scholarly journals Is the cochlear implant a successful long-term solution for single-sided deaf and asymmetric hearing-impaired patients?

2020 ◽  
Author(s):  
Iva Speck ◽  
Pascal Challier ◽  
Thomas Wesarg ◽  
Till Fabian Jakob ◽  
Antje Aschendorff ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Sound Localization ◽  
Background Noise ◽  
Speech Intelligibility ◽  
Subjective Evaluation ◽  
Term Treatment ◽  
Long Term Results ◽  
Long Term Treatment

Abstract Purpose We investigated the long-term results of cochlear implant (CI) recipients with asymmetric hearing loss (AHL) or single-sided deafness (SSD). We focused on wearing behavior, audiometric hearing rehabilitation, and subjective benefits of the CI. CI is expected to improve audiological results, subjective hearing perception, and tinnitus burden. Methods Speech recognition in background noise and sound localization were assessed preoperatively and after at least six years of CI experience. Validated questionnaires determined the subjective benefit of CI use and the subjective evaluation of tinnitus. Results Over 80% of the included AHL and SSD CI recipients used their CI between 6 and 10 h daily; four subjects with SSD were non-users. Speech recognition in background noise and sound localization improved significantly compared with the unaided preoperative situation. Additionally, CI improved subjective speech intelligibility and spatial hearing impression while reducing tinnitus burden. Conclusion Subjects with AHL and SSD benefit from CI, subjectively and audiologically. Cochlear implant is a successful long-term treatment for AHL and SSD.

Long-Term Results of Radiofrequency Volumetric Tissue Reduction of the Palate for Snoring

2003 ◽  
Vol 112 (3) ◽  
pp. 276-279 ◽  
Author(s):  
Bassem Said ◽  
Marshall Strome
Keyword(s):  
Patient Satisfaction ◽  
Medical Center ◽  
Academic Medical Center ◽  
Term Treatment ◽  
Response To Treatment ◽  
Long Term Results ◽  
Long Term Treatment ◽  
Radiofrequency Volumetric Tissue Reduction ◽  
Tissue Reduction

To assess the long-term efficacy and morbidity of radiofrequency volumetric tissue reduction (RFVTR) of the soft palate for snoring, we examined the medical records of 39 patients who received this treatment at an academic medical center. Telephone interviews were conducted with the patients to evaluate the long-term subjective efficacy and sequelae. The average follow-up was 14 months (range, 3 to 26 months). Twenty-eight patients (72%) responded to treatment, defined as a 4-point decrease on a 10-point scale. The self-reported snoring score decreased an average of 52% (8.8 ± 1.9 to 4.2 ± 2.9). Sixty-seven percent of the patients were satisfied. The response to treatment did not always correlate with patient satisfaction. The snoring relapse rate was 11% among responders. No significant differences were identified between responders and nonresponders. No significant complications or long-term sequelae were observed. We conclude that RFVTR of the palate is a relatively safe and effective long-term treatment for snoring. Defining realistic pretreatment expectations is important in maximizing patient satisfaction.

Atezolizumab (atezo) in patients with metastatic urothelial carcinoma (mUC): A 2-year clinical update from a phase Ia study.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 290-290 ◽  
Author(s):  
Daniel Peter Petrylak ◽  
Thomas Powles ◽  
Joaquim Bellmunt ◽  
Fadi S. Braiteh ◽  
Yohann Loriot ◽  
...  
Keyword(s):  
Objective Response ◽  
The United States ◽  
Term Treatment ◽  
Long Term Results ◽  
Platinum Based Chemotherapy ◽  
Long Term Treatment ◽  
Previously Treated ◽  
Ecog Ps

290 Background: Atezo (anti–PD-L1) has demonstrated safety and efficacy in a broad range of cancers and is approved in the United States for mUC previously treated with platinum-based chemotherapy. Here we report long-term results in mUC from Phase Ia study NCT01375842 (PCD4989g). Methods: Previously treated mUC patients received atezo 15 mg/kg or 1200 mg IV q3w. Enrollment in this Phase Ia expansion cohort initially required PD-L1–selected status and later opened to patients regardless of PD-L1 expression on tumor-infiltrating immune cells. The primary endpoint was safety/tolerability. Secondary endpoints included investigator-assessed RECIST v1.1 ORR (confirmed), DOR and OS. Results: 95 patients were safety evaluable (Table). Median age was 66 years, 76% were male and 80% had primary bladder tumors. 61% had ECOG PS 1. 52% received ≥ 3 prior systemic therapies for mUC (70% platinum). Median treatment duration was 3 months (range: 0-32 months); 24% were treated for ≥ 1 year. Treatment-related AEs occurred in 66% (all Grade) and 8% (Grade 3-4) of patients. No treatment-related deaths were reported. In 94 objective response–evaluable patients (follow-up ≥ 12 weeks), the ORR was 27% (95% CI: 18, 37%), and the CR rate was 10%; the SD rate was 19%. mDOR was 22.1 months (95% CI: 12.1, NE months) in all patients; 56% of responses (7/9 CRs and 7/16 PRs) were ongoing at the December 15, 2015 data cutoff. With a 24-month median follow-up duration (range: 1+ to 32 months), the 1-year OS rate was 47% (95% CI: 36, 58%), and the 2-year rate was 29% (19, 40%); mOS is in the Table. Updated clinical data with further follow-up and analyses by PD-L1 status will be presented. Conclusions: Long-term treatment with atezo was well tolerated, without new safety signals in heavily pre-treated mUC patients. The durability of responses, including CRs, along with extended OS, confirm atezo as a new standard for previously treated mUC patients. Clinical trial information: NCT01375842. [Table: see text]

Long-Term Treatment of Severe Dysarthria

1988 ◽  
Vol 53 (4) ◽  
pp. 433-440 ◽  
Author(s):  
Marianne B. Simpson ◽  
James A. Till ◽  
Anne M. Goff
Keyword(s):  
Speech Intelligibility ◽  
Measurement Techniques ◽  
Term Treatment ◽  
Single Subject ◽  
Basilar Artery Thrombosis ◽  
Long Term Treatment ◽  
Velopharyngeal Function

This case study describes the long-term treatment and changing symptoms in a single subject with dysarthria secondary to basilar artery thrombosis. Initially, the subject was anarthric. Treatment efforts thereafter were directed toward modifying speech respiration, velopharyngeal function, articulatory precision, speech intensity, and speech intelligibility. A variety of treatment and measurement techniques are illustrated. The behavioral change resulting from each of the treatments was small. However, when combined, these small gains in conjunction with some neurological recovery resulted in significantly improved communication and quality of life for this subject. Implications for management Of similar subjects are discussed.

scholarly journals Cyclosporine A in Ullrich Congenital Muscular Dystrophy: Long-Term Results

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Luciano Merlini ◽  
Patrizia Sabatelli ◽  
Annarita Armaroli ◽  
Saverio Gnudi ◽  
Alessia Angelin ◽  
...  
Keyword(s):  
Muscular Dystrophy ◽  
Cyclosporine A ◽  
Congenital Muscular Dystrophy ◽  
Respiratory Muscles ◽  
Primary Outcome Measure ◽  
Term Treatment ◽  
Long Term Results ◽  
Long Term Treatment ◽  
Ullrich Congenital Muscular Dystrophy

Six individuals with Ullrich congenital muscular dystrophy (UCMD) and mutations in the genes-encoding collagen VI, aging 5–9, received 3–5 mg/kg of cyclosporine A (CsA) daily for 1 to 3.2 years. The primary outcome measure was the muscle strength evaluated with a myometer and expressed as megalimbs. The megalimbs score showed significant improvement (P=0.01) in 5 of the 6 patients. Motor function did not change. Respiratory function deteriorated in all. CsA treatment corrected mitochondrial dysfunction, increased muscle regeneration, and decreased the number of apoptotic nuclei. Results from this study demonstrate that long-term treatment with CsA ameliorates performance in the limbs, but not in the respiratory muscles of UCMD patients, and that it is well tolerated. These results suggest considering a trial of CsA or nonimmunosuppressive cyclosporins, that retains the PTP-desensitizing properties of CsA, as early as possible in UCMD patients when diaphragm is less compromised.

Peripheral Neurostimulation for Treatment of Intractable Occipital Neuralgia

Neurosurgery ◽  
2006 ◽  
Vol 58 (1) ◽  
pp. 112-119 ◽  
Author(s):  
Konstantin V. Slavin ◽  
Hrachya Nersesyan ◽  
Christian Wess
Keyword(s):  
Pain Syndrome ◽  
Good Alternative ◽  
Term Treatment ◽  
Long Term Results ◽  
Intractable Pain ◽  
Occipital Neuralgia ◽  
Beneficial Effects ◽  
Long Term Treatment ◽  
Patient Reported

Abstract OBJECTIVE: Medically intractable pain caused by occipital neuralgia (ON) can be very difficult to control with traditional pain management. Peripheral nerve stimulation (PNS) may serve as a good alternative to destructive surgical manipulations used currently for the treatment of severe ON. METHODS: We analyzed records of 14 consecutive patients (9 women and 5 men; mean age, 43.3 yr) with intractable ON treated with PNS during the period from April 2002 to November 2004. Five patients had unilateral and nine had bilateral PNS electrodes inserted for trial, which was considered successful if patient reported at least 50% decrease of pain on the visual analogue scale. Ten patients proceeded with system internalization, and their long-term results were analyzed. RESULTS: At the time of the last follow-up examination (5–32 mo, mean 22 mo), seven patients (70%) with implanted PNS systems continue to experience beneficial effects of stimulation, including adequate pain control, continuous employment, and decrease in oral pain medications intake. Two patients had their systems explanted because of loss of stimulation effect or significant improvement of pain, and one patient had part of his hardware removed because of infection. CONCLUSION: Overall, the beneficial effect from chronic stimulation in our series persisted in more than half of the patients for whom procedure was considered and in 80% of those who significantly improved during the trial and proceeded with internalization. Thus, chronic PNS may be a safe and relatively effective method for long-term treatment of chronic pain syndrome in patients with medically intractable ON.

scholarly journals LONG-TERM RESULTS OF SURGICAL TREATMENT OF DIVERTICULAR DISEASE OF COLON

2016 ◽  
Vol 175 (2) ◽  
pp. 101-104
Author(s):  
V. I. Pomazkin ◽  
V. V. Khodakov
Keyword(s):  
Diverticular Disease ◽  
Emotional Disorders ◽  
Elective Surgery ◽  
Term Treatment ◽  
Long Term Results ◽  
Number Of Patients ◽  
Sf 36 ◽  
Long Term Treatment

The work evaluated the long-term treatment results of 103 patients with complicated diverticular disease, who underwent the elective surgery in the volume of left hemicolectomy. The first group included 53 patients with recurrent diverticula. The second group consisted of 50 patients, who underwent the operation on diverticula of sigmoid colon with formation of sigmostoma on the first stage. The number of patients with functional gastro-intestinal and psyco-emotional disorders was more significant in the first group compared with the second group and it was associated with presence of these disorders before the operation. There was noted the reliable decrease of quality of life rates according to questionnaire scales MOS-SF 36 in the first group. The average indices of scales had some matching to the rates of health people in the patients of the second group. The authors came to conclusion, that indications for elective surgery should be determined very carefully in case of recurrent diverticula.

scholarly journals A Clinical Study of Direct Composite Full-Coverage Crowns: Long-Term Results

2012 ◽  
Vol 37 (4) ◽  
pp. 432-441 ◽  
Author(s):  
V Alonso ◽  
M Caserio
Keyword(s):  
Public Health Service ◽  
Term Treatment ◽  
Long Term Results ◽  
Full Coverage ◽  
Acceptable Range ◽  
Long Term Treatment ◽  
Usphs Criteria ◽  
The Mean ◽  
Strip Crown

SUMMARY Objective Long-term assessment of the clinical behavior of direct composite full-coverage crowns using transparent strip crowns as a matrix. Method A retrospective observational study without controls of 21 restorations was performed: nine teeth with hypoplasia, six conoid teeth, and six with microdontia. The mean patient age was 22.5 ± 8.2 years. The clinical procedure consisted of cleaning the tooth, acid etching and application of adhesive, after which a transparent strip crown was filled with composite and placed on the tooth. The gingival contour was polished using multifluted burs and interproximal spaces polished with polishing strips. Patients were examined after a period of 12.5 (±4.6) years by two observers who recorded the plaque index and evaluated the restorations in accordance with the modified U. S. Public Health Service (USPHS) criteria. Results Except for one case, all the scores obtained on the basis of the USPHS criteria were within the acceptable range. There were no cases of secondary caries. The statistically significant variations were anatomical form, marginal adaptation, marginal discolouration, and surface roughness. Discussion This technique is simple and noninvasive. It is a viable long-term treatment option for teeth with amelogenesis or microdonts and is especially suitable for patients still undergoing growth.

scholarly journals Long-term results of sirolimus treatment in lymphangioleiomyomatosis: a single referral centre experience

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eva Revilla-López ◽  
◽  
Cristina Berastegui ◽  
Alejandra Méndez ◽  
Berta Sáez-Giménez ◽  
...  
Keyword(s):  
Term Treatment ◽  
Term Effect ◽  
Long Term Results ◽  
Published Data ◽  
Referral Centre ◽  
Partial Responder ◽  
Long Term Effect ◽  
Long Term Treatment ◽  
Predicted Values

AbstractThere are few published data on long-term treatment with sirolimus in lymphangioleiomyomatosis (LAM). The objective of this study was to describe the long-term effect of sirolimus in a series of LAM patients followed up in a referral centre, focusing on pulmonary function. We retrospectively reviewed a series of 48 patients with LAM diagnosed, followed up and treated with sirolimus in a single centre. Response to sirolimus was evaluated at 1 and 5 years. A negative sirolimus response was defined as an FEV1 decline greater than − 75 ml/year. A mixed-effects model was used to estimate the longitudinal changes in FEV1 (average slope), both as absolute (ml/year) and as predicted values (%predicted/year). From a total of 48 patients, 9 patients underwent lung transplantation and 4 died during the study. Mean (95% CI) FEV1 slope over 5 years was − 0.14 (− 26.13 to 25.85) ml/year in the whole LAM group, 42.55 (14.87 to 70.22) ml/year in the responder group, − 54.00 (− 71.60 to − 36.39) ml/year in the partial responder group and − 84.19 (− 113.5 to − 54.0) ml/year in the non-responder group. After 5 years of sirolimus treatment 59% had a positive response, 30% had a partial response and 11% had a negative response. Our study found that sirolimus treatment had a positive long-term effect on most LAM patients.

scholarly journals THERAPY OF ENDOCRINE DISEASE: Surgery in microprolactinomas: effectiveness and risks based on contemporary literature

2016 ◽  
Vol 175 (3) ◽  
pp. R89-R96 ◽  
Author(s):  
Metaxia Tampourlou ◽  
Raluca Trifanescu ◽  
Alessandro Paluzzi ◽  
Shahzada K Ahmed ◽  
Niki Karavitaki
Keyword(s):  
Transsphenoidal Surgery ◽  
Young Patients ◽  
Cost Effective ◽  
High Volume ◽  
Term Treatment ◽  
Long Term Results ◽  
Complication Rates ◽  
Management Algorithm ◽  
Long Term Treatment

Microprolactinomas are the most common pituitary adenomas. In symptomatic patients, dopamine agonists are the first-line treatment of choice; when cabergoline is used, biochemical control rates between 85 and 93% have been reported. Long-term treatment is needed in most of the cases with compliance, patient convenience, and potential adverse effects representing areas requiring attention. Based on the literature published in the past 15 years, transsphenoidal surgery can lead to normal prolactin in the postoperative period in usually 71–100% of the cases with very low postoperative complication rates. Surgical expertise is the major determinant of the outcomes, and it may be a cost-effective option in young patients with life expectancy greater than 10 years (provided it is performed by experienced surgeons at high volume centers with confirmed optimal outcomes). Larger series of patients with adequate follow-up could further validate the place of transsphenoidal surgery (particularly through the endoscopic approach for which long-term results are currently limited) in the management algorithm of patients with microprolactinoma.

APPLICATION OF NEW TECHNIQUES IN THE TREATMENT OF PATIENTS WITH FRACTURES OF LONG TUBULAR BONES IN SEVERE COMBINED TRAUMA

2021 ◽  
pp. 59-66
Author(s):  
Khromov A.A. ◽  
Gumanenko E.K. ◽  
Linnik S.A.
Keyword(s):  
Quality Of Life ◽  
Surgical Intervention ◽  
Term Treatment ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Long Term Treatment ◽  
Combined Injuries ◽  
Tubular Bones

Severe combined injuries, and especially polytrauma, differ significantly from other types of injuries by high requirements for the organization of medical care at all its stages, miltidisciplinarity, high financial costs, poor short-term outcomes and long-term treatment results. Therefore, the search for new concepts, strategies and tactics for the treatment of victims is an urgent problem not only for surgeons, resuscitators and traumatologists, but also for healthcare in general. Fractures of long tubular bones accompanying severe combined injuries or polytrauma pose a lesser threat to the life of the victim than severe traumatic brain injuries or damage to internal organs, but they are the main cause of long-term treatment and disability. Such victims make up a significant group of patients-66.2%, therefore they represent a separate problem in traumatology and injury surgery. A modern solution to this problem, improving the results of treatment and the quality of life of victims after suffering a severe combined injury or polytrauma is possible on the basis of new approaches, as well as on the new ideology of osteosynthesis. In the present study, 392 minimally invasive osteosyntheses were performed in 274 patients with severe combined trauma and polytrauma. The indication was the need to fix fractures in order to create favorable conditions for rapid and lasting fusion, early functional treatment and rehabilitation of victims, and to achieve the highest possible level of quality of life after treatment. The possibility and duration of osteosynthesis were determined by the severity of the condition of the victims, assessed by objective methods: a simple clinical scale of VPH-SG or, much less often, specialized resuscitation scales of VPH-SS, SAPS or MODS. The surgical intervention was possible when the severity of the victim's condition reached the highest level of compensation: 16-30 points on the VPH-SG scale. The immediate outcomes of treatment of 274 patients with severe combined trauma and polytrauma after performing a full and final volume of surgery were good. There were no fatal outcomes. The frequency of mild local infectious complications in the field of surgical intervention was 4.0%. The average duration of inpatient treatment was 23.8±2.3 days: with closed intramedullary osteosynthesis - 19.8±0.3 days, with bone osteosynthesis - 24.2±1.2 days, with non - focal osteosynthesis-27.3±1.9 days. The long-term and anatomical and functional results of treatment were analyzed in 158 patients. There were no unsatisfactory long-term results of treatment. Good long-term results were achieved in 81.0%, satisfactory – in 19.0% of the victims. Thus, the results of the analysis of the immediate outcomes and long-term results of treatment of fractures of long tubular bones using the technology of minimally invasive osteosynthesis in patients with severe combined trauma and polytrauma demonstrated the high effectiveness of this surgical technology, on the one hand, and the direct dependence of the treatment outcomes on the severity of the injuries, the severity of the condition of the victims and the number of fractures in one victim, on the other hand.

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