A five year follow up of incus transposition in relation to the first stage tympanoplasty technique

1992 ◽  
Vol 106 (7) ◽  
pp. 607-609 ◽  
Author(s):  
I. Donaldson ◽  
D. G. Snow
Keyword(s):  
Hearing Level ◽  
Hearing Results ◽  
Factors Affecting ◽  
Ossicular Reconstruction ◽  
Second Stage ◽  
Cortical Mastoidectomy ◽  
Primary Procedure ◽  
Set Up

AbstractThis study was set up, prospectively, to determine factors affecting the long-term hearing results of patients undergoing incus transposition as a second stage in ossicular reconstruction, following a successful drumhead repair in non-cholesteatoma ears. Seventy-one patients were entered into the study over five years from 1980–1985, 66 were available to be studied throughout the five year follow-up period.Nine weeks post-operatively, 74 per cent of all patients has an air-bone gap of less than 15 dB (48/66). The type of first stage procedure had a significant effect on the hearing levels in the final five year assessment. The most successful sub-group were those patients who had a cortical mastoidectomy and silastic sheeting inserted in the first staging procedure. The air-bone gap, of less than 15 dB, was maintained in 71 per cent of this group (17/24). The sub-group who had a simple myringoplasty as the primary procedure had a good initial hearing level. By five years, however, only 30 per cent of the patients had maintained the air-bone gap of less than 30 dB (3/11).

Tympanosclerosis: Long-Term Hearing Results after Ossicular Reconstruction

2002 ◽  
Vol 126 (3) ◽  
pp. 264-272 ◽  
Author(s):  
Karen Borne Teufert ◽  
Antonio De La Cruz
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Retrospective Chart Review ◽  
Sensorineural Hearing ◽  
Short Term ◽  
Hearing Results ◽  
Ossicular Reconstruction ◽  
Second Stage

OBJECTIVE: The study goal was to analyze long-term hearing results and factors likely to affect outcome after ossicular reconstruction in patients with tympanosclerosis, particularly tympanosclerotic stapes fixation. METHODS: We conducted a retrospective chart review of the past 10 years. The short- and long-term (up to 9 1/2 years) hearing results of first-stage and second-stage operations for middle ear tympanosclerosis in 203 consecutive patients, performed in a tertiary referral otologic private practice, are presented. There were 160 tympanoplasties and 43 tympanoplasties with mastoidectomy performed, with ossicular fixation secondary to tympanosclerosis in 135 cases. Of these 203, 42.9% were primary cases, with the majority being planned second-stage or revision procedures. RESULTS: The average preoperative air-bone gap (ABG) was 30.9 dB. The average short-term postoperative ABG was 17.4 dB with closure of the ABG within 20 dB in 64.6%. The success rate (ABG ≤ 20 dB) for patients with ossicular fixation was 65.3%. Partial sensorineural hearing loss occurred in 1.0% of the patients, and none experienced profound sensorineural hearing loss (dead ears). There was no statistically significant change from short-term to long-term follow-up in either ABG or air PTA, with mean differences of only 0.3 and 2.0 dB, respectively. The mean time to the last follow-up was 1.6 years. CONCLUSION: Ossicular reconstruction in individuals with tympanosclerosis can yield satisfactory, lasting hearing results with a low incidence of complications and no dead ears.

Tympanomastoidectomy for Chronic Otitis Media without Cholesteatoma

1992 ◽  
Vol 106 (3) ◽  
pp. 230-234 ◽  
Author(s):  
Eero Vartiainen ◽  
Martti Kansanen
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Concomitant Disease ◽  
Suppurative Otitis Media ◽  
Hearing Results ◽  
Second Stage ◽  
Cortical Mastoidectomy ◽  
Revision Operations ◽  
Air Cells

A series of 221 ears with chronic suppurative otitis media without cholesteatoma is presented—84% of the cases were treated using one-stage tympanomastoidectomy and 15% underwent cortical mastoidectomy with planned second-stage tympanoplasty. Mean follow-up period was 6.3 years. Control of infection succeeded in 92% after the primary operation. Failures were most common in ears infected with Pseudomonas aeruginosa. Postoperative cholesteatoma developed in 5 ears (2.2%). Hearing results were unsatisfactory; a postoperative air-bone gap within 20 dB was achieved in only 62%. In revision operations, retained mastoid air cells were found in 64% of ears with recurrent or persistent discharge. Thirty-seven percent of patients with unsuccessful outcome were observed to have a possible underlying or concomitant disease. The importance of intensive preoperative conservative treatment and careful surgical technique is stressed.

Long-term follow-up after bowel resection for necrotizing enterocolitis: Factors affecting outcome

1998 ◽  
Vol 33 (7) ◽  
pp. 967-972 ◽  
Author(s):  
Alan P Ladd ◽  
Frederick J Rescorla ◽  
Karen W West ◽  
L.R Scherer ◽  
Scott A Engum ◽  
...  
Keyword(s):  
Necrotizing Enterocolitis ◽  
Bowel Resection ◽  
Factors Affecting ◽  
Long Term Follow Up

scholarly journals ACTR-38. A SINGLE CENTER STUDY: LONG-TERM OUTCOMES OF COMBINED CHEMORADIATION THERAPY WITH TEMOZOLOMIDE FOR NEWLY DIAGNOSED GLIOBLASTOMA IN KOREAN PATIENT

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi21-vi21
Author(s):  
Kyeong-O Go ◽  
Ha Young Yang ◽  
Kihwan Hwang ◽  
Jung Ho Han ◽  
Hyoung Soo Choi ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Adjuvant Treatment ◽  
Genetic Factors ◽  
Newly Diagnosed ◽  
Factors Affecting ◽  
Korean Patients ◽  
Significant Difference ◽  
Newly Diagnosed Glioblastoma

Abstract In newly diagnosed glioblastoma (GBM), Temozolomide (TMZ) during and after radiation therapy has become standard treatment. This study describes the long-term use and follow-up results of this therapy for GBM. From 2004 to 2013 in a single institute, 112 Korean patients with newly diagnosed GBM were analyzed retrospectively. The Kaplan-Meier method, the two-sided log-rank test and Cox’s regression analysis was used to determine survival and its affecting factors. The toxicities of TMZ were evaluated using CTCAE v5.0. During the median follow-up period of 18.8 months, median PFS and OS were 9.2 and 20.3 months, respectively. This better survival outcome than the Stupp’s original study might be probably a large treatment effect of a single institution, ethnicity, and associated genetic factors. The TMZ during radiation therapy was completed in 108 patients (96.4%) and TMZ after radiation therapy in 59 patients (52.7%). Eight patients presented with grade 3 or 4 hematologic toxic effects during the protocol. Sixty-six patients (58.9%) received salvage treatment because of the poor response to adjuvant treatment or progression of the disease who achieved completion of adjuvant treatment was shown significantly longer median OS (p= 0.007) and PFS (p< 0.001). Age (< 60 years), preoperative KPS score (≥ 90), the extent of resection (≥ 78% by volumetric measurement, gross total resection), and completion of the Stupp’s protocol were significant factors affecting better survival. Between the sexes, and ages over 65 years did not show any significant difference among their groups. With marginal significances, the mutated IDH-1 and the methylated MGMT promoter showed longer median PFS(p= 0.075 and 0.777, respectively) and OS (p= 0.085 and 0.131, respectively). TMZ during and after radiation therapy might be effective and safe for newly diagnosed Korean patients with GBM. Further studies about various clinical and genetic factors affecting better survival are mandatory.

scholarly journals Lifestyle and Long-Term Smoking Cessation

2020 ◽  
Vol 13 ◽  
pp. 1179173X2096306
Author(s):  
Tove Sohlberg ◽  
Karin Helmersson Bergmark
Keyword(s):  
Smoking Cessation ◽  
Smoking Initiation ◽  
Lifestyle Changes ◽  
Factors Affecting ◽  
Quit Smoking ◽  
Swedish Health Care ◽  
The Impact ◽  
Term Maintenance

Background: Since smoking is the leading cause of preventable death, discouraging smoking initiation, encouraging smoking cessation, and exploring factors that help individuals to stay smoke free are immensely important. One such relevant factor may be the impact of lifestyle for long-term smoking cessation. Method: A representative sample of successful quitters was recruited for a study about smoking cessation. These respondents are now part of a 7-year follow-up with the overall aim of revealing factors affecting long-term smoking cessation. Descriptive analyses were carried out at baseline and at follow-up, as well as a further two-step cluster analysis to explore profiles of long-term smoke-free individuals. Results: A majority did not make any particular lifestyle changes, but among those who did, most adopted a healthier lifestyle and/or increased their quota of physical training, where permanent changes in this direction seem to promote a more enduring smoke-free life. Conclusions: Individuals who want to quit smoking should be encouraged to increase their level of physical activity. Swedish health care institutions should be able to provide support for this both initially and over time to promote the long-term maintenance of a smoke-free lifestyle.

Unit Manager's Role with Family Members of Clients in Complex Continuing Care Settings: An Untold Story

2005 ◽  
Vol 24 (2) ◽  
pp. 127-137
Author(s):  
Sepali Guruge ◽  
Katherine McGilton ◽  
Linda Yetman ◽  
Heather Campbell ◽  
Ruby Librado ◽  
...  
Keyword(s):  
Family Relationships ◽  
Family Members ◽  
Future Research ◽  
Continuing Care ◽  
Theory Approach ◽  
Term Care ◽  
Factors Affecting ◽  
Closing The Loop

ABSTRACTMost literature on staff-family relationships has come from studies of long-term care settings, has focused mainly on the families' perspectives on factors affecting their relationships with staff, and has included scant findings from the staff's perspective. No studies that examined staff-family relationships in complex continuing care (CCC) environments from the perspective of staff were found in the literature. A qualitative study that draws on a grounded theory approach was conducted to explore staff-family relationships in CCC, and the findings presented in this article illuminate the unit manager's role. Data were collected through in-depth interviews with nine unit managers and a follow-up focus group with five unit managers who work in three CCC facilities. Three categories reflecting the unit manager's role with family members of clients in CCC settings were derived: establishing supportive entry; building and preserving relationships; and closing the loop. Implications of the findings for practice and future research are presented.

Validating the Excision of Cholesteatoma

1985 ◽  
Vol 93 (3) ◽  
pp. 288-292 ◽  
Author(s):  
Arnold G. Schuring ◽  
William H. Lippy
Keyword(s):  
Surgical Procedures ◽  
Radical Mastoidectomy ◽  
Hearing Results ◽  
Second Stage ◽  
Retraction Pockets ◽  
Third Stage ◽  
Second Procedure ◽  
Lost To Follow Up

In lieu of a radical mastoidectomy, 138 patients underwent a closed tympanomastoidectomy with subsequent staged surgical procedures until the excision of cholesteatoma could be validated. All the patients underwent two surgical procedures, 29% underwent three procedures, and 4% underwent four procedures. The surgical findings at the second procedure were: negative, 41.5%; retraction pockets, 7%; squamous pearls, 14%; recurrent cholesteatoma, 12%; and residual cholesteatoma, 25.5%. At each stage the likelihood of finding any form of cholesteatoma lessens. A conversion from a closed to an open mastoidectomy was necessary for 9% of the patients, and 4% were lost to follow-up. The opportunity to adjust the reconstructed ossicular assembly exists at each stage. With the use of semibiologic prostheses (ossicle cup and columella), the hearing results were: first stage, 67% within 20 dB, 84% within 30 dB; second stage, 77% and 90%; third stage, 77% and 96%.

scholarly journals Evaluation of installation effects on set-up of field displacement piles in sand

2019 ◽  
Vol 56 (4) ◽  
pp. 461-472 ◽  
Author(s):  
Ivana Anusic ◽  
Barry M. Lehane ◽  
Gudmund R. Eiksund ◽  
Morten A. Liingaard
Keyword(s):  
Test Data ◽  
Impact Frequency ◽  
Short Term ◽  
Factors Affecting ◽  
Installation Effects ◽  
Field Displacement ◽  
Small Influence ◽  
Set Up ◽  
Shaft Friction

The paper presents results from a new series of tests on displacement piles in sand, involving different installation modes, and combines these with results from previous tests at the same site as well as with test data at two other well-investigated sand sites to provide fresh insights into factors affecting “short-term” capacity and set-up of shaft friction. It is shown that the shaft capacity measured shortly after installation reduces systematically with the logarithm of the number of impact blows or jacking increments per unit shaft area imparted during installation. However, the degree of set-up of shaft friction for piles increases with an increase in the number of blows, and piles installed using a large number of blows can attain highest “long-term” shaft capacities, despite having the lowest short-term capacity. The tests indicated that the driving impact frequency had a relatively small influence on shaft friction, while piles installed by vibration attain short-term capacities comparable to driven impact piles, but showed negative set-up.

scholarly journals Anti-NMDAR encephalitis

2019 ◽  
Vol 7 (1) ◽  
pp. e633 ◽  
Author(s):  
Xiaolu Xu ◽  
Qiang Lu ◽  
Yan Huang ◽  
Siyuan Fan ◽  
Lixin Zhou ◽  
...  
Keyword(s):  
Ovarian Teratoma ◽  
Long Term Outcomes ◽  
First Line ◽  
Factors Affecting ◽  
First Line Therapy ◽  
Nmdar Encephalitis ◽  
Clinical Presentations ◽  
Long Term Prognosis

ObjectiveTo describe the detailed clinical characteristics, immunotherapy, and long-term outcomes of patients with anti-NMDA receptor (NMDAR) encephalitis in China.MethodsA single-center, prospective study. Patients who met the diagnostic criteria were enrolled from 2011 to 2017 and followed up. The clinical features, treatment, and long-term outcomes were collected prospectively. Factors affecting the long-term prognosis were analyzed.ResultsThe study included 220 patients. The most common clinical presentations were psychosis (82.7%) and seizures (80.9%). Of the patients, 19.5% had an underlying neoplasm; of which ovarian teratoma was 100% of tumors in females and only one male had lung cancer. Most patients (99.5%) received first-line therapy (glucocorticoids, IV immunoglobulin, or plasmapheresis alone or combined), and only 7.3% received second-line immunotherapy (rituximab, cyclophosphamide alone, or combined). Long-term immunotherapy (mycophenolate mofetil or azathioprine >1 year) was administered to 53.2% of patients. During the first 12 months, 207 (94.1%) patients experienced improvement, and 5 (2.3%) died, whereas 38 (17.3%) experienced relapses. At 12-month follow-up, 92.7% had favorable clinical outcomes (modified Rankin Scale score ≤2).ConclusionsPatients in China present with psychosis and seizure frequently but have a low percentage of underlying neoplasms. Re-enforced first-line immunotherapy is effective in managing anti-NMDAR encephalitis in the acute phase. Although relapse is relatively common, with combined first-line and long-term immunotherapy, most patients reached favorable outcomes.

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