Analysis of postoperative strokes in patients after resection or suturing of the left atrial appendage

Abstract Funding Acknowledgements Type of funding sources: None. Introduction In 30%, the cause of strokes is AF. 90% of cases, thromboembolism occurs in the cerebral arteries, condemning the patient not only to disability, but also to death. Considering that the formation of blood clots occurs in hemodynamically inactive areas of the LA, which is the apendege of the LA, it is advisable to combine surgical treatment of AF with its exclusion from systemic blood flow. Purpose Analyze the frequency of strokes in the follow up period in patients who have undergone surgical treatment of AF in combination with LAA resection. Materials and Methods 364 patients were divided into 3 groups depending on the volume of operative treatment and the rhythm of the controlling strategy, 105 dropped out of the study due to the lack of data collection capability. • Group I included 80 patients who underwent surgical AF treatment with LAA resection combined with valvular pathology correction or myocardial revascularization. Lethal outcome in this group was recorded in 6 (7.5%) patients caused by non-cardiac pathology. Surgical treatment of AF was performed by MAZE IV and left side MAZE. • Group II - 140 people who performed valve pathology correction, without surgical treatment of AF and without LAA resection. • Group III included 39 patients with a persistent form of AF who performed only LAA resection in combination with correction with another cardiac pathology. Group II and III mortality were 23 patients. All patients in group I and III underwent LAA resection to exclude a possible source of blood clots. The stump was sutured with a continuous two-row suture on the base up to 2 mm from the LA wall. After 36 months, patients from group I underwent echocardiography, electrocardiography, Holter monitoring, and a cardiologist examination. Group II and III analyses were performed by patient telemetry. Results • Long-term three-year results showed complete 100% freedom from acute cerebral circulation disorder in group I, where surgical treatment of AF was performed in combination with LAA resection; • In group I with a persistent form of AF without LAA resection - acute cerebral circulation disorder occurred in 36 patients, which was 28.8%; • In group III with permanent fibrillation with LAA resection, of the 31 patients, thromboembolic complication occurred in 4 patients (12.9%). It is worth noting that after surgery in the distant period, patients of group I increased the average value of the ejection fraction by 4%, decreased volumes of the LA, and the functional class on NYHA changed from III to II, I. Conclusion The study performed the highest degree of absence of stroke in group I in early and follow up period. First of all, this is due to a comprehensive approach to the treatment of cardiac pathology, the preservation of sinus rhythm and LAA resection. Which, in addition to absence of stroke, leads to an improvement in the quality of life and a decrease in the functional class of heart failure.

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Outcomes of ophtalmologic surgical procedures of esotropia in children and adolescents

Vojnosanitetski pregled ◽

10.2298/vsp0808627k ◽

2008 ◽

Vol 65 (8) ◽

pp. 627-631

Author(s):

Tamara Kljakovic-Avramovic ◽

Miroslav Vukosavljevic ◽

Sinisa Avramovic

Keyword(s):

Surgical Treatment ◽

Prospective Study ◽

Children And Adolescents ◽

Deviation Angle ◽

Group Iii ◽

Military Medical Academy ◽

Group I ◽

Medical Academy ◽

Group Ii ◽

Common Manifestation

Background/Aim. Esotropia is the most common manifestation form of strabism accompanied by refraction deviations and amblyopia. The aim of this prospective study was to present the outcomes of surgical treatment of esotropia in children and adolescents. Methods. Within the period from January 1st 2006 to February 1st 2007 at the Clinic for Ophtalmology, Military Medical Academy, Belgrade a total of 25 patients with esotropia (34 eyes) and previously corrected refraction anomaly and treated amblyopia were operated on. The patients were 4-19-year of age. All of the patients were submitted to a complete ophtalmologic and orthoptic examination prior to the surgery, and a month, three months and six months after the surgery. The surgery was performed under general anesthesia. Out of the total number of the patients nine were operated on both eyes, while 16 patients on one eye with amblyopia or frequent esodeviation. Nine patients were submitted to retroposition of the inner straight muscle, two to myectomy of the outer straight muscle, while in 14 of the patients a combination of retroposition and myectomy was performed. The patients were divided into three groups according to the preoperative angle at the distance and followed-up accordingly after the surgery. Deviation angle at the distance in the group I was 18-25 DP, in the group II 26-35 PD, while in the group III it was 36-60 PD. Results. The most numerous, group I (12 patients; 48%), a month following the surgery showed angle reduction by 55.58%, after three months 63.25%, and after six months 63.92%. The group II consisted of 8 patients (32%) showed angle reduction by 70.75% a month following the surgery, by 76% after three months, and by 79.12% after six months. The group III (5 patients; 20%) showed angle reduction by 72.20% a month following the surgery, 79.20 after three months, and 80.12% after six months following the surgery. Conclusion. The best postoperative outcomes after a month, three and six months were obtained in the group of patients with the highest esodeviation angle at the distance solved by the surgery on both eyes. Timely surgical treatment befell into major precondition for developing and maintaining the elements of binocular vision in the operated on patients. .

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Hormonal status of patients after surgical treatment of fibrocystic mastopathy and possibilityes of its corrections

HEALTH OF WOMAN ◽

10.15574/hw.2017.121.128 ◽

2017 ◽

pp. 128-131

Author(s):

Yu.Ya. Pryshash ◽

Keyword(s):

Surgical Treatment ◽

Standard Dose ◽

Treatment Phase ◽

Nodule Formation ◽

Double Dose ◽

Postoperative Rehabilitation ◽

Group Iii ◽

Group I ◽

Group Ii ◽

High Doses

The purpose of the study was to investigate the efficacy of Mastodynon in terms of indications in elevated doses versus the standard dose. Materials and methods. Data were analyzed for 60 patients after surgical treatment of fibro-cystic mastopathy. Depending on the postoperative therapy received by the patients, they were divided into three groups. Group I (n = 20): patients were observed in accordance with the standards established in mammal practice and did not receive special agents that affect hormonal homeostasis. Group II (n = 20): In addition to observation, patients received Mastodynon® (1 tablet or 30 drops 2 times a day) for 6 months. Group III (n = 20): Patients were given for a post-operative rehabilitation Mastodynon® in a double dose (2 tablets or 60 drops 2 times a day) for 6 months. Results Surgical treatment without conservative therapy eliminates organic changes in the thoracic glands (GH), but hormonal disorders that have led to pathologic and histological changes in the tissues of GZ continue to exist for a long time and can lead to repeated nodal formations. In group І, 25% of patients within 2 years performed repeated sectoral resections on recurrence of nodule formation. In group І, 25% of patients within 2 years performed repeated sectoral resections on recurrence of nodule formation. The use of Mastodynon® in standard doses (group II) for postoperative rehabilitation contributes to a significant improvement in hormonal homeostasis (normalization of prolactin, estradiol and progesterone levels), a 24.7 mm decrease in the degree of cyclic mastodynia according to the visual analog scale (VAS), and the improvement of ultrasound scan Pictures of GZ in 75% of patients. The most pronounced effect of this rehabilitation approach after the surgical treatment phase was noted for the use of Mastodynone in doble doses (2 tablets or 60 drops 2 times a day) in Group III. In these patients, the degree of reduction of cyclic mastodynia was 30 mm for VAS and positive changes in the tissues of GH were noted in 85% of patients. However, the highest incidence of adverse events was also noted in Group III, although they were temporary in nature and did not require withdrawal or dose reduction. Conclusion. Despite the presence of short-term side effects and rapid rebounding in the double-dose Mastodynon® group, our study showed better results than standard doses, faster and more stable therapeutic effect. Taking into account the results obtained, it can be argued that the use of high doses of Mastodynon® may be recommended to patients for the treatment of mastopathy. For a more complete study of such an important aspect as the tolerability of high doses of Mastodynon®, it is advisable to conduct more extensive studies, taking into account the dosage form and the use of other drugs. Key words: mastopathy, postoperative rehabilitation, Mastodynon®, mastodynia.

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Evolving Solutions in the Surgical Treatment of Isolated Pulmonary Valve Stenosis

10.37191/mapsci-jccr-2(3)-044 ◽

2021 ◽

Author(s):

Sonia B. Albanese Albanese

Keyword(s):

Surgical Treatment ◽

Pressure Gradient ◽

Pulmonary Valve ◽

Balloon Valvuloplasty ◽

Pulmonary Valve Stenosis ◽

Group I ◽

Mean Pressure ◽

Valve Function ◽

Group Ii

Background: Surgical treatment of isolated pulmonary valve stenosis in infants and children has evolved over the years, shifting from the original exclusive aim at lowering right ventricle pressure to the current concomitant focus on preserving pulmonary valve function. In our study, we sought to analyze the effect of such evolving philosophy on long-term results. Methods: All consecutive patients treated in our center between July 1983 and March 2019 were included. Patients were categorized into 2 groups based on the introduction into treatment practice of sparing valve techniques (1995). Actuarial survival, freedom from reintervention on the right outflow tract, transvalvular mean pressure gradient decrease, and pulmonary valve function at follow-up were analyzed. Results: One hundred twenty-three patients operated before (Group I, n=81) or since (Group II, n=42) 1995 were enrolled in the study. Mean age and weight were 3.0 ± 0.36 years and 16.6 ± 1.7kg, respectively. Early mortality occurred exclusively in 3 patients of Group 1. Transvalvular mean pressure gradient decreased in the entire patient population (from 63.28 ± 12.9mmHg to 16.46 ± 7.9mmHg). At a mean follow-up interval of 4.9 ± 33 years, freedom from death was comparable, but freedom from right ventricular outflow tract reintervention was significantly greater in Group II. Although the transvalvular gradient remained stable over time in non-reoperated survivors (mean value of 16.46 ± 7.9mmHg), pulmonary valve function on 2D-Echo showed severe incompetence in 2 patients of Group I and just mild to moderate incompetence in 20 patients of Group II, with a significantly negative effect of unsuccessful preoperative pulmonary balloon valvuloplasty (14/20 vs 6/20, p=0.025) in the latter. Conclusion: Current pulmonary valve sparing techniques are associated with better results, particularly in terms of freedom from re-interventions and pulmonary valve function at follow-up. Balloon valvuloplasty prior to surgery may worsen operative results, promoting pulmonary insufficiency and therefore should probably be avoided in all patients in whom anatomical characteristics predict failure of percutaneous therapy.

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Prospective Evaluation of Intravitreal Triamcinolone Acetonide Injection in Macular Edema Associated with Retinal Vascular Disorders

European Journal of Ophthalmology ◽

10.1177/112067210501500513 ◽

2005 ◽

Vol 15 (5) ◽

pp. 619-626 ◽

Cited By ~ 19

Author(s):

H.K. Tewari ◽

P. Sony ◽

R. Chawla ◽

S.P. Garg ◽

P. Venkatesh

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Triamcinolone Acetonide ◽

Macular Thickness ◽

Intravitreal Triamcinolone ◽

Group Iii ◽

Vein Occlusion ◽

Group I ◽

Group Ii

Purpose To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity and macular thickness using optical coherence tomography (OCT) in macular edema associated with various retinal vascular disorders. Methods This prospective nonrandomized clinical interventional study included 81 eyes (76 patients) comprised of Group I, 57 eyes (51 patients) with diabetic macular edema; Group II, 10 eyes (10 patients) with branch retinal vein occlusion; and Group III, 13 eyes (13 patients) with central retinal vein occlusion. All eyes received an intravitreal injection of 4 mg triamcinolone acetonide (with the solvent) in the operation theater under sterile conditions. Results Mean preinjection central macular thickness was 531.84±132 μm in Group I, 458.4±149 μm in Group II, and 750.81±148 μm in Group III. All groups showed a statistically significant decrease in mean central macular thickness at 1 month (300.7±119 μM in Group I, 218.2±99 μm in Group II, and 210.5 ±56 μm in Group III) and 3 months (253.19±109 μm in Group I, 187±47 μm in Group II, and 182±50 μm in Group III) after injection (p<0.05). Mean follow-up was 22±2.4 weeks. Mean visual acuity increased in all three groups (preoperative visual acuity in Group I, 1.2±0.4 logMAR units; Group II, 1.24±0.5 logMAR units; Group III, 1.1 ±0.4 logMAR units; 1 month postinjection in Group I, 0.88±0.3 logMAR units; Group II, 0.67±0.3 logMAR units; Group III, 0.86±0.4 logMAR units; 3 months postinjection in Group I, 0.84±0.4 logMAR units; Group II, 0.59±0.3 logMAR units; Group III, 0.82±0.5 logMAR units) (p<0.05). Forty-one eyes completed 6 months and 20 eyes completed 9 months follow-up. Twelve of 20 (41%) eyes in Group I, 2/6 (33%) eyes in Group II, 3/6 (50%) eyes in Group III, and 8/15 (53%) eyes in Group I, 1/3 (33%) eyes in Group II, and 2/2 (100%) eyes in Group III developed recurrence of macular edema with worsening of visual acuity at 6 and 9 months, respectively. Thirty-three (40.7%) eyes developed IOP elevation (at least one reading > 24 mmHg). One eye developed infective endophthalmitis. Conclusions Intravitreal injection of triamcinolone acetonide may be considered as an effective treatment for reducing macular thickening due to diffuse diabetic macular edema, venous occlusion associated macular edema, and may result in increase in visual acuity at least in the short term. Further follow-up and analysis is required to demonstrate its long-term efficacy.

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The Complete Normalization of the Adrenocortical Function as the Criterion of Cure after Transsphenoidal Surgery for Cushing’s Disease

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.86.12.8069 ◽

2001 ◽

Vol 86 (12) ◽

pp. 5695-5699 ◽

Cited By ~ 3

Author(s):

Javier Estrada ◽

José García-Uría ◽

Cristina Lamas ◽

José Alfaro ◽

Tomás Lucas ◽

...

Keyword(s):

Cushing’S Disease ◽

Transsphenoidal Surgery ◽

Plasma Cortisol ◽

Cushing's Disease ◽

Adrenocortical Function ◽

Urinary Cortisol ◽

Group Iii ◽

Group I ◽

Group Ii

Transsphenoidal microsurgery is the standard treatment for patients with Cushing’s disease. However, there is general lack of agreement regarding the definition of cure. We studied 58 patients with corrected hypercortisolism after transsphenoidal surgery for Cushing’s disease. Plasma and urinary cortisol levels were measured after surgery. After the postsurgical hypocortisolism stage (or periodically in patients without hypocortisolism), urinary free cortisol, plasma cortisol at 0800 h and 2300 h, morning cortisol after 1 mg dexamethasone, and cortisol response to insulin-induced hypoglycemia were performed. Patients were classified in 3 groups: group I, patients with transient hypocortisolism and normal hypothalamus-pituitary-adrenal axis afterwards; group II, patients with transient hypocortisolism and abnormalities in the circadian rhythm or the stress response afterwards; and group III, patients without postoperative hypocortisolism. Thirty-three patients were included in group I, 8 in group II, and 17 in group III. Groups I and II were similar in postsurgical plasma cortisol (46.9 ± 30.3 vs. 60.7 ± 38.6 nm) and mean follow-up (69.8 vs. 68.8 months) but were significantly different in their recurrence rate (3.4% vs. 50%, P < 0.001). Patients in group III had normal postsurgical plasma and urinary cortisol but persistent abnormalities in circadian rhythm and stress response. After a mean follow-up of 39.1 months, their recurrence rate was similar to that of group II (64.7% vs. 50%). The complete normalization of the adrenocortical function, which is always preceded by postsurgical hypocortisolism, is associated with a very low recurrence risk and should be considered, in our opinion, the main criterion of surgical cure in Cushing’s disease.

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EFFICACY OF ATRIAL FIBRILLATION DETECTION IN CRYPTOGENIC STROKE ACCORDING TO DATA OF IMPLANTABLE LOOP RECORDERS: PILOT STUDY

Siberian Medical Journal ◽

10.29001/2073-8552-2019-34-2-47-53 ◽

2019 ◽

Vol 34 (2) ◽

pp. 47-53

Author(s):

S. E. Mamchur ◽

E. A. Ivanitskiy ◽

O. M. Polikutina ◽

T. Yu. Chichkova ◽

I. N. Mamchur ◽

...

Keyword(s):

Recurrent Stroke ◽

Cryptogenic Stroke ◽

Ecg Monitoring ◽

Group Iii ◽

External Monitoring ◽

Group I ◽

Monitoring Group ◽

Group Ii

Aim. To estimate the efficacy of invasive and non-invasive long-term ECG monitoring in comparison with conventional follow-up for the detection of silent atrial fibrillation (AF)/atrial flutter (AFL)/atrial tachycardia (AT) in patients with a cryptogenic stroke.Methods. The randomized, prospective, two-center study enrolled 36 patients who suffered cryptogenic stroke (CS) or transient ischemic attack (TIA) without past history of AF/AFL/AT. Patients were randomized in a 1:1:1 ratio to one of the three ECG monitoring strategies: standard arrhythmia monitoring (group I, n=12), ECG-monitoring with implantable loop recorder (group II, n=12), and ambulatory noninvasive ECG monitoring (group III, n=12). The primary endpoint was the time to the first detection of AF/AFL/AT. Patients, assigned to the group I, underwent an assessment at scheduled and unscheduled visits and received ambulatory ECG monitoring 28 days and 1 year after randomization. Patients in the group II underwent implantation of Reveal XT (Medtronic, USA) with the daily remote data transmission to CareLink Network. In the group III, for long-term external monitoring, Spyder system (WEB Biotechnology, Singapore) was used for up to 28 days.Results. During the first 28 days of observation, there were no significant differences in AF detection rates between groups I, II, and III: 0 (0%), 1 (8%), and 2 (17%) cases, respectively, р=0.537. During the year of observation, AF/AFL/AT episodes were detected in 1 case (8%) in the group I, 6 cases (50%) in the group II, and 2 cases (17%) in the group III, p=0.0486. The mean time from enrollment into the study to detection of the first AF/AFL/AT episode was 67 days (15; 97) in all groups. In the groups II and III, the first arrhythmia episodes were detected by monitoring devices on days 24 and 6, respectively. In most cases, arrhythmia episodes detected by long-term monitoring were asymptomatic. Recurrent stroke or TIA events occurred in group I and III (1 case in each group), but not in the group with implantable cardiac monitors. Subgroup analysis showed that significantly higher AF/AFL/AT detection rate was associated with stroke, CHA2DS2VASc score ≥2, and the presence of hypertension. For the 12 months of follow-up, the mean AF burden in the group II was 0.4 (0.2; 0.5) hours per day (1.6%). In the patients with recurrent stroke, AF burden was 3.2% compared to 0.9% in the rest of patients.Conclusion. Detection of silent AF with implantable cardiac monitors is superior to standard and long-term external monitoring in cryptogenic stroke patients.

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Keratorefractive Surgery for Residual Refractive Error Correction in Pseudophakic Patients

Ophthalmology in Russia ◽

10.18008/1816-5095-2020-2-209-215 ◽

2020 ◽

Vol 17 (2) ◽

pp. 209-215

Author(s):

Е. P. Gurmizov ◽

К. B. Pershin ◽

N. F. Pashinova ◽

А. Iu. Tsygankov

Keyword(s):

Refractive Error ◽

High Efficiency ◽

Group Iii ◽

Spherical Component ◽

Cylindrical Component ◽

Group I ◽

Keratorefractive Surgery ◽

Group Ii ◽

Target Refraction

Purpose. Evaluation of the visual and refractive results of additional correction using LASIK and PRK methods in patients with residual refractive error after previous cataract surgery. Patients and methods. The prospective open study included 57 patients (79 eyes) who previously underwent cataract phacoemulsification (n = 37) or refractive lensectomy (n = 42) with various IOL models implantation (2012–2017). The average age of patients was 50.8 ± 13.9 (19–79) years. Operations LASIK (91.1 %) and PRK (8.9 %) were carried out according to standard methods. In 6 cases, femtosecond laser supported by laser correction. The target refraction ranged from –0.25 to 0.25 D in most (97.5 %) cases. The follow-up period ranged from 6 to 9 months. Results. The patients were divided into groups according to the type of residual refractive error (Group 1 — myopia, group II — emmetropia and group III — hyperopia). Statistically significant differences were determined for the species of previously implanted IOLs — in group II, the frequency of monofocal IOLs was significantly higher (p < 0.05). In group II, the values of the cylindrical component of refraction were significantly higher compared with groups I and III (p < 0.05). In group I, a significant (p < 0.05) decrease in the spherical component of refraction from –1.36 ± 0.92 to –0.2 ± 0.8 D was observed. In patients of group II, there was a slight increase in the spherical component of refraction from 0 ± 0.20 to 0.25 ± 0.29 D (p > 0.05). In group III, a significant (p < 0.05) decrease was observed in the spherical component of refraction from 1.27 ± 0.69 to 0.43 ± 0.49 D. When analyzing the cylindrical component of refraction in group I, its decline was noted from –0.69 ± 0.5 to –0.38 ± 0.46 D (p > 0.05). In group II, the largest decrease in the cylindrical component was observed from –1.6 ± 1.0 to 0.03 ± 1.10 Dptr (p < 0.01). In all the studied groups, a statistically significant (p < 0.05) increase in UCFVA was revealed in the postoperative period. Indicators K1 and K2 did not significantly change. Conclusion. The high efficiency of the correction using the LASIK, PRK and femtoLASIK methods on pseudophakic eyes with the achievement of the target refraction in most of the studied cases was shown. This method can be used as an alternative to spectacle and contact correction in patients with residual refractive error after cataract phacoemulsification and refractive lensectomy with IOL implantation.

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Incidence of Late Failure Following Myeloablative Conditioning with BuCy2 and Matched Sibling Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia.

Blood ◽

10.1182/blood.v112.11.2172.2172 ◽

2008 ◽

Vol 112 (11) ◽

pp. 2172-2172

Author(s):

Shubham Pant ◽

Sayed Mehdi Hamadani ◽

Pamela Crilley ◽

Jeffrey Szer ◽

Anthony J. Dodds ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Myeloid Leukemia ◽

Chronic Gvhd ◽

Group Iii ◽

Group I ◽

Group Ii ◽

Acute Myeloid

Abstract Allogeneic stem cell transplantation (ASCT) is an important curative modality for patients with acute myeloid leukemia (AML), but no large studies with mature followup after a uniform conditioning regimen and stem cell source have been reported. We previously published (Copelan EA. Blood; 78:838–43, 1992) the results of 127 patients with AML who underwent ASCT following preparation with oral busulfan (16 mg/kg) and cyclophosphamide (120mg/kg) (BuCy2) with a median follow-up of 3 years. We now present data on 316 AML patients, including the initial cohort, who underwent ASCT from 1984 to 1995 at 7 participating institutions the United States and Australia. All patients received bone marrow grafts from HLA-identical sibling donors following myeloablative preparation with BuCy2. One hundred fifty-seven patients were transplanted in first remission (CR1, group I), 49 in second remission (CR2, group II) and 110 patients were beyond CR2 or had refractory disease (group III). Cyclosporine or tacrolimus-based regimens were routinely administered to prevent graft-versus-host-disease (GVHD). Median follow-up of surviving patients exceeds 12 years (range 3 – 18 years). At the time of analysis 126 patients (40%) were alive. The estimated leukemia-free survival (LFS) for group I at 3 and 12 years is 63% (95% CI: 47 – 79%) and 49% (95% CI: 33 – 66%), for group II is 50% (95% CI 36 – 64%) and 33% (95% CI: 17 – 49%) and group III is 25% (95% CI: 17 – 32%) and 16% (95%CI: 8 – 24%) respectively. The estimated relapse rate for patients in group I at 3 and 12 years is 15% (95%CI: 9 – 21%) and 28% (95% CI: 20 – 36%), for group II is 38% (95% CI: 24 – 52%) and 48% (95% CI: 31 – 65%), and group III is 56% (95% CI: 4 – 68%) and 65% (95% CI: 53 – 77%). For the entire cohort (n=317), using multivariate analysis, younger age (p<0.004) and transplantation in CR1 (p<0.001) were predictive of long-term overall survival (OS) and LFS. Transplantation in CR1 (p<0.001), and presence of chronic GVHD (p=0.003) were associated with decreased risk of relapse. One hundred forty-two patients were alive and free of leukemia at 3 years; of these patients, 75% are leukemia-free survivors at 12 years. Considering only these patients, the cumulative incidence of relapse beyond 3 years was 17% and the cumulative incidence of non-relapse mortality was 9%; only 2 patients died beyond 3 years from respiratory failure. For this group, none of the factors analyzed (including age, remission status at the time of transplantation or the presence of chronic GVHD) was predictive for OS, LFS or relapse. In conclusion, although most remissions in AML patients surviving leukemia-free for at least 3 years following ASCT are durable, late relapse occurs in 17%. One in four patients alive and free of leukemia at 3 years will relapse or die from NRM over the subsequent 9 years. Figure Figure

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Neonatal intracranial hemorrhage

Journal of Neurosurgery ◽

10.3171/jns.1980.53.5.0642 ◽

1980 ◽

Vol 53 (5) ◽

pp. 642-651 ◽

Cited By ~ 34

Author(s):

Richard Leblanc ◽

Augustin M. O'Gorman

Keyword(s):

Computerized Tomography ◽

Intracranial Hemorrhage ◽

Lateral Ventricle ◽

Mass Effect ◽

Ventricular System ◽

Ct Scans ◽

Group Iii ◽

Group I ◽

Group Ii

✓ Forty-six neonates with intracranial hemorrhage were classified into three groups on the basis of the major computerized tomography (CT) scan findings: Group I consisted of 24 cases of subarachnoid hemorrhage, Group II 20 cases of intracerebral and/or intraventricular hemorrhage, and Group III two cases of subdural hemorrhage. The initial scans in Group I showed blood in the interhemispheric fissure and the supratentorial recess. Sixty percent had an associated hypodensity in the frontal and/or parietal areas, thought to be an indication of ischemia. Changes in the configuration of the ventricular system were infrequent. Initial scans in Group II showed hematomas as follows: one in the brain stem, five in the basal ganglia, 10 in the temporal lobes, and 11 in the ventricles. In 70% of these cases, changes in the configuration of the ventricular system were seen, including compression of a lateral ventricle by mass effect, ventricular dilatation with blood, and obstructive hydrocephalus. Subarachnoid blood was an associated finding in 55% of cases, and focal and diffuse cerebral edema in 40%. Scans in both Group III patients initially showed a mass effect from a subdural clot. In all, 30 patients had one or more follow-up CT scans, and 13 of these were scanned at regular intervals. None of the Group I patients developed hydrocephalus, but 85% of Group II patients with intraventricular blood extending from an intracerebral hemorrhage had this complication. A seizure disorder occurred in 31% of Group I patients and 20% of Group II patients, where it was seen exclusively in those with an intralobar hematoma. A major motor disturbance occurred in 16% of patients; their CT scans showed evidence of brain destruction involving enlargement of a lateral ventricle, porencephaly, or focal atrophy. Computerized tomography is a useful adjunct to the diagnosis, management, and follow-up study of neonatal intracranial hemorrhage, and correlates well with the clinical findings.

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Developmental milestones of vertically HIV infected and seroreverters children: follow up of 83 children

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2001000500007 ◽

2001 ◽

Vol 59 (3B) ◽

pp. 691-695 ◽

Cited By ~ 18

Author(s):

Isac Bruck ◽

Tony Tannous Tahan ◽

Cristina Rodrigues da Cruz ◽

Luzilma Terezinha Flenik Martins ◽

Sérgio Antonio Antoniuk ◽

...

Keyword(s):

Screening Tests ◽

Control Group ◽

Basal Ganglia Calcification ◽

Group Iii ◽

Computed Tomographic ◽

Group I ◽

Immunodeficiency Virus ◽

Neurological Exam ◽

Group Ii

The aim of the study was to detect neurological abnormalities in human immunodeficiency virus (HIV) infected children. This was achieved by a prospective evaluation, from November/1995 to April/2000, of 43 HIV infected children (group I) and 40 HIV seroreverters children (group II) through neurological exam and neurodevelopmental tests: Denver Developmental Screening Test (DDST) and Clinical Adaptive Test / Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS). A control group (III), of 67 children, were evaluated by CAT/CLAMS. Hyperactivity, irritability and hypotonia were the findings on neurological examination, without statistical differences between group I and II. On CAT/CLAMS, the group I developmental quotient (DQ) was significantly lower than the other groups. The same occurred in DDST, with group I presenting significantly more failures than group II. Nineteen HIV children of group I had brain computed tomographic scan, with abnormalities in three of them (basal ganglia calcification, white matter hypodensity and asymmetry of lateral ventricles). We conclude that in HIV infected children a neurodevelopment delay occur early in the disease, and it can be detected by screening tests.

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