THU0685 THE IMPACT OF ACHIEVEMENT OF RESPONSE AT ONE YEAR AFTER STARTING THERAPY ON THE LONG-TERM OUTCOME OF LUPUS NEPHRITIS

Abstract Background Medical thoracoscopy (MT) is recommended in patients with undiagnosed exudative pleural effusion and offers a degree of diagnostic sensitivity for pleural malignancy. However, not all patients who undergo MT receive an exact diagnosis. Our previous investigation from 2014 summarized the long-term outcomes of these patients with nonspecific pleurisy (NSP); now, we offer updated data with the goal of refining our conclusions. Methods Between July 2005 and August 2018, MT with pleural biopsies were performed in a total of 1,254 patients with undiagnosed pleural effusions. One hundred fifty-four patients diagnosed with NSP with available follow-up data were included in the present study, and their medical records were reviewed. Results A total of 154 patients were included in this study with a mean follow-up duration of 61.5 ± 43.7 months (range: 1–180 months). No specific diagnosis was established in 67 (43.5%) of the patients. Nineteen patients (12.3%) were subsequently diagnosed with pleural malignancies. Sixty-eight patients (44.2%) were diagnosed with benign diseases. Findings of pleural nodules or plaques during MT and the recurrence of pleural effusion were associated with malignant disease. Conclusions Although most NSP patients received a diagnosis of a benign disease, malignant disease was still a possibility, especially in those patients with nodules or plaques as noted on the MT and a recurrence of pleural effusion. One year of clinical follow-up for NSP patients is likely sufficient. These updated results further confirm our previous study’s conclusions.

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Perinatal Care at the Threshold of Viability

PEDIATRICS ◽

10.1542/peds.96.5.974 ◽

1995 ◽

Vol 96 (5) ◽

pp. 974-976

Author(s):

◽

Keyword(s):

Perinatal Care ◽

Survival Rates ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants ◽

Term Outcome ◽

Long Term Outcome ◽

Obstetric Management ◽

The Cost ◽

The Impact

The survival rate for infants at the threshold of viability has been improving. However, there are insufficient data regarding the cost(s) of initial and ongoing care of these infants and the long-term outcome of survivors. Furthermore, there has been little study of the impact of obstetric management on the survival rates of extremely low birth weight infants and on long-term morbidities. Continued research on these issues is imperative, and physicians need to remain informed of changing statistics.

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Abstract 18649: Long-term Outcome and the Mechanisms of Pulmonary Antrum Radial-linear Ablation in Patients With Paroxysmal Atrial Fibrillation

Circulation ◽

10.1161/circ.132.suppl_3.18649 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Xue Zhao ◽

Jianqiang Hu ◽

Yan Huang ◽

Yawei Xu ◽

Yanzhou Zhang ◽

...

Keyword(s):

Atrial Fibrillation ◽

Paroxysmal Atrial Fibrillation ◽

Holter Monitoring ◽

Pericardial Tamponade ◽

Term Outcome ◽

Long Term Outcome ◽

Long Term Follow Up ◽

One Year

Objectives: The aim of this study was to determine the mechanisms and effectiveness of pulmonary antrum radial-linear (PAR) ablation in comparison with pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (AF) after a long-term follow-up. Background: The one-year follow up data suggested that PAR ablation appeared to have a better outcome over the conventional PVI for paroxysmal AF. Methods: The enrollment occurred between March, 2011, and August, 2011, with the last follow-up in May, 2014. A total of 133 patients with documented paroxysmal AF were enrolled from 5 centers and randomized to PAR group or PVI group. Event ECG recorder and Holter monitoring were conductedduring the follow-up for all patients. Results: The average procedure time was 151±23 min in PAR group and 178±43 min in PVI group ( P <0.001). The average fluoroscopy time was 21±7 min in PAR group and 27±11 min in PVI group ( P= 0.002). AF triggering foci were eliminated in 59 patients (89.4%) in PAR group, whereas, only 4 patients (6.0%) in PVI group (P<0.001).At median 36 (37-35) months of follow-up after single ablation procedure, 43 of 66 patients in PAR group (65%) and 28 of 67 patients in PVI group (42%) had no recurrence of AF off antiarrhythmic drug (AAD) (P=0.007); and 47 of 66 patients in PAR group (71%) and 32 of 67 patients in PVI group (48%) had no recurrence of AF with AAD (P=0.006). At the last follow-up, the burden of AF was significantly lower in PAR group than in PVI group (0.9% ± 2.3% vs 4.9% ± 9.9%;90th percentile, 5.5% vs 19.6%; P=0.008). No major adverse event (death, stroke, PV stenosis) was observed in all the patients except one case of pericardial tamponade. Conclusions: PAR ablation is a simple, safe, and effective strategy for the treatment of paroxysmal AF with better long-term outcome than PVI. PAR ablation might exhibit the beneficial effect on AF management through multiple mechanisms. Registration: ChiCTR-TRC-11001191

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Psychological profiles derived by cluster analysis of Minnesota Multiphasic Personality Inventory and long term clinical outcome after coronary artery by pass grafting

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2012.141 ◽

2015 ◽

Vol 78 (1) ◽

Author(s):

Maddalena Modica ◽

Roberta Carabalona ◽

Rosa Spezzaferri ◽

Monica Tavanelli ◽

A. Torri ◽

...

Keyword(s):

Cluster Analysis ◽

Coronary Artery ◽

Clinical Characteristics ◽

Minnesota Multiphasic Personality Inventory ◽

Personality Inventory ◽

Psychological Characteristics ◽

Term Outcome ◽

Long Term Outcome ◽

The Impact

Background: To evaluate the psychological characteristics of coronary heart disease (CHD) patients after coronary artery bypass grafting (CABG) by cluster analysis of Minnesota Multiphasic Personality Inventory (MMPI-2) questionnaires and to assess the impact of the profiles obtained on long-term outcome. Methods: 229 CHD patients admitted to cardiac rehabilitation filled in self-administered MMPI-2 questionnaires early after CABG. We assessed the relation between MMPI- 2 profiles derived by cluster analysis, clinical characteristics and outcome at 3-year follow-up. Results: Among the 215 patients (76% men, median age 66 years) with valid criteria in control scales, we identified 3 clusters (G) with homogenous psychological characteristics: G1 patients (N=75) presented somatoform complaints but overall minimal psychological distress. G2 patients (N=72) presented type D personality traits. G3 subjects (N=68) showed a trend to cynicism, mild increases in anger, social introversion and hostility. Clusters overlapped for clinical characteristics such as smoking (G1 21%, G2 24%, G3 24%, p ns), previous myocardial infarction (G1 43%, G2 47%, G3 49% p ns), LV ejection fraction (G1 60 [51 – 60]; G2 58 [49- 60]; G3 60 [55-60], p ns), 3-vessel-disease prevalence (G1 69%, G2 65%, G3 71%, p ns). Three-year event rates were comparable (G1 15%; G2 18%; G3 15%) and Kaplan- Meier curves overlapped among clusters (p ns). Conclusions: After CABG, the interpretation of MMPI- 2 by cluster analysis is useful for the psychological and personological diagnosis to direct psychological assistance. Conversely, results from cluster analysis of MMPI-2 do not seem helpful to the clinician to predict long term outcome.

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The impact of individual extended donor criteria on short- and long-term outcome after liver transplant in the MELD-score era

HPB ◽

10.1016/j.hpb.2019.10.1354 ◽

2019 ◽

Vol 21 ◽

pp. S1002

Author(s):

V.J. Lozanovski ◽

E. Khajeh ◽

C.W. Michalski ◽

H. Fonouni ◽

R. von Haken ◽

...

Keyword(s):

Liver Transplant ◽

Meld Score ◽

Term Outcome ◽

Long Term Outcome ◽

Short And Long Term ◽

Donor Criteria ◽

The Impact ◽

Extended Donor Criteria

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Fluvastatin reduces the impact of diabetes on long-term outcome after coronary intervention—A Lescol Intervention Prevention Study (LIPS) substudy

American Heart Journal ◽

10.1016/j.ahj.2004.03.067 ◽

2005 ◽

Vol 149 (2) ◽

pp. 329-335 ◽

Cited By ~ 19

Author(s):

Chourmouzios A. Arampatzis ◽

Dick Goedhart ◽

Patrick W. Serruys ◽

Francesco Saia ◽

Pedro A. Lemos ◽

...

Keyword(s):

Coronary Intervention ◽

Prevention Study ◽

Term Outcome ◽

Long Term Outcome ◽

The Impact

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Abstract 2008: Impact of Hyperglycemia on Myocardial Damage and its Prognostic Implications in Patients with Acute ST-Segment Elevation Myocardial Infarction (STEMI) Assessed by Contrast-Enhanced Cardiac Magnetic Resonance Imaging (CMR)

Circulation ◽

10.1161/circ.118.suppl_18.s_656 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Christoph J Jensen ◽

Markus Jochims ◽

Kai Nassenstein ◽

Michael Bell ◽

Thomas Schlosser ◽

...

Keyword(s):

Logistic Regression Model ◽

Microvascular Obstruction ◽

Myocardial Damage ◽

Term Outcome ◽

Long Term Outcome ◽

Glucose Levels ◽

Contrast Enhanced ◽

Lv Mass ◽

The Impact

To investigate the impact of admission glucose levels on myocardial damage and long term outcome in patients with acute STEMI using contrast-enhanced CMR. 130 consecutive patients (104 males; mean age 59.4±11.8 years) with first reperfused STEMI were included. Hyperglycemia was defined as glucose levels above 7.8mmol/l. CMR was performed within 3.9±2.2 days after admission on a 1.5 Tesla MR System. The imaging protocol included SSFP cine sequences for the calculation of LV function, volumes and mass. Total no reflow volumes (NRV) and delayed enhancement volumes (DEV) were calculated from planimetry of the IR-SSFP stacks of short axis images by disc-summation performed early / late following administration of 0.2mmol/kg/BW of gadodiamid. NRV and DEV were expressed as percent of LV Mass (NR%, DE%). Continuous variables were compared by Mann-Whitney test. Correlation of admission hyperglycemia and NR% was tested by spearman rank test. Patients were prospectively followed for 30±9 months. A stepwise logistic regression model was used to analyze the impact of hyperglycemia and CMR parameters on NR% and outcome. 55 of 130 (42%) patients had hyperglycemia on admission. Patients with admission hyperglycemia had lower LV ejection fraction (38.6±12.9% vs. 47.7±11.9%, p=0.001), greater ESV (89.2±39.2ml vs. 71.7±34.1ml, p=0.002), greater LV Mass (156.7±40.4g vs. 136.3±36.7g, p=0.003), larger DE% (19.3±13.8% vs. 9.7±8.5%, p<0.001) and larger NR% (8.1± 9.2% vs. 2.3± 4.2%, p<0.001). Admission hyperglycemia correlated moderate but significant to DE% (r=0.386, p<0.001) and NR% (r=0.421, p<0.001). In a multivariable logistic regression model admission hyperglycemia was an independent predictor (OR 6.8; CI 2.8 −16.6) of extensive (> median) microvascular obstruction, extensive delayed enhancement (OR 3.2; CI 1.5–7.1) and was associated with an increased risk for death and reinfarction (OR 4.7; CI 1.2–18.3) during follow up. Admission hyperglycemia in acute, reperfused STEMI is independently related to the extent of microvascular obstruction on early contrast-enhanced CMR and is associated with worse long-term outcome. Thus, CMR may play a major role in monitoring effects of glucose control on myocardial damage in AMI.

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