while only 2 of 22 children treated with a 50 mg. dose died, one of these having developed meningitis. Twenty-six of the original 32 patients were alive 12 months after the start of treatment. Relapse of miliary disease was not encountered during the first year of this study. The optimum duration of treatment is still uncertain. The combination of para-aminosalicylic acid with streptomycin may be assumed to delay the emergence of streptomycin-resistant organisms in miliary and meningeal diseases just as it does in pulmonary tuberculosis. Thus, a six month or even one year course of streptomycin can now be considered feasible. Although some patients may have been treated longer than necessary, the observation that three patients developed meningitis at 110, 125 and 130 days of study suggests that treatment should be relatively long. A child who survives miliary tuberculosis only to develop tuberculous meningitis has received little real benefit from therapy. As the over-all mortality in miliary tuberculosis is lowered, the prevention of meningitis in the survivors becomes an increasingly important goal. Disturbing side effects of promizole® therapy were less frequent among the patients reported here than among other reported groups. The daily dose, however, was small in comparison with the amounts recommended by Lincoln. Ninety-three children with tuberculous meningitis, 23 of whom also had miliary tuberculosis, were observed for a period of one year while under treatment with a combination of tuberculostatic agents. Half the patients were given intramuscular streptomycin, intrathecal streptomycin, and para-aminosalicylic acid and promizole® by mouth. The remainder received an identical regimen except that promizole® was omitted. Forty-two patients (45%) survived the first year; 24 of these had no serious sequelae from the disease. No differences were noted in the course of the disease among those who received promizole® and those who did not, and the one year survival rates in the two groups were practically identical. Revision of the streptomycin dosage, which took place after the study had been in progress seven months, produced results which appear to justify the change. An intramuscular streptomycin dose of 50 mg./kg. twice daily to a maximum of 1.5 gm. twice daily was apparently more effective than 20 mg./kg. twice daily. Lincoln whose results in childhood meningitis are the most successful yet reported and the British Medical Research Council both depend on a regimen which includes intrathecal streptomycin. The investigators in this study favor its use and had no unusual difficulty with it. Relapse occurred in eight children, all of whom survived the first year. A poorer prognosis was noted in infants, in nonwhites, and in patients with miliary tuberculosis. The most common toxic effects were due to streptomycin, which caused vestibular damage in a large number of patients, but the capacity of children to compensate for this dysfunction is so great that this risk is minor in the face of the otherwise hopeless outcome. Streptomycin may have been partially responsible for marked hearing loss in six. Para-aminosalicylic acid and promizole® act less rapidly than streptomycin. They are easily administered and rarely produce significant toxicity even when given over extended periods. They appear to reinforce the effect of streptomycin, and para-aminosalicylic acid at least postpones the emergence of streptomycin resistance. Their use appears to decrease the likelihood of relapse. Finally, their daily use at home maintains the patient's awareness that he requires prolonged medical supervision and brings him back for examination when his drug supply needs replenishing. The use of these drugs with streptomycin in tuberculous meningitis is recommended.

scholarly journals One-Year Clinical Evaluation of the Bonding Effectiveness of a One-Step, Self-Etch Adhesive in Noncarious Cervical Lesion Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Babacar Faye ◽  
Mouhamed Sarr ◽  
Khaly Bane ◽  
Adjaratou Wakha Aidara ◽  
Seydina Ousmane Niang ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Retention Rate ◽  
Recall Rate ◽  
Acid Etching ◽  
Significant Difference ◽  
Usphs Criteria ◽  
One Step ◽  
One Year ◽  
The One ◽  
Self Etch

This study evaluated the one-year clinical performance of a one-step, self-etch adhesive (Optibond All-in-One, Kerr, CA, USA) combined with a composite (Herculite XRV Ultra, Kerr Hawe, CA, USA) to restore NCCLs with or without prior acid etching. Restorations performed by the same practitioner were evaluated at baseline and after 3, 6, and 12 months using modified USPHS criteria. At 6 months, the recall rate was 100%. The retention rate was 84.2% for restorations with prior acid etching, but statistically significant differences were observed between baseline and 6 months. Without acid etching, the retention rate was 77%, and no statistically significant difference was noted between 3 and 6 months. Marginal integrity (93.7% with and 87.7% without acid etching) and discoloration (95.3% with and 92.9% without acid etching) were scored as Alpha or Bravo, with better results after acid etching. After one year, the recall rate was 58.06%. Loss of pulp vitality, postoperative sensitivity, or secondary caries were not observed. After one year retention rate was of 90.6% and 76.9% with and without acid conditioning. Optibond All-in-One performs at a satisfactory clinical performance level for restoration of NCCLs after 12 months especially after acid etching.

scholarly journals Early Administration of Tolvaptan Can Improve Survival in Patients with Cirrhotic Ascites

2021 ◽  
Vol 10 (2) ◽  
pp. 294
Author(s):  
Atsushi Hosui ◽  
Takafumi Tanimoto ◽  
Toru Okahara ◽  
Munehiro Ashida ◽  
Kohsaku Ohnishi ◽  
...  
Keyword(s):  
Conventional Therapy ◽  
Low Dose ◽  
Therapy Group ◽  
Survival Rates ◽  
Refractory Ascites ◽  
High Dose ◽  
Term Survival ◽  
Conventional Therapy Group ◽  
One Year ◽  
The One

(1) Backgrounds and aim: Tolvaptan, a selective vasopressin type 2 receptor antagonist, was approved for ascites, and its short-term efficacy and safety have been confirmed. However, it is still unclear whether this novel drug may improve long-term survival rates in cirrhotic patients with ascites. (2) Patients and methods: A total of 206 patients who responded insufficiently to conventional diuretics and were hospitalized for refractory ascites for the first time were retrospectively enrolled in this study. Among them, the first 57 consecutive patients were treated with conventional diuretics (the conventional therapy group); the latter 149 consecutive patients were treated with tolvaptan in addition to the conventional therapy (the tolvaptan group). (3) Results: The exacerbation of renal function was significantly milder in the tolvaptan group than in the conventional therapy group. The prognostic factors for survival in the tolvaptan group were being male, having hyperbilirubinemia, having a high blood urea nitrogen (BUN), and receiving high-dose furosemide at the start of tolvaptan treatment. The one-year and three-year cumulative survival rates were 67.8 and 45.3%, respectively, in patients with low-dose furosemide (<40 mg/day) at the start of tolvaptan treatment. The prognosis was significantly better in the tolvaptan group with low-dose furosemide than in the conventional therapy group (p < 0.001). (4) Conclusion: Tolvaptan can improve survival in patients with cirrhotic ascites, especially when tolvaptan is started before high-dose furosemide administration.

scholarly journals An evaluation of the nature and level of musculoskeletal imaging training in physiotherapy educational programme in Nigeria

2020 ◽  
Author(s):  
Ogochukwu Kelechi Onyeso ◽  
Joseph O Umunnah ◽  
Charles Ikechukwu Ezema ◽  
Joseph A Balogun ◽  
Chigozie Uchenwoke ◽  
...  
Keyword(s):  
Diagnostic Imaging ◽  
Economic Cost ◽  
Educational Programme ◽  
Medical Rehabilitation ◽  
Musculoskeletal Imaging ◽  
Significant Difference ◽  
Level Of Training ◽  
One Year ◽  
The One ◽  
Training Programmes

Abstract Background: Previous studies have shown that deficiency in training may lead to inappropriate utilisation of diagnostic imaging among healthcare professionals, thus, raising concerns about patient safety and economic cost. This study aimed to evaluate the nature and level of musculoskeletal imaging (MI) training received by physiotherapists who graduated from Nigerian universities and completed the one-year mandatory internship. Methods: An online version of the Physiotherapist Musculoskeletal Imaging Profiling Questionnaire (PMIPQ), which was previously validated, was administered to all eligible physiotherapists identified through the database of the Medical Rehabilitation Therapist Board’s (MRTBN). Data were obtained on demographics, nature, and level of training on various MI modalities using the PMIPQ. Descriptive statistics, Friedman’s ANOVA, and Kruskal-Wallis tests were used for the data analysis at P ≤ 0.05. Results: The results showed that only 10.0% of the respondents had a standalone undergraduate course in MI, 92.8% did not have any MI clinical posting exposure during the internship, and 67.3% had never attended any MI workshop. There was a significant difference in the level of training received across various MI modalities [χ2 (15) = 1285.899; P = 0.001]. However, there was no significant difference in the level of MI training across the institutions (P = 0.36). The study participants with Doctor of Physiotherapy (DPT) education were better trained in MI than their counterparts with a bachelor’s degree (P = 0.047). Conclusions: The self-reported level of MI training among the respondents was deficient, but the knowledge of X-ray was significantly higher than other MI modalities. Based on the overall findings in this study, we recommend that diagnostic imaging contents be introduced early in the current and future physiotherapy training programmes.

P2754Streptococcal infective endocarditis: distribution of species and their prognosis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Chamat ◽  
A Dahl ◽  
C Hassager ◽  
M Arpi ◽  
L Oestergaard ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Electronic Device ◽  
Species Level ◽  
University Hospital ◽  
Heart Valve Disease ◽  
Significant Difference ◽  
Streptococcal Species ◽  
Species Groups ◽  
One Year ◽  
The One

Abstract Background Infective endocarditis (IE) is frequently caused by streptococcal species. However, there is limited knowledge about the relationship between different streptococcal species and IE, and their associated outcomes. Purpose To examine the prevalence of streptococci at species level in IE, and to relate these different species to outcomes. Methods From 2002–2012 we prospectively collected consecutive patients with IE admitted to two tertiary heart centres covering a catchment area of 2.4 million people. The registry comprises 915 IE patients, 366 (40%) with streptococcal IE. Based on phylogenetic relationship, streptococcal species were classified into seven main groups: Mitis, Bovis, Mutans, Anginosus, Salivarius, Pyogenic and Nutritionally Variant Streptococcus (NVS). Classification at species level was not possible in 51 patients, who were excluded. Complications and prognosis of streptococcal IE were compared between the subgroups, and at species level. Results We included 315 patients with streptococcal IE. Mean age was 63 (IQR 52–76) years, and most were men (67%). A total of 115 patients (37%) had a previous heart valve disease, 58 (18%) had a prosthetic valve, 22 (7%) had previously had IE and 29 (9%) had a cardiac electronic device. With 148 episodes (47%) the Mitis group was the most common cause of IE. Other frequent groups were the Pyogenic group and the Bovis group, accounting for 66 (21%) and 51 (16%) of the cases, respectively. Surgery was carried out in 55% (n=173) of all cases. Patients infected with S. pneumoniae or S. agalactiae had a significantly higher rate of surgery, 72.2% (n=13) and 71.9% (n=23) respectively, whereas the Bovis group had a significantly lower rate, 35.5% (n=18) (p=0.048). The aortic valve was infected in 137 patients (43.5%), mitral valve in 105 patients (33.3%) and both valves were infected in 53 patients (16.8%). Twenty patients (6.3%) had right-sided IE, including pacemaker lead IE. There was no significant difference between the species subgroups regarding type of infected valve. Embolization and osteitis were observed in 76 (24.1%) and 30 (9.5%) patients, respectively. There was no significant difference between the species groups, as was the case with mortality: 23 patients (7.3%) died in-hospital and the one-year mortality was 16% (n=50). Distribution of streptococcal IE Conclusion Species of the Mitis group were the most frequent Streptococci causing IE. Patients infected with S. pneumonia or S. agalactiae had significantly higher rate of surgery, and patients infected with S. bovis group had lower rate of surgery. There was no significant difference in rate of complications such as abscesses, embolization, osteitis or mortality between the streptococcal species. Acknowledgement/Funding Supported by grants from Herlev-Gentofte University Hospital Research Foundation

Aspects of Lactation in the Platypus, Ornithorhynchus anatinus (Monotremata), in Waters of Eastern New South Wales.

1983 ◽  
Vol 31 (6) ◽  
pp. 881 ◽  
Author(s):  
TR Grant ◽  
M Griffiths ◽  
RMC Leckie
Keyword(s):  
New South ◽  
New South Wales ◽  
Young Leave ◽  
South Wales ◽  
Ornithorhynchus Anatinus ◽  
Significant Difference ◽  
Lactating Females ◽  
One Year ◽  
The One ◽  
First Time

Female platypuses captured in waters of eastern New South Wales were found to be lactating between the months of October and March. Lactating females were most numerous in December, accounting for 64% of females captured. Non-lactating females were taken in all months, indicating that not all females breed successfully every year. There was no significant difference between the fatty acid complement of milk taken from a platypus lactating very late in the season and those of others sampled in December at the peak of the lactation season. Some evidence exists that females do not become reproductive until at least their second year of life. Some females were found lactating in consecutive years, and others lactated one year and not in the one following. Animals of over 9 years of age are known to breed. Most juveniles were captured in February, March and April, and it is suggested that the young leave the breeding burrows for the first time in late January through to March, and become independent from their mothers, who are ceasing lactation at that time.

Characteristics of colorectal cancer in patients younger than 40 years compared to older patients.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 371-371
Author(s):  
Mohamed E. Salem ◽  
Monica Arun ◽  
Greg Dyson ◽  
Chadi Saad ◽  
Cassra Arbabi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Rates ◽  
Age Groups ◽  
Cancer Center ◽  
Tumor Characteristics ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Poorly Differentiated ◽  
One Year ◽  
The Right

371 Background: The incidence of colorectal cancer (CRC) in younger patients (pts) is increasing. There is limited data on tumor characteristics and treatment outcome in this population. Methods: Patients with CRC treated at the Karmanos Cancer Center from 2005 to 2011 were studied. Younger (≤40 years) and older (>40 years) groups from a predominantly inner city population were compared for patient and tumor characteristics, treatment patterns, and survivals. T-tests and Fisher’s exact tests were used to determine statistical differences between age groups while the Kaplan-Meier method was used to estimate survival. Results: 42 pts were ≤ 40 (range, 17-40 years) and 96 pts were > 40 (range, 42-88 years). Mean ages for the groups were 33 and 60 years, respectively. There was no statistically significant difference in the distribution of race, gender, stage or KRAS mutation status between the two groups; however, older pts had a higher mean body mass index compared to younger pts (28 versus 23, p<0.001). Older pts were more likely to have a right colon primary (OR = 7.5, p = 0.04), while younger pts had higher likelihood of having sigmoid primary (OR = 3.4, p = 0.002) and worse grade (poorly differentiated) tumors (OR = 8.3, p <0.001). There were no significant differences between metastatic status or sites of metastases between the two groups. Significantly more young pts underwent surgery than older pts (92% versus 62%, p = 0.005). FOLFOX plus bevacizumab was the most commonly used first line treatment for both groups. The median survival estimates were 16.9 (8.1-23.9) and 17.1 months (13.3-31.0) for the younger and older pts, respectively. Importantly, the one-year survival rates were similar for both groups: 41% for both (p = 1). On the multivariate analysis, whether pts had a primary in the right or sigmoid colon was the only independent predictor of survival. Conclusions: Younger pts with colon cancer were diagnosed at a similar stage of the disease as older pts, but more likely to have poorly differentiated tumors. Younger pts were more likely to receive surgical interventions; however, both groups had equivalent one-year survivals. These results support the need for further prospective investigation in a larger population.

Early radiotherapy versus late radiotherapy after incomplete transarterial chemoembolization in hepatocellular carcinoma.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 459-459
Author(s):  
Mi Sun Kim ◽  
Do Young Kim ◽  
Kwang-Hyub Han ◽  
Jong Yun Won ◽  
Do Yun Lee ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Treatment Group ◽  
Survival Rates ◽  
Three Dimensional ◽  
Evaluation Criteria ◽  
Progression Free Survival ◽  
Free Survival ◽  
Vessel Invasion ◽  
One Year ◽  
The One

459 Background: To investigate the efficacy of early RT (ERT) in comparison to late RT (LRT) in HCC patients after incomplete TACE. Methods: Between January 2006 and December 2011, 99 BCLC B and C stage HCC patients were reviewed. We defined ERT as curative aimed additional RT after the first TACE, and LRT was defined as salvage aimed additional RT for recurrent or re-growing remnant tumors after repeated TACE. The median prescribed dose was 45 Gy (range, 21.6 Gy–60 Gy) given in daily dose of 1.8 Gy–3 Gy. Three-dimensional conformal RT or intensity modulated RT was used for all patients. The in-field tumor response rate (IFTR) was evaluated using the modified response evaluation criteria in solid tumors. Results: Fifty eight (58.6%) patients received ERT and 41 (41.4%) patients received LRT. All patients had BCLC B-C stage HCC and the characteristics between two groups were not different significantly. However, vessel invasion was observed more often in the LRT group (p=0.039). The median interval between last TACE and RT was 2weeks in the ERT group, and 4 weeks in the LRT group. The IFTR at one month and three months were significantly higher in the ERT group. The one-year in-field progression-free survival rates were 79.5% and 45.9% in the ERT and LRT groups, respectively (p=0.007).The one-year overall survival rates were 75.9% and 48.8% in the ERT and LRT groups, respectively (p = 0.01). In the multivariate analysis, vessel invasion and treatment group (ERT vs.LRT) were independent predictor of OS (p=0.039 and p=0.035). PVTT and treatment group (ERT vs.LRT) showed correlation with IFPFS in the multivariate analysis (p=0.002 and p=0.01). Conclusions: While this finding may reflect differences in biological characteristics between the two groups, ERT within 2weeks after incomplete TACE should be considered.

Correlation Between MRI Findings and Clinical Impairment In Patients With Shoulder Adhesive Capsulitis: A Prospective Study

2020 ◽  
Author(s):  
Romain GILLET ◽  
Francois ZHU ◽  
Pierre PADOIN ◽  
Gabriella HOSSU ◽  
Aymeric RAUCH ◽  
...  
Keyword(s):  
Signal Intensity ◽  
Adhesive Capsulitis ◽  
Mri Findings ◽  
Significant Difference ◽  
Clinical Impairment ◽  
Pain Duration ◽  
One Year ◽  
The One ◽  
A Prospective Study

Abstract Objectives: MRI diagnostic criteria of shoulder adhesive capsulitis (AC) are widely used, but there is little information available on the association between MRI findings and clinical impairment. The aim of our study was to determine the correlation of MRI findings with the Constant-Murlay Score (CMS), pain duration, and symptoms at the one-year follow-up in AC patients. Methods: MRI of 132 patients with a clinical diagnosis of shoulder AC were prospectively studied. A radiologist examined all patients and completed the CMS just prior to MRI. Pain duration was assessed. The signal intensity and the maximal thickness of the inferior glenohumeral (IGHL) and coracohumeral (CHL) ligaments were measured by two radiologists. Medical record analysis was performed in a sub-group of 49 patients to assess correlation approximately one year after the MRI examination. Results: There was a significant difference in mean pain duration score (3.8 ± 1.2 versus 3.2 ± 0.9 and 3.8 ± 1.2 versus 3.2 ± 0.9 respectively for readers 1 and 2) and in mean mobility scores (15.7 ± 8 points versus 19.6 ± 10.1 points and 15.8 ± 8.2 points versus 19.4 ± 10 points respectively for readers 1 and 2) in patients with a high IGHL signal compared to those with a low signal (P < .05). IGHL was thicker in patients with clinical improvement at one-year follow-up compared to those presenting clinical stability or worsening (P < .05). Conclusion: In shoulder AC patients, the degree of signal intensity at the IGHL was inversely related to shoulder pain duration and range of motion, and a thickened IGHL indicated a favorable outcome at one-year follow-up.

The effectiveness of telepsychiatry measured using the Health of the Nation Outcome Scale and the Mental Health Inventory

2003 ◽  
Vol 9 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Craig Kennedy ◽  
Peter Yellowlees
Keyword(s):  
Mental Health ◽  
Health Outcome ◽  
General Practice ◽  
Initial Assessment ◽  
Face To Face ◽  
Significant Difference ◽  
Outcome Scores ◽  
The Face ◽  
One Year

In a telepsychiatry project in rural Queensland, data were collected from 124 patients attending hospital and general practice facilities for mental health-care and then again at follow-up one year later. Thirty-two of the patients were dealt with using telepsychiatry. Two health status scales were used to measure effectiveness: the Health of the Nation Outcome Scale (HoNOS), administered by the practitioners; and the Mental Health Inventory (MHI), which was self-administered by the patients. There was a significant difference between the initial assessment and follow-up groups on most subscales of the HoNOS, but no significant difference between the face-to-face and telepsychiatry groups. Similarly, the MHI results showed a significant difference on all subscales between the initial assessment and follow-up groups, but no significant difference between the face-to-face and telepsychiatry groups. Individuals who used and did not use telepsychiatry all had improved health outcome scores on the HoNOS and MHI during the study period. Telepsychiatry was as effective as face-to-face care.

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