The relationship between contact stress elevations and the long-term outcome of congenital hip dislocation

1988 ◽  
Vol 21 (10) ◽  
pp. 858
Author(s):  
Nancy A. Hadley ◽  
Thomas D. Brown ◽  
Stuart L. Weinstein
Keyword(s):  
Contact Stress ◽  
Hip Dislocation ◽  
Congenital Hip Dislocation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Relationship

The relationship between aortoiliac calcification and long-term outcome in rectal cancer resection.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 705-705
Author(s):  
Katrina Knight ◽  
Kate Boland ◽  
Donald C McMillan ◽  
Paul G. Horgan ◽  
Campbell SD Roxburgh ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Overall Survival ◽  
Tnm Stage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Iliac Arteries ◽  
Cancer Resection ◽  
Rectal Cancer Resection ◽  
The Relationship

705 Background: The interaction between host and tumour factors is an important determinant of long-term outcome following rectal cancer resection. At cellular level, hypoxia within the tumour microenvironment stimulates neovascularisation, alters tumour metabolism and is implicated in dissemination and metastases. At host level, restricted blood flow to the tumour may play a role in tumour hypoxia. Significant calcification of the distal aortic and iliac arteries could result in impaired rectal perfusion. We aimed to investigate the relationship between aortoiliac calcification (AC) and long-term outcome following rectal cancer resection. Methods: Patients were identified from a prospectively maintained database. Recurrence and survival data were abstracted. On staging CT images, the sum of calcified quadrants of the distal aorta and iliac arteries at the level of the bifurcation was calculated. ROC analysis was used to identify the optimum threshold for determining significant calcification. Results: Between 2008-2016, 181 patients with available CT scans underwent surgery for rectal cancer. Most were male (60%), aged over 65 (53%) and TNM stage II/III (72%). Median follow-up was 63 months. Significant AC was identified in 44 patients (24%). Recurrence occurred in 42 patients: local in 16 (9%) and systemic in 26 (14%) patients. Recurrence was associated with significant AC (p = 0.017), TNM stage (p = 0.002) and venous invasion (p = 0.006). When considering those with and without significant AC, there were differences in the rates of local (11% vs. 8%) and systemic (25% vs. 11%) recurrence respectively (p = 0.043). On univariate Cox regression analysis, overall survival was related to age (p = 0.012), ASA grade (p = 0.042) and significant AC (p = 0.001). On multivariate analysis, significant AC (p = 0.011) was the only independent predictor of overall survival. Conclusions: The burden of aortoiliac calcification appears to play an important role in influencing long-term outcome following rectal cancer resection, independent of traditional determinants such as TNM stage and ASA grade. While validation is required, further investigation of the mechanism underlying this relationship is warranted.

III. Relapse Postponement or Relapse Prevention? The Implications for Long-term Outcome

1985 ◽  
Vol 146 (5) ◽  
pp. 474-480 ◽  
Author(s):  
D. A. Curson ◽  
T. R. E. Barnes ◽  
R. W. Bamber ◽  
S. D. Platt ◽  
S. R. Hirsch ◽  
...  
Keyword(s):  
Social Performance ◽  
Severity Of Illness ◽  
Drug Discontinuation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Maintenance Medication ◽  
Frequent Relapses ◽  
The Relationship ◽  
Relapse Rates

SummaryThe relapse and admission histories revealed a positive correlation between number of schizophrenic episodes and time on maintenance medication, probably reflecting severity of illness. Relapse rates after drug discontinuation rose to 45% within 13 months. There were no differences of predictive value between those relapsing on or off medication. The relationship between relapse rates, drug treatment, and social outcome is complex; antipsychotic drugs may postpone relapse, and frequent relapses might inhibit improvement in social performance long after florid symptoms have been controlled by medication.

scholarly journals Long-term outcome after anterolateral open reduction and Salter osteotomy for late presenting developmental dysplasia of the hip

2018 ◽  
Vol 12 (4) ◽  
pp. 364-368 ◽  
Author(s):  
S. R. Y. W. Thomas
Keyword(s):  
Femoral Head ◽  
Open Reduction ◽  
Skeletal Maturity ◽  
Hip Dislocation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Femoral Head Osteonecrosis ◽  
Salter Osteotomy ◽  
Innominate Osteotomy

IntroductionOnly a handful of studies report outcomes after open reduction for developmental hip dislocation beyond skeletal maturity. For successfully reduced hips it is the outcome into late adulthood on which the results of this intervention should be judged. These studies indicate clearly the importance of preservation of the acetabular growth centres during surgery. The acetabulum must also be addressed when insufficient growth remains reliably to remodel residual dysplasia even after stable, concentric reduction.SummaryComparing the longest-term outcome studies for open reduction to less invasive, but mainly historical, techniques of gradual traction reduction it is unsettling to note that the latter protocols are associated with the best results. Whereas open reduction and innominate osteotomy are practised as originally described by Salter, gradual traction reduction has largely been abandoned.ConclusionsThere are probably aspects of the more time-consuming methods of gradual reduction that do not violate the hip joint capsule that expose the femoral head to a lower risk of femoral head osteonecrosis leading to better long-term outcomes.

scholarly journals Initial overcorrection after surgery for intermittent exotropia in children less than 4 years old: Comparison with older children

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257465
Author(s):  
Jinju Choi ◽  
Dong Gyu Choi
Keyword(s):  
Older Children ◽  
Intermittent Exotropia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Age At Surgery ◽  
Angle Of Deviation ◽  
The Mean ◽  
The Relationship ◽  
Consecutive Esotropia

Purpose While initial overcorrection after exotropia-correcting surgery is widely accepted for a favorable long-term outcome, some have not advocated such overcorrection in younger children owing to concerns regarding rapid deterioration of bifixation ability. This study aimed to evaluate the relationship between initial overcorrection after intermittent exotropia surgery and the surgical outcome in patients aged <4 years. Methods In this retrospective study, 391 patients who had undergone surgery for intermittent exotropia were classified into two groups according to the age at surgery: <4 years old (group Y [young], 130 patients) and 4–16 years old (group O [old], 261). The patients were subdivided into three groups according to the angle of deviation at postoperative 1 week: esophoria-tropia (ET) ≥10 prism diopters (PD) (subgroup I), ET 1–9 PD (II), and orthotropia or exophoria-tropia (XT) (III). We compared the surgical outcomes between the two groups and among subgroups; then, we analyzed consecutive esotropia patients. Results The mean exodeviation was smaller in the order of subgroup I, II, and III at every postoperative visit (p<0.05) in group Y but showed no difference among subgroups after 2 years in group O. Consecutive esotropia occurred at 1 month, postoperatively, in 6.9% and 2.6% of the patients in groups Y and O (p = 0.133), respectively. However, it persisted in two and one patient in groups Y and O, respectively, until the last visit. Conclusion Early overcorrection after intermittent exotropia surgery was a safe and desirable result in terms of motor outcome in children aged under 4 years, as well as for children aged between 4–16 years.

scholarly journals Initial GCS and laboratory findings of patients with TBI are associated with the GOSE and mortality rate at one year

2017 ◽  
Vol 6 (1) ◽  
pp. 14 ◽  
Author(s):  
Shahram Paydar ◽  
Elahe Bordbar ◽  
Mehdi Taghipour ◽  
Hosseinali Khalili ◽  
Mehran Jafari
Keyword(s):  
Mortality Rate ◽  
Laboratory Data ◽  
Base Deficit ◽  
Final Outcome ◽  
Laboratory Findings ◽  
Term Outcome ◽  
Long Term Outcome ◽  
One Year ◽  
The Relationship

Background: To evaluate the relationship between presenting Glasgow Coma Scale (GCS) or laboratory data of patients with TBI and Extended Glasgow Outcome Scale (GOSE) and final outcome (deceased, survived) at one year.Methods: 74 patients (59 males and 15 females; mean age ±SD of 40±19years) who presented with TBI were entered into the study, and their GCS and laboratory data were recorded. After one year, GOSE level and final outcome were evaluated with 11 yes/no questions obtained from the patients or their first-degree relatives.Results: The patients with lower GCS on admission or day six, significantly had lower GOSE. Moreover, the lower the GCS in the first week of admission, the poorer the final outcome. Among laboratory data, the base deficit (BD) level of -6 or worse on admission was an indicator of mortality at one year. Hypernatremia was the only laboratory factor which predicted poor GOSE after a year. Furthermore, patients with serum hypernatremia, hyperkalemia, or high PTT levels on the first week of admission had poor final outcome.Conclusions: Presenting GCS and metabolic derangements are reliable indicators of long-term outcome and GOSE at one year. 

Matching early arterial oxygenation to long-term outcome in severe traumatic brain injury: target values

2020 ◽  
Vol 132 (2) ◽  
pp. 537-544 ◽  
Author(s):  
Aziz S. Alali ◽  
Nancy Temkin ◽  
Monica S. Vavilala ◽  
Abhijit V. Lele ◽  
Jason Barber ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neuropsychological Tests ◽  
Cognitive Outcomes ◽  
Cognitive Outcome ◽  
Arterial Oxygenation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Relationship

OBJECTIVEThe aim of this study was to examine the relationship between early arterial oxygenation thresholds and long-term outcome after severe traumatic brain injury (TBI).METHODSIn a post hoc analysis of a randomized trial, adults with severe TBI were classified based on exposure to different levels of arterial oxygenation as measured using the average of arterial partial pressure of oxygen (PaO2) values obtained within 24 hours of admission. Potentially important PaO2 thresholds were defined a priori. The primary outcome was Glasgow Outcome Scale–Extended (GOSE) score at 6 months. Secondary outcomes were cognitive outcomes measured using a battery of 9 neuropsychological tests administered at 6 months, and 6-month mortality.RESULTSIn adjusted analyses, oxygenation thresholds of 150 and 200 mm Hg were associated with better functional outcome at 6 months (adjusted OR for better functional outcome on GOSE 1.82 [95% CI 1.12–2.94] and 1.59 [95% CI 1.06–2.37], respectively) and improved cognitive outcome at 6 months (adjusted beta coefficients for better cognitive percentile across 9 neuropsychological tests: 6.9 [95% CI 1.3–12.5] and 6.8 [95% CI 2.4–11.3], respectively). There was no significant association between oxygenation level and 6-month mortality except at a PaO2 threshold of 200 mm Hg (OR for death 0.36, 95% CI 0.18–0.71). Higher or lower oxygenation thresholds were not associated with functional or cognitive outcome.CONCLUSIONSIn this observational study, the relationship between early arterial oxygenation and long-term functional and cognitive TBI outcomes appears to be U-shaped. Mild levels of hyperoxemia within the first 24 hours after injury were associated with better long-term functional and cognitive outcomes. These findings highlight the importance of examining balanced oxygen supplementation as a potential strategy to improve TBI outcomes in future research.

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