Incidence of pocket infection during long- term follow- up

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac implantable electronic devices (CIEDs) are being implanted worldwide in increasing numbers, so the incidence of hospitalizations due to their infections is also increasing. Purpose The aim of this study was to analyze the incidence of pocket infection related to the CIED procedure, as well as clinical presentation, diagnostic approach and methods of treatment during long-term follow- up on large cohort of patients. Methods: This was a retrospective, observational, single-center study. We enrolled patients who underwent CIED procedure between January 2011 and December 2015. The CIED procedure included implantation and replacement of the device. Pocket infection is defined as an infection limited to the generator pocket and can be presented from redness, swelling, pain to the skin erosion with exposure of the generator and/or leads. It may also be associated with lead infections and systemic CIED infections and/or infective endocarditis. All patients with CIED infection underwent the same diagnostics: complete blood count and inflammatory markers, pocket swab, three sets of blood cultures and echocardiography. Results: During the observed period 5 969 CIED procedures were performed (anti-bradycardia pacemakers 68.6%; ICD 21.4%; CRT-P/D 10.0%; CIED replacement 26.1%). CIED infection was registered in 41 patients (0.68%), most often after the ICD procedure (59.0%). In 22 patients (53.6%) the infection occurred after primo-implantation. The average time from intervention to infection was 17 ± 7.3 months. The mean follow-up was 52.2 ± 13.4 months. The most common manifestations of infection were redness (68.1%) and swelling (56.0%), then the protrusion of the generator or electrode (41.5%). Pacemaker pocket swabs and wound swabs were positive in 61.1% of samples and coagulase negative staphylococcus was found to be the most prevalent cause of infection (64.2%). The hemoculture test was positive in 10 patients, and the isolated causative agent matched the swab finding. The valvular vegetation was found in 4 patients. Pacemaker removal and surgical wound treatment were performed in all patients. Complete removal of all leads was achieved in 32 patients. In all pacemaker dependent patients and patients with ICD implanted in the secondary prevention of sudden cardiac death, reimplantation of the new device was performed in the same hospitalization on the opposite side. The remaining patients were operated on 3 to 4 weeks after the end of treatment. Conclusions: It has been shown that the risk of pocket infection was low in a large number of patients, during long-term follow-up. The risk was higher in patients with ICD devices, and slightly higher after primo-implantation.

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Improved Biochemical Parameters in Patients Who Undergo Early Resection in Isolated Ileocaecal Crohn’s Disease

Surgery Research and Practice ◽

10.1155/2017/4396573 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Mirzafaraz Saeed ◽

Hari Hullur ◽

Amro Salem ◽

Abbas Ali ◽

Yousif Sahib ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Surgical Resection ◽

Complete Blood Count ◽

Long Term Results ◽

Number Of Patients ◽

Long Term Follow Up ◽

One Year

Introduction. The aim of this study is to evaluate the outcome of introduction of early surgery in the course of isolated ileocecal Crohn’s disease, where there is no absolute indication of surgery. Methods. Observational study involving patients with isolated ileocecal Crohn’s disease who underwent early surgical resection (within one year of the presentation of the hospital). A complete blood count, ESR, and CRP were done and compared between the preoperative value, 1st postoperative visit (3-4 weeks), and last follow-up visit. Statistical analysis was done using Analysis of Variance (ANOVA) to compare the different figures. Results. There was a statistically significant increase in the hemoglobin levels between preoperative, postoperative, and long-term follow-up and a significant decrease in leukocyte count between the pre- and postoperative values (F=19.8, p<0.001 and F=8.9, p=0.002, resp.). Similarly, the ESR and CRP values were decreased significantly at long-term follow-up (F=8.5, p=0.019 and F=8.3, p=0.013, resp.). Conclusion. Early surgical resection in isolated ileocaecal Crohn’s disease achieved significant biochemical improvements. These successful results in this small number of patients indicate that early surgical intervention may provide better outcomes. These initial results encourage larger and comparative studies of long-term results versus long-term use of biological agents.

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Meningiomas of pineal region in children

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2007000600016 ◽

2007 ◽

Vol 65 (4a) ◽

pp. 1000-1006 ◽

Cited By ~ 9

Author(s):

Hamilton Matushita ◽

Fernando Campos Pinto ◽

José Píndaro Pereira Plese

Keyword(s):

Clinical Presentation ◽

Complete Removal ◽

Pineal Region ◽

Total Resection ◽

Long Term Follow Up ◽

One Year ◽

Velum Interpositum ◽

Transtentorial Approach

Meningiomas are uncommon tumors in children and either more rarely encountered in the pineal region. We report two cases of meningioma of the pineal region in children. One of these cases was a five years-old girl and the other a one year-old boy. No specific clinical presentation or tomographic examinations findings was identified before treatment, suggestive of a diagnosis of menigioma. The clinical and laboratory features were very similar to the most common tumors of the pineal region. Prior to the surgery, the histology of these tumors was not suspected. Both patients underwent direct surgery and complete removal was achieved by a suboccipital transtentorial approach. The tumors originated from velum interpositum in both cases. At the follow up, one case presented with recurrence six years later, and she underwent a reoperation with total resection without morbidity. Long-term follow up presented no other recurrences.

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A Conservative Approach to a Peripheral Ameloblastoma

Case Reports in Dentistry ◽

10.1155/2016/8254571 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Rocco Borrello ◽

Elia Bettio ◽

Christian Bacci ◽

Marialuisa Valente ◽

Stefano Sivolella ◽

...

Keyword(s):

Oral Cavity ◽

Soft Tissues ◽

Complete Removal ◽

The Other ◽

Conservative Approach ◽

Choice Of Treatment ◽

Long Term Follow Up ◽

One Year

Peripheral Ameloblastoma (PA) is the rarest variant of ameloblastoma. It differs from the other subtypes of ameloblastoma in its localization: it arises in the soft tissues of the oral cavity coating the tooth bearing bones. Generally, it manifests nonaggressive behavior and it can be treated with complete removal by local conservative excision. In this study we report a case of PA of the maxilla in a 78-year-old female patient and we describe the four different histopathological patterns revealed by histological examination. After local excision and diagnosis, we planned a long term follow-up: in one year no recurrence had been reported. The choice of treatment is illustrated in Discussion.

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Liver Resection Using a Four-Prong Radiofrequency Transection Device

The American Surgeon ◽

10.1177/000313480907501028 ◽

2009 ◽

Vol 75 (10) ◽

pp. 991-994 ◽

Cited By ~ 1

Author(s):

Lawrence D. Wagman ◽

Byrne Lee ◽

Erick Castillo ◽

Hisham El-Bayar ◽

Lily Lai

Keyword(s):

Blood Loss ◽

Metastatic Tumor ◽

New Device ◽

Time To Recurrence ◽

Institutional Review ◽

Long Term Follow Up ◽

Surgery Outcomes ◽

Mean Time

Multiple techniques are available for division of hepatic parenchyma. This is the largest United States report examining the use of the Habib 4X tissue coagulator (AngioDynamics, Queensbury, NY). The objective was to collect standard parameters associated with successful, benchmarked liver surgery outcomes using this new device, and in particular, examine the risk of margin failure. Ninety-four consecutive operations using the Habib 4X were analyzed with special attention to local failure at resection margin, blood loss/transfusion, and operative times. An institutional review board approved protocol allowed collection and analysis of demographic information and outcomes for intraoperative, perioperative, and long term follow-up. Eighteen patients had biopsy only. Thirty-one had lobar resections and 46 had wedge or segmental resections. There were 30 primary hepatic and 46 metastatic tumor diagnoses. There were a total of 33 (43%) recurrences with a mean time to recurrence of 212 days (range 15-974). Of the 27 intrahepatic recurrences, four (15%) were at the margin. The OR time ranged from 115 to 642 minutes (average 283 min). The average recorded blood loss was 427 mL; 11 patients were transfused (average 0.43 units). The Habib 4X is a safe tool to use when evaluating the parameters of blood loss, transfusion, and margin recurrence.

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Five non-mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes phenotype adult patients with m.3243A>G mutation after kidney transplantation: follow-up and review of the literature

Clinical Kidney Journal ◽

10.1093/ckj/sfz020 ◽

2019 ◽

Vol 12 (6) ◽

pp. 840-846 ◽

Cited By ~ 2

Author(s):

Paul de Laat ◽

Nienke van Engelen ◽

Jack F Wetzels ◽

Jan A M Smeitink ◽

Mirian C H Janssen

Keyword(s):

Kidney Transplantation ◽

Lactic Acidosis ◽

Renal Disease ◽

Mitochondrial Myopathy ◽

Renal Involvement ◽

Adequate Treatment ◽

Number Of Patients ◽

Long Term Follow Up

Abstract Background Renal involvement in patients with the m.3243A>G mutation may result in end-stage renal disease (ESRD) requiring renal replacement therapy. Although kidney transplantations have been performed in a small number of patients, short- and long-term follow-up data are lacking. Methods We describe five patients with the m.3243A<G mutation who received a kidney transplant, including follow-up data up to 13 years. We also summarize all cases (n = 13) of kidney transplantation in m.3243A>G carriers described in the literature. Results Proteinuria with or without renal failure was the first clinical presentation of renal involvement in 13 of 18 (72%) patients. Focal segmental glomerulosclerosis (FSGS) was found in 9 of 13 (69%) biopsies. Sixteen of 18 (84%) patients developed hearing loss. All patients were diagnosed with diabetes mellitus, of whom eight (44%) developed the disease after transplantation. All patients with reported follow-up data (13/18) had stable kidney function from 6 months to 13 years of follow-up after transplantation. Conclusions Renal involvement in carriers of the m.3243A>G mutation most commonly leads to proteinuria and FSGS and may lead to ESRD. Proper recognition of the mitochondrial origin of the renal disease in these patients is important for adequate treatment selection and suitable supportive care. This case series and review of the available literature on long-term follow-up after kidney transplantation shows it is feasible for non-mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes phenotype carriers of the m.3243A>G mutation to be considered for kidney transplantation in case of ESRD. These patients should not be excluded from transplant solely for their mitochondrial diagnosis.

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A contextual needs assessment of families with home invasive mechanical ventilation patients: A qualitative study

Chronic Illness ◽

10.1177/17423953211026362 ◽

2021 ◽

pp. 174239532110263

Author(s):

Maryam Esmaeili ◽

Parvaneh Asgari ◽

Nahid Dehghan Nayeri ◽

Fatemeh Bahramnezhad ◽

Samrand Fattah Ghazi

Keyword(s):

Mechanical Ventilation ◽

Home Care ◽

Invasive Mechanical Ventilation ◽

Multidisciplinary Treatment ◽

Psychological Needs ◽

Number Of Patients ◽

Study Results ◽

Long Term Follow Up

Objectives With the advancement of technology the number of patients surviving critical illness has increased. Home mechanical ventilation (HMV) is a growing option for patients requiring long-term mechanical ventilation. Caring for these patients is demanding and challenging. The aim of this study was to explore family caregivers’(carers) needs when providing care to adult patients under HMV from the perspective of nurses, home care attendants, and the caregivers themselves. Methods Overall, 15 participants (nine carers, three home nurses, and three home care attendants) were selected by purposive sampling. Data were collected by in-depth semi-structured interviews and structured observation. Finally, data were analyzed through conventional content analysis with MAXQDA software. Results Three categories of carers’needs were identified, including educational needs (basic and emergencies), psychological needs, and economic needs. In addition, since the needs, feelings, and views of caregivers change over time, the noted needs were divided into three periods: Pre-discharge preparation, initial transition from hospital to home, and appropriate long-term follow-up. Conclusion The study results showed that the families of patients under invasive HMV require a standard discharge plan based on their care needs, financial concerns, and psychological screening before discharge as well as a suitable long-term follow-up plan in collaboration with a multidisciplinary treatment team, insurance providers, and home care services.

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Abstract 15142: Left Bundle Branch Pacing, Procedure Characteristics, Feasibility and Long-term Safety: Insights From a Large Sample Single Center Study

Circulation ◽

10.1161/circ.142.suppl_3.15142 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Weijian Huang ◽

Lan Su ◽

Songjie Wang ◽

Shengjie Wu ◽

Lei Xu ◽

...

Keyword(s):

Left Ventricular ◽

Left Ventricular Ejection ◽

Large Sample Size ◽

Ventricular Ejection Fraction ◽

Large Sample ◽

Number Of Patients ◽

Operative Revision ◽

Long Term Follow Up

Introduction: Left bundle branch pacing (LBBP) is a novel pacing method and has been proven to have low and stable pacing thresholds. However, data on large numbers of patients with long-term follow-up is still needed to evaluate its feasibility and safety. Hypothesis: To evaluate the feasibility and safety of LBBP in a large sample with long-term follow up. Methods: This study prospectively enrolled 632 consecutive patients with left bundle branch block, AV block or sick sinus syndrome with attempted LBBP from April 2017 to July 2019. Pacing parameters, ECG, echocardiographic measurements, complications were assessed at implant, and during follow-up of 1, 6, 12 and 24 months. Results: LBBP was successful in 618/632 (97.8%) patients according to the strict criteria for LBB capture. Mean follow-up time was 17.8±6.9 months. LBB capture threshold at implant was 0.65±0.27 [email protected] and 0.71±0.35 [email protected] at 2-year follow-up (n=166). Left ventricular ejection fraction were improved in QRS≥120ms and <120ms groups (60.62±14.22% vs. 63.95±11.29 %, p<0.001; 49.77±17.58 % vs. 58.58±12.79 %, p<0.001; respectively). The number of patients with moderate and sever tricuspid regurgitation decreased at 1-year (120 to 66;28 to 16; respectively). Permanent right bundle branch injury occurred in 55 (8.9%) patients. LBB capture threshold increased greater than 2 V in 6 patients, loss of capture in 2 patients, two lead dislodgements requiring operative revision within 1 month after implantation during 2-years follow-up. Conclusions: Feasibility and safety of LBBP were confirmed by this large sample size and long-term follow-up study. It is a reliable physiologic method for standards pacing indications.

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Long-Term Technical Performance of the Osypka QT-5® Ventricular Pacemaker Lead

Journal of Clinical Medicine ◽

10.3390/jcm10040639 ◽

2021 ◽

Vol 10 (4) ◽

pp. 639 ◽

Cited By ~ 1

Author(s):

Georg Semmler ◽

Fabian Barbieri ◽

Karin Thudt ◽

Paul Vock ◽

Deddo Mörtl ◽

...

Keyword(s):

High Rate ◽

Pacing Threshold ◽

Technical Performance ◽

Cardiac Implantable Electronic Devices ◽

Kaplan Meier ◽

Ventricular Lead ◽

Long Term Follow Up ◽

Technical Issues

Background: Lead-associated complications and technical issues in patients with cardiac implantable electronic devices are common but underreported in the literature. Methods: All patients undergoing implantation of the Osypka QT-5® ventricular lead at the University Clinic St. Pölten between 1 January 2006 and 31 December 2012 were retrospectively analyzed (n = 211). Clinical data including pacemaker follow-up examinations and the need for lead revisions were assessed. Kaplan–Meier analysis to estimate the rate of lead dysfunction during long-term follow-up was conducted. Results: Patients were followed for a median of 5.2 years (interquartile range (IQR) 2.0–8.7). R-wave sensing properties at implantation, compared to last follow-up, remained basically unchanged: 9.9 mV (IQR 6.8–13.4) and 9.6 mV (IQR 5.6–12.0), respectively). Ventricular pacing threshold significantly increased between implantation (0.5 V at 0.4 ms; IQR 0.5–0.8) and the first follow-up visit (1.0 V at 0.4 ms; IQR 0.8–1.3; p < 0.001) and this increase persisted throughout to the last check-up (0.9 V at 0.4 ms; IQR 0.8–1.2). Impedance significantly declined from 1142 Ω (IQR 955–1285) at implantation to 814 Ω (IQR 701–949; p < 0.001) at the first check-up, followed by a further decrease to 450 Ω (IQR 289–652; p < 0.001) at the last check-up. Overall, the Osypka QT-5® ventricular lead was replaced in 36 patients (17.1%). Conclusions: This report shows an unexpected high rate of technical issues of the Osypka QT-5® ventricular lead during long-term follow-up.

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Psychopharmacological Medication Has No Influence on Vitamin Status After Bariatric Surgery in Long-term Follow-up

Obesity Surgery ◽

10.1007/s11695-020-04698-8 ◽

2020 ◽

Vol 30 (10) ◽

pp. 3753-3760

Author(s):

Hannes Beiglböck ◽

Alexander Kautzky ◽

Paul Fellinger ◽

Tamara Ranzenberger-Haider ◽

Bianca Itariu ◽

...

Keyword(s):

Bariatric Surgery ◽

Laboratory Data ◽

Control Group ◽

Vitamin Deficiencies ◽

Vitamin Status ◽

Number Of Patients ◽

Long Term Follow Up ◽

The Impact

Abstract Context A substantial number of patients undergoing bariatric surgery are prescribed psychopharmacological medication. However, the impact of concomitant psychopharmacological medication on the frequency of relevant vitamin deficiencies in postoperative follow-up is not known. Methods Five hundred twenty-four patients with obesity who underwent bariatric surgery (January 2004 to September 2018) with follow-up of at least 12 months, were included in retrospective analysis. Postoperative follow-up visits between January 2015 and September 2019 were analyzed. Anthropometric and laboratory data were analyzed at the first documented follow-up visit after on average 39.5 ± 37.3 months and at every following visit during the observation period. Patients with prescribed psychopharmacological drugs (PD) were compared with patients without (control group, CON). Results Psychopharmacological medication was documented in 25% (132) of patients. In 59 patients documented prescription of more than one psychiatric drug was found, whereas psychopharmacological monotherapy was found in 73 patients. Frequencies of vitamin deficiencies were comparable between PD and CON (vitamin A: p = 0.852; vitamin D: p = 0.622; vitamin E: p = 0.901; folic acid: p = 0.941). Prevalence of vitamin B12 deficiency was rare (6% CON, 1% PD) but was significantly higher in CON (p = 0.023). A comparison of CON and POLY also showed no significant differences between the groups concerning prevalence of vitamin deficiencies. Conclusions Intake of psychopharmacological medication is highly prevalent in patients after bariatric surgery. Patients with psychopharmacological medication, who participate in structured follow-up care after bariatric surgery, are not at higher risk for vitamin deficiencies compared with controls.

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Long-term follow-up of posttraumatic olfactory disorders

Rhinology Journal ◽

10.4193/rhino11.141 ◽

2012 ◽

Vol 50 (1) ◽

pp. 67-72

Author(s):

Antje Welge-Lussen ◽

Andrea Hilgenfeld ◽

Thomas Meusel ◽

Thomas Hummel

Keyword(s):

Visual Analogue Scale ◽

Analogue Scale ◽

Olfactory Function ◽

Recovery Method ◽

Number Of Patients ◽

Identification Score ◽

Long Term Follow Up ◽

Tdi Score

Objective: This study aims to determine the long-term recovery rate of posttraumatic olfactory disorders and to evaluate whether a lateralized disorder influences recovery. Method: Olfactory function of 67 patients with posttraumatic olfactory disorders were examined twice using the `Sniffin` Sticks` test battery. Olfactory function was classified based on composite TDI (Threshold, Discrimination and Identification) score. Subjective impairment was rated by visual analogue scale ranging from 0 to 10. Results: First and second examinations were conducted an average of 16.7 months and 74 months after trauma, respectively. From first to second examination, mean TDI score of the better nostril increased significantly, the number of patients with anosmia of the better nostril decreased, and number of hyposmic and normosmic patients increased. Subjective impairment decreased. Neither age, sex, nor side differences between nostrils affected improvement. Conclusion: After the follow-up period, in 27% of the patients the TDI score improved ≥ 6 points score and subjective impairment decreased. A follow-up period of more than 2 years is recommended.

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