Natural History of Arteriovenous Malformations

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P41-P42
Author(s):  
James Y Suen ◽  
Lisa M Buckmiller ◽  
Chun-Yang Fan ◽  
Gal Shafirstein ◽  
Robert Glade
Keyword(s):  
Quality Of Life ◽  
Natural History ◽  
Surgical Resection ◽  
Healthcare Providers ◽  
Previous Treatment ◽  
Insurance Companies ◽  
Preoperative Embolization ◽  
Presenting Symptoms ◽  
History Of

Objective 1) To demonstrate the natural history of arteriovenous malformation (AVMs) when left untreated or inadequately managed. 2) To demonstrate the need for major treatment to patients, families, healthcare providers, and insurance companies. Methods Records from 10 of 50 representative patients treated at University of Arkansas for Medical Sciences (UAMS) for advanced AVMs were reviewed for age at presentation, gender, presenting symptoms, previous treatment, disease course, and post-presentation management. Patients were asked if quality of life had improved after treatment at UAMS Facial photos from childhood were obtained and compared with photos taken at time of presentation. Results 10 patients (7 male, 3 female, range 21–46 years) received treatment. All patients presented with bleeding, pain and/or facial destruction. 6 of 10 patients received previous embolization. No patients had undergone previous surgical resection. All were informed by a previous physician that the disease was incurable or treatment options had been exhausted. All patients experienced subsequent worsening of symptoMS All patients were treated at UAMS with preoperative embolization followed by surgical resection and required multiple surgeries to remove persistent AVM. All patients indicated quality of life improved after embolization/surgical resection. Comparison of photos revealed progression of disease in all cases marked by facial destruction and deformity. Conclusions AVMs display a progressive and destructive nature when left untreated or inadequately managed. Natural history can be used to demonstrate to patients, families, and healthcare providers the seriousness of disease and convince insurance companies that radical treatment is typically necessary to obtain control or cure.

scholarly journals Natural History, Multimodal Management, and Quality of Life Outcomes of Trigeminal Schwannomas

2018 ◽  
Vol 79 (06) ◽  
pp. 586-592 ◽  
Author(s):  
Vincent Ye ◽  
Ryojo Akagami ◽  
Serge Makarenko
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Natural History ◽  
Surgical Resection ◽  
Clinical Presentation ◽  
Treatment Goals ◽  
Life Outcomes ◽  
Quality Of Life Outcomes ◽  
History Of

Background Trigeminal schwannomas are the second most common among intracranial schwannomas. These can arise from anywhere between the root and the distal extracranial branches of the trigeminal nerve. Clinical presentation depends on location and size, including but not limited to facial hypesthesia or pain, headaches, dizziness, ataxia, and diplopia. Literature is strikingly scant discussing the natural history of these lesions, while the treatment goals are heavily dependent on tumor presentation. Management decisions must be individualized to each tumor and each patient, while attempting to maximize the quality of life. We present the natural history of these lesions as well as their management by surgical resection or radiation therapy, and report long-term quality of life outcomes. Methods Between 2001 and 2015, 24 patients (66.7% female) with trigeminal schwannomas were diagnosed and managed at Vancouver General Hospital. We analyzed the clinical presentation, surgical results, resection rates, patient quality of life, and complications. To complete the evaluation, we prospectively collected 36-Item Short Form Health Survey (SF-36) quality of life assessments for comparison. Results We identified 12 patients treated with a craniotomy and surgical resection, 4 were treated with radiation therapy, while 8 patients were followed by observation. Mean age of study cohort was 49.2 years (range, 23–79 years), and most patients presented with facial hypesthesia (54.2%) and headaches (37.5%), while 37.5% were incidental findings. There were no major differences in patient demographics between the three groups. Patients offered surgery had larger lesions (mean diameter, 3.4 ± 1.1 cm) when compared with those that were irradiated or observed, and were more likely to have extracranial extension. Overall patient quality of life improved following treatment (ΔSF-36 + 12.9) at 3.9 years. Conclusions The treatment goals of trigeminal schwannomas focus on improvement in neurologic symptoms, relief of mass effect, and preservation of cranial nerve function. We demonstrate that smaller lesions found incidentally with minimal symptoms can be followed safely with serial imaging, with 1 of 9 (11.1%) progressing to require treatment over the course of 7.1 years. Management of trigeminal schwannomas should be individualized with an involvement of a multidisciplinary skull base team.

scholarly journals Improving the understanding of how patients with non-dystrophic myotonia are selected for myotonia treatment with mexiletine (NaMuscla): outcomes of treatment impact using a European Delphi panel

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ann-Marie Chapman ◽  
Marieke Schurer ◽  
Laure Weijers ◽  
Amer Omar ◽  
Hiba Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Natural History ◽  
Negative Impact ◽  
Phase Iii ◽  
Future Research ◽  
Delphi Panel ◽  
Economic Modelling ◽  
Patient Access ◽  
History Of

Abstract Background Non-dystrophic myotonias (NDMs) comprise muscle chloride and sodium channelopathies due to genetic defects of the CLCN1- and SCN4A-channels. No licensed antimyotonic treatment has been available until approval of mexiletine (NaMuscla®) for adult patients by the EMA in December 2018. This Delphi panel aimed to understand how outcomes of the pivotal phase III Mexiletine study (MYOMEX) translate to real world practice and investigate health resource use, quality of life and the natural history of NDM to support economic modelling and facilitate patient access. Methods Nine clinical experts in treating NDM took part in a two-round Delphi panel. Their knowledge of NDM and previous use of mexiletine as an off-label treatment prior to NaMuscla’s approval ensured they could provide both qualitative context and quantitative estimates to support economic modelling comparing mexiletine (NaMuscla) to best supportive care. Consensus in four key areas was sought: healthcare resource utilization (HRU), treatment with mexiletine (NaMuscla), patient quality of life (QoL), and the natural history of disease. Concept questions were also asked, considering perceptions on the feasibility of mapping the validated Individualized Neuromuscular Quality of Life (INQoL) instrument to the generic EQ-5D™, and the potential impact on caregiver QoL. Results Consensus was achieved for key questions including the average long-term dosage of mexiletine (NaMuscla) in practice, the criteria for eligibility of myotonia treatment, the clinical importance of QoL outcomes in MYOMEX, the higher proportion of patients with increased QoL, and the reduction in the need for mental health resources for patients receiving mexiletine (NaMuscla). While consensus was not achieved for other questions, the results demonstrated that most experts felt mexiletine (NaMuscla) reduced the need for HRU and was expected to improve QoL. The QoL mapping exercise suggested that it is feasible to map domains of INQoL to EQ-5D. Points of interest for future research were identified, including that mexiletine (NaMuscla) may slow the annual decrease in QoL of patients over their lifetime, and a significant negative impact on QoL for some caregivers. Conclusions This project successfully provided data from an informed group of clinical experts, complementing the currently available clinical trial data for mexiletine (NaMuscla) to support patient access decisions.

Natural history of Charcot–Marie-Tooth 2: 2-year follow-up of muscle strength, walking ability and quality of life

2009 ◽  
Vol 31 (2) ◽  
pp. 175-178 ◽  
Author(s):  
Luca Padua ◽  
D. Pareyson ◽  
I. Aprile ◽  
T. Cavallaro ◽  
D. A. Quattrone ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Natural History ◽  
Walking Ability ◽  
Charcot Marie Tooth ◽  
History Of

scholarly journals Cardioversion and subsequent quality of life and natural history of atrial fibrillation

2017 ◽  
Vol 185 ◽  
pp. 59-66 ◽  
Author(s):  
Sean D. Pokorney ◽  
Sunghee Kim ◽  
Laine Thomas ◽  
Gregg C. Fonarow ◽  
Peter R. Kowey ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Natural History ◽  
History Of

scholarly journals Natural history of reflux oesophagitis: a 10 year follow up of its effect on patient symptomatology and quality of life.

Gut ◽  
1996 ◽  
Vol 38 (4) ◽  
pp. 481-486 ◽  
Author(s):  
N I McDougall ◽  
B T Johnston ◽  
F Kee ◽  
J S Collins ◽  
R J McFarland ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Natural History ◽  
Reflux Oesophagitis ◽  
History Of ◽  
Reflux Œsophagitis

scholarly journals Prevalence of Hyperthyroidism and its Impact on Quality of Life Among Students of the Islamia University of Bahawalpur Pakistan

2020 ◽  
Vol 8 (2) ◽  
pp. 85-90
Author(s):  
Shifa Shaffique ◽  
Haseeb Anwar ◽  
Hafiz Muhammad Asif ◽  
Imran ul Haq ◽  
Muhammad Akram
Keyword(s):  
Quality Of Life ◽  
Family History ◽  
Previous History ◽  
Previous Treatment ◽  
Population Based ◽  
Causative Factors ◽  
Associated Symptoms ◽  
History Of ◽  
Middle Class Families

Aim: Population based studies on prevalence of hyperthyroidism and its impact on quality of life, with variability of weight, height and distribution, their associated symptoms are limited. Knowledge and awareness about the prevalence of hyperthyroidism and their associated symptoms and its treatment option is necessary for the patient education and evaluation of underlying causative factors of this disease. Methodology: Apopulation-based study was conducted from October 2018 to May 2019 to determine the prevalence of hyperthyroidism and its impact on quality of life among the students of The Islamia University Bahawalpur. Questioner were developed and distributed among the consenting participants. Thirty-six males and one hundred and six females were included in this study. Results: Our study concluded that prevalence of hyperthyroidism is n=10(6.6%) and its prevalence ishigher in middle class families. Hyperthyroidism has a positive link with family history and previous history as shown in the results i.e. n=8 (5.3%) with family history and n=5 (3.3%) linked with previoushistory. It is the leading cause of morbidity and its prevalence is raised day by day. We studied that hyperthyroidism produces following effects on quality of life; n=10 (6.6%) participants were presented with loss of concentration in work / studies=10 (6.6%) with body ache, n=8 (5.3%) with social isolation, n=10 (6.6%) with mental health changes, n=6 (4%) with a history of previous treatment, n=8 (5.3%) with need of repeated checkups. Conclusion: It is concluded from present study that the hypehyperthyroidism significantly affects the quality of life and it is positively linked with the family history and history.

Natural history of prostatism: Impact of urinary symptoms on quality of life in 2115 randomly selected community men

Urology ◽  
1994 ◽  
Vol 44 (6) ◽  
pp. 825-831 ◽  
Author(s):  
Cynthia J. Girman ◽  
Robert S. Epstein ◽  
Steven J. Jacobsen ◽  
Harry A. Guess ◽  
Laurel A. Panser ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Natural History ◽  
Urinary Symptoms ◽  
History Of

scholarly journals Corneal-Based Surgical Presbyopic Therapies and Their Application in Pseudophakic Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Grace L. Paley ◽  
Roy S. Chuck ◽  
Linda M. Tsai
Keyword(s):  
Quality Of Life ◽  
Laser Ablation ◽  
Natural History ◽  
Cataract Surgery ◽  
Refractive Surgery ◽  
Corneal Inlay ◽  
History Of ◽  
Surgical Options ◽  
Laser Refractive Surgery

Purpose. The purpose of this review is to provide a summary of laser refractive surgery and corneal inlay approaches to treat presbyopia in patients after cataract surgery.Summary. The presbyopic population is growing rapidly along with increasing demands for spectacle independence. This review will focus on the corneal-based surgical options to address presbyopia including various types of corneal intrastromal inlays and laser ablation techniques to generate either a multifocal cornea (“PresbyLASIK”) or monovision. The natural history of presbyopia develops prior to cataracts, and these presbyopic surgeries have been largely studied in phakic patients. Nevertheless, pseudophakic patients may also undergo these presbyopia-compensating procedures for enhanced quality of life. This review examines the published reports that apply these technologies to patients after cataract surgery and discusses unique considerations for this population.

scholarly journals Atrial Fibrillation a Benign Condition? Quality of Life Approach

2018 ◽  
Vol 1 (1) ◽  
pp. 67-75
Author(s):  
Țica Ovidiu ◽  
Otilia Anca Țica ◽  
Adrian Hatos ◽  
Larisa Roșan ◽  
Mircea Ioachim Popescu
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Oral Anticoagulants ◽  
Previous Treatment ◽  
Good Clinical Practice ◽  
Benign Condition ◽  
History Of ◽  
Hospital Ethics ◽  
Cardiac Rhythm Disorder

Abstract Introduction: Atrial fibrillation (AF) is the most frequent cardiac rhythm disorder, considered until recently benign. Due to its major complications (cardio-embolic episodes) patients need to be anticoagulated. Aim: To assess the quality of life (QOL) in patients with new oral anticoagulants (NOAC) versus those using classical anticoagulants (VKA). Methods: A total of 483 patients admitted consecutively in our clinic were evaluated during hospitalization and after discharge. Follow-up visits were conducted: at baseline, 6, 12, 18 and 24 months; the quality of life (QoL) was measured by a specific questionnaire (EQ-5D-3L), and the results were assessed. Patients were divided in two groups considering their anticoagulant use: NOAC or VKA. Baseline characteristics, clinical outcomes as well as QoL indices were compared between the two groups The current research has been conducted in accordance with the ethical prin ciples set out in the Helsinki Declaration and Good Clinical Practice Recommendations and was approved by our hospital Ethics Committee. Results: The mean age of our studied group (374 eligible patients) was 64.7 ± 8.2 years (p=0.220); 116 patients (31.01%) used NOAC. Patients with NOAC obtained better results in all domains: physical (57.0±8.9 vs. 51.1±12.5 vs. 42.0±6.2; p<0.001), social (62.6±19.8 vs. 52.5±20.0 vs. 45.7±16.0; p=0.019) and environmental (62.9±12.7 vs. 52.7±7.6 vs. 60.7±3.6; p =0.018). Compared to VKAs, NOACs were more commonly prescribed in patients with a history of stroke or with a higher thromboembolic risk (p<0.001). EQ-5D-3L total score: 75.6 ± 20.9; visual analogue scale: 63.1 ± 20.6. Conclusion(s): Satisfaction and QoL with oral anticoagulants were high, although they were both better with NOACs. A worse QoL was associated with comorbidities, polypragmasy, and previous treatment with VKA. Patients strongly expressed their desire to improve their QoL.

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