scholarly journals Prevention of Vascular Dysfunction after Preeclampsia: A Potential Long-Term Outcome Measure and an Emerging Goal for Treatment

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Merzaka Lazdam ◽  
Esther F. Davis ◽  
Adam J. Lewandowski ◽  
Stephanie A. Worton ◽  
Yvonne Kenworthy ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Molecular Mechanisms ◽  
Outcome Measure ◽  
Vascular Dysfunction ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Insight Into

Preeclampsia is increasingly being recognised as more than an isolated disease of pregnancy. In particular, preeclampsia has emerged as an independent risk factor for maternal cardiovascular disease and has recently been recognised as a risk factor for cardiovascular disease in children exposed in utero. Preeclampsia and cardiovascular disease may share important pathophysiological and molecular mechanisms and further investigation into these is likely to offer insight into the origins of both conditions. This paper considers the links between cardiovascular disease and preeclampsia and the implication of these findings for refinement of the management of patients whose care is complicated by preeclampsia.

scholarly journals Predictors for the Immediate and Long-Term Outcome of Avascular Surgical Procedure

2009 ◽  
Vol 98 (3) ◽  
pp. 164-168 ◽  
Author(s):  
J. Virkkunen ◽  
M. Venermo ◽  
J. Saarinen ◽  
J. Salenius
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Predictive Value ◽  
Surgical Procedure ◽  
Operative Mortality ◽  
Survival Rates ◽  
Term Outcome ◽  
Long Term Outcome

Background and Aims: The ability to predict post-operative mortality reliably will be of assistance in making decisions concerning the treatment of an individual patient. The aim of this study was to test the GAS score as a predictor of post-operative mortality in vascular surgical patients. Material and Methods: A total of 157 consecutive patients who underwent an elective vascular surgical procedure were included in the study. The Cox proportional hazards model was used in analyzing the importance of various preoperative risk factors for the postoperative outcome. ASA and GAS were tested in predicting the short and long-term outcome. On the basis of the GAS cut-off value 77, patients were selected into low-risk (GAS low: GAS < 77) and high-risk (GAS high: GAS > = 77) groups, and the examined risk factors were analyzed to determine which of them had predictive value for the prognosis. Results: None of the patients in the GAS low group died, and mortality in the GAS high group was 4.8% (p = 0.03) at 30 days' follow-up. The 12-month survival rates were 98.6% and 78.6% (p = 0.0001), respectively, with the respective 5-year survival rates of 76.7% and 44.0% (p = 0.0001). The only independent risk factor for 30-day mortality was the renal risk factor (OR 20.2). The combination of all three GAS variables(chronic renal failure, cardiac disease and cerebrovascular disease), excluding age, was associated with a 100% two-year mortality. Conclusions: Mortality is low for patients with GAS<77. For the high-risk patients (GAS> = 77), due to its low predictive value for death, GAS yields limited value in clinical practice. In cases of patients with all three risk factors (renal, cardiac and cerebrovascular), vascular surgery should be considered very carefully.

Cochlear Implant Nonuse: Insight from Deaf Adults

2020 ◽  
Vol 25 (3) ◽  
pp. 270-282
Author(s):  
Maryam Salehomoum
Keyword(s):  
Identity Development ◽  
Cochlear Implant ◽  
Accurate Information ◽  
Term Outcome ◽  
Perceptual Development ◽  
Long Term Outcome ◽  
Deaf Identity ◽  
Deaf Adults ◽  
Insight Into

Abstract Research examining the outcome of pediatric cochlear implantation consists of certain limitations, including the use of assessments that are often restricted to auditory-spoken skills, biased recruitment practices, and lack of consideration for identity development. To better understand the long-term outcome of implantation, it is vital to seek out individuals who decide to stop using their device and elicit feedback related to their decision. Thus, 11 adults, who were past cochlear implant (CI) users, were interviewed to gain insight into factors that had led to their decision regarding cochlear implant nonuse. Results indicated several variables to have played a role, but the most prominent factors were limitations in postimplant auditory perceptual development and development of a d/Deaf identity. Although cochlear implant practices and technology have improved over the past few decades, we need to recognize the continued variability in outcome to ensure the provision of the most accurate information and appropriate services.

Molecular targets of lithium action

2003 ◽  
Vol 15 (6) ◽  
pp. 316-340 ◽  
Author(s):  
B Corbella ◽  
E Vieta
Keyword(s):  
Bipolar Disorder ◽  
Molecular Mechanisms ◽  
Molecular Targets ◽  
Mood Stabilizers ◽  
Lithium Cation ◽  
Therapeutic Effects ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Brain

Lithium is an effective drug for both the treatment and prophylaxis of bipolar disorder. However, the precise mechanism of lithium action is not yet well understood. Extensive research aiming to elucidate the molecular mechanisms underlying the therapeutic effects of lithium has revealed several possible targets. The behavioral and physiological manifestations of the illness are complex and are mediated by a network of interconnected neurotransmitter pathways. Thus, lithium's ability to modulate the release of serotonin at presynaptic sites and modulate receptor-mediated supersensitivity in the brain remains a relevant line of investigation. However, it is at the molecular level that some of the most exciting advances in the understanding of the long-term therapeutic action of lithium will continue in the coming years. The lithium cation possesses the selective ability, at clinically relevant concentrations, to alter the PI second-messenger system, potentially altering the activity and dynamic regulation of receptors that are coupled to this intracellular response. Subtypes of muscarinic receptors in the limbic system may represent particularly sensitive targets in this regard. Likewise, preclinical data have shown that lithium regulates arachidonic acid and the protein kinase C signaling cascades. It also indirectly regulates a number of factors involved in cell survival pathways, including cAMP response element binding protein, brain-derived neurotrophic factor, bcl-2 and mitogen-activated protein kinases, and may thus bring about delayed long-term beneficial effects via under-appreciated neurotrophic effects. Identification of the molecular targets for lithium in the brain could lead to the elucidation of the pathophysiology of bipolar disorder and the discovery of a new generation of mood stabilizers, which in turn may lead to improvements in the long-term outcome of this devastating illness (1).

Long-term outcome and medical radiation exposure in patients hospitalized for cardiovascular disease

2015 ◽  
Vol 195 ◽  
pp. 30-36 ◽  
Author(s):  
Clara Carpeggiani ◽  
Giuseppe Rossi ◽  
Patrizia Landi ◽  
Claudio Michelassi ◽  
Marco Brambilla ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Radiation Exposure ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Medical Radiation ◽  
Medical Radiation Exposure

scholarly journals Childhood bacterial meningitis: Impact of age at illness and acute medical complications on long term outcome.

1997 ◽  
Vol 3 (2) ◽  
pp. 147-158 ◽  
Author(s):  
VICKI ANDERSDON ◽  
LYNDAL BOND ◽  
CATHY CATROPPA ◽  
KEITH GRIMWOOD ◽  
EDDIE KEIR ◽  
...  
Keyword(s):  
Risk Factor ◽  
Bacterial Meningitis ◽  
Reading Skills ◽  
Language Skills ◽  
Medical Complications ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Verbal Abilities ◽  
History Of

This study compared postmeningitic children (N = 130) with grade and sex matched controls (N = 130) selected from target children's schools on measures of intellectual, linguistic, learning, and reading skills. Results showed that children with a history of meningitis are at greater risk for impairment in these areas, with experience of the disease prior to 12 months of age being an important risk factor. Within the postmeningitic sample presence of medical complications was associated with poorer verbal abilities. Finally, a significant relationship was identified between depressed language skills and later educational difficulty, with these findings interpreted with respect to both developmental and neuropsychological principles. (JINS, 1997, 3, 147–158.)

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