Behavioural outcome in twin–twin transfusion syndrome survivors treated with laser surgery

ObjectiveEvaluate the incidence of and risk factors for behavioural problems in twin–twin transfusion syndrome (TTTS) survivors treated with fetoscopic laser coagulation.DesignObservational cohort study.SettingNational referral center for fetal therapy, Leiden University Medical Center, The Netherlands.PatientsBehavioural outcome was assessed in 417 TTTS survivors, at the age of 2 years.InterventionsParents completed the Child Behavior Checklist for their twins. Antenatal, neonatal and follow-up data including Bayley III and a neurological exam were recorded from the medical database.Main outcome measuresThe incidence of and risk factors for behavioural problems.Results332 twin pregnancies (664 fetuses) were treated with fetoscopic laser for TTTS between 2008 and 2015. For 517 children eligible for follow-up, 417 (81%) Child Behavior Checklist questionnaires were completed. The study group was born at a mean gestational age of 32.8 weeks±3.2. Total behavioural problems within the borderline to clinical range were reported in 8% (95% CI 5.9 to 11.2) of survivors, compared with 10% in the general Dutch population (p=0.12). No difference between donors and recipients was detected (p=0.84). Internalising and externalising problems were reported in 9.4% (95% CI 6.9 to 12.6) and 11.5% (95% CI 8.8 to 15.0), respectively. Severe neurodevelopmental impairment was more frequent in the children with behavioural problems. High maternal educational level was associated with lower behavioural problem scores.ConclusionParents of twins treated with fetoscopic laser therapy for TTTS do not report more behavioural problems compared with general population norms. More behavioural problems are reported in children with severe neurodevelopmental impairment.

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Assessing emotional and behavioural problems with the Child Behavior Checklist: Exploring the relevance of adjusting the norms for the Flemish community

PsycEXTRA Dataset ◽

10.1037/e578442014-121 ◽

2011 ◽

Cited By ~ 1

Author(s):

Mark Schittekatte ◽

Caroline Braet ◽

Justine Callens ◽

Veerle Soyez ◽

Celina Druart ◽

...

Keyword(s):

Child Behavior ◽

Child Behavior Checklist ◽

Behavioural Problems ◽

Emotional And Behavioural Problems ◽

Flemish Community

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Abstract W P21: Should We Perform Thrombectomy In Patients With Wake-up Strokes? A Case Series Using Ct Perfusion For Patient Selection

Stroke ◽

10.1161/str.46.suppl_1.wp21 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Gabriel Vidal ◽

James Milburn ◽

Garrett Bennett ◽

Vivek Sabharwal ◽

Mustafa Al Hasan

Keyword(s):

Risk Factors ◽

Ct Perfusion ◽

Medical Center ◽

Case Series ◽

Stroke Severity ◽

Vessel Occlusion ◽

Single Center Experience ◽

Aspiration Technique ◽

Group 2

Background and objectives: Approximately 25% of patients who present with acute ischemic stroke are wake-up strokes. These patients are often not treated with IV thrombolytics because of unclear onset of symptoms. Little data exists on endovascular therapy as acute treatment for this population, particularly with an aspiration technique. The objective of this study is to compare outcomes of patients who presented with wake-up strokes due to large vessel occlusion treated with neuroendovascular procedures versus those who received conservative treatment, based on a 2-year (2012-2013), single center experience at Ochsner Medical Center in New Orleans, LA. Method: 24 consecutive patients, who presented with wake-up strokes, were outside the IV tPA window, and had both CTA confirmed intracranial LVO and CT-perfusion data upon arrival to our institution were retrospectively studied. Patients with hemorrhages, tandem lesions, or high-grade carotid stenosis were excluded from this analysis. Decision to perform endovascular treatment was made by the vascular neurologist and neuro-interventionalist based on stroke severity and CTA/perfusion data. Patients in group 1 (n = 8) underwent endovascular revascularization procedures; patients in group 2 (n = 16) were treated conservatively (medical management alone). Presentation NIHSS, risk factors, mortality, discharge NIHSS, discharge mRS, and follow up mRS were compared. Results: There were no statistical differences in patient population regarding age, gender, and risk factors. There was no statistical difference in their initial NIHSS (16.8 vs. 21.8, p=0.05162), or mortality (0% vs 21%, pr=0.262). The two groups were statistically different in their discharge NIHSS (7.25 vs 21.81, p<0.00045), discharge mRS (2 vs 5, p<0.00001), clinic follow up mRS (1.37 vs 4.94, p<0.00001), and good outcome at discharge (mRS 0-2)(75% vs 0%, pr<0.0002). Conclusion: Patients with wake-up strokes, LVO, and favorable CT-perfusion data who underwent neuroendovascular reperfusion treatment had significantly better outcomes in our population, despite similar stroke severity at presentation. This suggests that with careful selection, neuroendovascular therapy for wake-up strokes may lead to improved outcomes.

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Prevention of Infections Associated With Permanent Cardiac Antiarrhythmic Devices by Implementation of a Comprehensive Infection Control Program

Infection Control and Hospital Epidemiology ◽

10.1086/502428 ◽

2004 ◽

Vol 25 (6) ◽

pp. 492-497 ◽

Cited By ~ 20

Author(s):

Abraham Borer ◽

Jacob Gilad ◽

Eytan Hyam ◽

Francisc Schlaeffer ◽

Pnina Schlaeffer ◽

...

Keyword(s):

Risk Factors ◽

Infection Control ◽

Medical Center ◽

Tertiary Care ◽

Pacemaker Implantation ◽

Relative Weight ◽

Control Program ◽

Cardiac Device ◽

Infection Control Program

AbstractObjective:To implement a comprehensive infection control (IC) program for prevention of cardiac device-associated infections (CDIs).Design:Prospective before-after trial with 2 years of follow-up.Setting:A tertiary-care, university-affiliated medical center.Patients:A consecutive sample of all adults undergoing cardiac device implantation between 1997 and 2002.Intervention:An IC program was implemented during late 2001 and included staff education, preoperative modification of patient risk factors, intraoperative control of strict aseptic technique, surgical scrubbing and attire, control of environmental risk factors, optimization of antibiotic prophylaxis, postoperative wound care, and active surveillance. The clinical endpoint was CDI rates.Results:Between 1997 and 2000, there were 7 CDIs among 725 procedures (mean annual CDI incidence, 1%). During the first 9 months of 2001, there were 7 CDIs among 167 procedures (4.2%; P = .007): CDIs increased from 7 among 576 to 3 among 124 following pacemaker implantation (P = .39) and from 0 among 149 to 4 among 43 following cardioverter-defibrillator implantation (P = .002). Of the 14 CDIs, 5 involved superficial wounds, 7 involved deep wounds, and 2 involved endocarditis. Following intervention, there were no cases of CDI among 316 procedures during 24 months of follow-up (4.2% reduction; P = .0005).Conclusions:We observed a high CDI rate associated with substantial morbidity. IC measures had an impact on CDI. Although the relative weight of each measure in the prevention of CDI remains unknown, our results suggest that implementation of a comprehensive IC program is feasible and efficacious in this setting.

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Behavioural problems and psychiatric symptoms in 5?13 year-old Swedish children?a comparison of parent ratings on the FTF (Five to Fifteen) with the ratings on CBCL (Child Behavior Checklist)

European Child & Adolescent Psychiatry ◽

10.1007/s00787-004-3003-1 ◽

2004 ◽

Vol 13 (S3) ◽

pp. iii14-iii22 ◽

Cited By ~ 11

Author(s):

G. Bohlin ◽

L.-O. Janols

Keyword(s):

Child Behavior ◽

Child Behavior Checklist ◽

Psychiatric Symptoms ◽

Behavioural Problems ◽

Parent Ratings ◽

Old Swedish

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Risk factors for construct/implant related complications following primary posterior hemivertebra resection: Study on 116 cases with more than 2 years’ follow-up in one medical center

BMC Musculoskeletal Disorders ◽

10.1186/s12891-016-1229-y ◽

2016 ◽

Vol 17 (1) ◽

Cited By ~ 7

Author(s):

Jianwei Guo ◽

Jianguo Zhang ◽

Shengru Wang ◽

Hai Wang ◽

Yanbin Zhang ◽

...

Keyword(s):

Risk Factors ◽

Medical Center ◽

Hemivertebra Resection

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Risk factors for Lassa fever infection among survivors at the Federal Medical Center, Owo, Ondo State, Nigeria

International Journal of One Health ◽

10.14202/ijoh.2021.128-134 ◽

2021 ◽

Vol 7 (1) ◽

pp. 128-134

Author(s):

Olayinka Stephen Ilesanmi ◽

Oluwatosin Temitope Owoeye-Lawal ◽

Adewale Johnson Aro ◽

Aanuoluwapo Adeyimika Afolabi ◽

Adesola Olawumi Kareem ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Medical Center ◽

Public Information ◽

Lassa Fever ◽

Sources Of Information ◽

Cross Sectional ◽

Preventive Practices ◽

Ondo State

Background and Aim: There is insufficient information about the successfully managed Lassa fever (LF) patients in Nigeria. This study aimed to utilize the One Health approach to identify the risk factors for LF infection among LF patients who were managed and on follow-up at the Federal Medical Center, Owo, Ondo State, Nigeria. Materials and Methods: A cross-sectional study was done on 101 LF survivors who were managed and on follow-up at the Federal Medical Center. The data were collected using a semi-structured interviewer-administered questionnaire. The respondents were assessed for symptoms and factors that might have predisposed them to LF, and the data were analyzed with SPSS version 23 (IBM Corp., NY, USA). Those who had more than 3 identifiable risks were categorized as high risk. Descriptive statistics were done, and the association between sociodemographic characteristics and high risk was explored using Chi-square test. Results: The median age of the respondents was 33 years (8-85 years); 62 (61.4%) were male, and 93 (92.1%) have heard of LF before diagnosis. The perceived cause of LF infection among the respondents included the consumption of food contaminated by rats' feces among 57 (56.4%) persons, while 16 (15.8) attributed their infection to contact with LF-infected persons. Among the respondents with primary education and below, 5 (29.4%) were at higher risk for LF infection compared to 7 (8.3%) with secondary education and above (p=0.014). Conclusion: The mass media and other sources of information should be well-harnessed in the communication of risks and preventive practices for LF. Public information campaigns should be organized to discourage bush burning in affected communities.

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Methicillin-ResistantStaphylococcus AureusCarriage Among Patients After Hospital Discharge

Infection Control and Hospital Epidemiology ◽

10.1086/502592 ◽

2005 ◽

Vol 26 (7) ◽

pp. 629-633 ◽

Cited By ~ 31

Author(s):

Menno R. Vriens ◽

Hetty E. M. Blok ◽

Ada C. M. Gigengack-Baars ◽

Ellen M. Mascini ◽

Chris van der Werken ◽

...

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Hospital Discharge ◽

Medical Center ◽

Eradication Therapy ◽

Infect Control Hosp ◽

The University ◽

Mrsa Colonization

AbstractBackground and Objective:At the University Medical Center Utrecht (UMCU), follow-up implies an inventory of risk factors and screening for MRSA colonization among all MRSA-positive patients for at least 6 months. If risk factors or positive cultures persist or re-emerge, longer follow-up is indicated and isolation at readmission. This study investigated how long MRSA-positive patients remained colonized after hospital discharge and which risk factors were important. Furthermore, the results of eradication therapy were evaluated.Design:All patients who were positive for MRSA at the UMCU between January 1991 and January 2001 were analyzed regarding carriage state, presence of risk factors for prolonged carriage ofStaphylococcus aureus, and eradication treatment.Results:A total of 135 patients were included in the study. The median follow-up time was 1.2 years. Eighteen percent of the patients were dismissed from follow-up 1 year after discharge. Only 5 patients were dismissed after 6 months. Among patients with no risk factors, eradication treatment was effective for 95% within 1 year. Among patients with persistent risk factors, treatment was effective for 89% within 2 years.Conclusions:Based on these findings, eradication therapy should be prescribed for all MRSA carriers, independent of the presence of risk factors. MRSA-positive patients should be evaluated for 6 months for the presence of risk factors and MRSA carriage. Screening for risk factors is important because intermittent MRSA carriage was found in a significant number of our patients. Patients with negative MRSA cultures and without risk factors for 12 months can be safely dismissed from follow-up. (Infect Control Hosp Epidemiol 2005;26:629-633)

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