scholarly journals Functional outcome of patients with unstable pelvic ring fracture

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668432 ◽  
Author(s):  
Yasuo Kokubo ◽  
Hisashi Oki ◽  
Daisuke Sugita ◽  
Kenichi Takeno ◽  
Tsuyoshi Miyazaki ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Lower Extremity ◽  
Functional Outcome ◽  
Pelvic Ring ◽  
Nerve Damage ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome

The purpose of this study was to evaluate factors that correlated with unsatisfactory short- and long-term outcome in patients who sustained unstable pelvic ring fracture. The study subjects of this study were those of type B and C pelvic ring fractures (82 patients; mean age 54 years). Age, gender, associated injuries, fracture type, Injury Severity Score rating and treatment methods were assessed, and Majeed score for functional outcome and radiographic studies at 1 year after injury (short-term) and at final follow-up (long-term), with mean follow-up of 98 months were analyzed. Significant univariate factors ( p < 0.05) were entered in a multivariate logistic regression model to determine the independent predictors of unsatisfactory functional outcome. Univariate analysis showed that fractures of the lower extremity, nerve damage, conservative treatment, and radiological outcome correlated with unsatisfactory short-term functional outcome, while female gender, brain injury, nerve damage, conservative treatment, fracture location at the posterior portion of pelvic ring, radiological outcome, and pure sacroiliac dislocation only for type C fracture correlated with unsatisfactory long-term outcome. Multiple logistic regression analysis identified fractures of the lower extremity (odds ratio (OR): 5.364), conservative treatment (OR: 13.690), and nerve damage (OR: 21.392) as determinants of unsatisfactory short-term functional outcome and nerve damage (OR: 66.926) and poor radiological results (OR: 33.944) as determinant of long-term functional outcome. In patients with unstable pelvic ring injury, fractures of the lower extremity, conservative therapy, and nerve damage influenced short-term functional outcome, while that nerve damage and the pelvic ring displacement over 20 mm negatively affected long-term outcome.

scholarly journals Comparative short-term and long-term outcomes between internal and external intestinal plication in the management of small bowel obstruction

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Song Liu ◽  
Qiongyuan Hu ◽  
Lihua Shao ◽  
Xiaofeng Lu ◽  
Xiaofei Shen ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Gut Dysfunction ◽  
Gut Function

Abstract Background Small bowel obstruction (SBO) is common and usually requires surgical intervention. Intestinal plication is a traditional but critical strategy for SBO in certain scenarios. This study is to compare the short-term and long-term outcome between internal and external plications in the management of SBO. Methods All patients receiving intestinal plication in our hospital were retrospectively collected. Short-term outcome including postoperative complications, reoperation, postoperative ICU stay, starting day of liquid diet and postoperative hospitalization, as well as long-term outcome including recurrence of obstruction, readmission, reoperation and death were compared between groups. Gut function at annual follow-up visits was evaluated as well. Results Nine internal and 11 external candidates were recruited into each group. The major causes of plication were adhesive obstruction, abdominal cocoon, volvulus and intussusception. Lower incidence of postoperative complication (p = 0.043) and shorter postoperative hospitalization (p = 0.049) was observed in internal group. One patient receiving external plication died from anastomosis leakage. During the 5-year follow-up period, the readmission rate was low in both groups (22.2 % vs. 9.1 %), and none of patients required reoperation or deceased. None of patients exhibited gut dysfunction, and all patients restored normal gut function after 4 years. Patients in external group demonstrated accelerated recovery of gut function after surgery. Conclusions This study compares short-term and long-term outcome of patients receiving internal or external intestinal plication. We suggest a conservative attitude toward external plication strategy. Surgical indication for intestinal plication is critical and awaits future investigations.

scholarly journals Long-Term Outcome after Successful Lower Extremity Free Flap Salvage

2018 ◽  
Vol 35 (04) ◽  
pp. 263-269 ◽  
Author(s):  
Amir Bigdeli ◽  
Emre Gazyakan ◽  
Volker Schmidt ◽  
Christoph Bauer ◽  
Günter Germann ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Free Flap ◽  
Free Flaps ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Component Score ◽  
Sf 36 ◽  
The Mean

Background Vascular occlusion after free flap surgery has become a rare complication but still poses a major challenge. It necessitates urgent re-exploration, but the logistic challenge to provide sufficient resources for the emergency intervention remains. The aim of this study was to analyze the long-term outcome after successful lower extremity free flap salvage. Methods A single-center retrospective study including long-term follow-up was approved by the local ethics committee. From January 1999 to December 2010, a total of 581 free flaps were performed for lower extremity reconstruction. Eighty-six flaps required emergency re-exploration, of which 65 could be salvaged. Fifteen salvaged flaps were excluded from the study because of secondary amputation. Of 50 patients, 29 (6 females and 23 males) were eligible for follow-up. The mean follow-up time was 54.5 ± 32.9 months. Health-related quality of life (Short Form 36 [SF-36]) and scar quality (Vancouver Scar Scale [VSS]) were analyzed. Results The overall flap survival rate was 94.7% and the total loss rate was 5.3%. The re-exploration rate was 14.8% (86 of 581 flaps). The salvage rate was 75.6% (65 of 86 flaps). Twenty-one free flaps were totally lost (24.4%). Partial flap loss occurred in 12 cases (14.0%); 67.5% of the vascular complications occurred during the first 24 hours, 20.9% between 24 and 72 hours, and 11.6% after more than 72 hours. The mean time from the first signs of impaired flap perfusion to re-exploration was 1.3 ± 0.4 hours, and from free tissue transfer to re-exploration was 16.2 ± 1.9 hours. The overall scar appearance was good with an average VSS score of 4.0 points. The average SF-36 physical component score was 54.4 ± 5.4 and the mental component score was 63.1 ± 10.7. Conclusion Careful monitoring and the opportunity for urgent re-exploration are the key to success for free flaps salvage. Following these principles, an acceptable long-term outcome can be achieved.

scholarly journals Clinical Characteristics and Long-Term Outcome of Headaches Associated With Moyamoya Disease in the Chinese Population—A Cohort Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Bin Gao ◽  
Kaijiang Kang ◽  
Jia Zhang ◽  
Dong Zhang ◽  
Xingquan Zhao
Keyword(s):  
Conservative Treatment ◽  
Moyamoya Disease ◽  
Chinese Population ◽  
Chinese Patients ◽  
Surgical Revascularization ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up

Background: Headache associated with Moyamoya disease (HAMD) in the Chinese population is not well-described. The long-term outcome of surgical revascularization and natural course of HAMD has not been disclosed either.Methods: A headache screening questionnaire in China based on the ICHD2 and a face-to-face interview performed by an experienced neurologist were used to investigate headache characteristics and frequency and pain intensity in the 3 months before admission, and a telephone interview was used for the follow-up of a large cohort of 119 Chinese patients with HAMD.Results: Headache intensity was rated as scores of 5.9 ± 2.0 on a visual analog scale (VAS), ranging from 0 to 10, in the 3 months before admission. Forty-six patients (38.6%) were categorized as having migraine-like headaches, 29 patients (24.3%) were categorized as having tension type-like headaches, and 44 patients (36.9%) had a combination of both. The majority of patients had migraine-like headaches (n = 34, 73.9%) with a migrainous aura. Both the frequency and intensity of the headache improved significantly in patients treated with surgical revascularization (n = 96, 80.7%) or the conservative treatment (n = 23, 19.3%) in a long-term follow-up.Conclusion: HAMD frequently presented with a migraine-like headache (75.5% in total). A tension type headache was present in 60.9% of patients. The symptom of dizziness is common in patients with HAMD (60.5%), and 19 of them (26.4%) met the diagnose of vestibular migraine. Both intensity and frequency of HAMD show a trend of spontaneous remission in a long-term follow-up, and there is no difference in long-term outcomes of HAMD between surgical revascularization and conservative treatment, which indicates that the effect of bypass intervention on HAMD may be a placebo effect.

Natural history of longitudinally extensive transverse myelitis in 35 Hispanic patients with systemic lupus erythematosus: good short-term functional outcome and paradoxical increase in long-term mortality

Lupus ◽  
2018 ◽  
Vol 27 (8) ◽  
pp. 1279-1286 ◽  
Author(s):  
F D Flores-Silva ◽  
O Longoria-Lozano ◽  
D Aguirre-Villarreal ◽  
H Sentíes-Madrid ◽  
F Vega-Boada ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Functional Outcome ◽  
Lupus Erythematosus ◽  
Transverse Myelitis ◽  
Systemic Lupus ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome

Background and objective Acute transverse myelitis (TM) is an infrequent neurological complication of systemic lupus erythematosus (SLE). Short-term outcome varies widely between cohorts. Little is known about the epidemiology and long-term functional outcome of TM associated to SLE. Methods Patients with SLE and acute TM were identified during hospital admission, visits to the Emergency Room or the Neurology Outpatient Clinic. We evaluated ambispectively those patients with SLE presenting with clinical myelopathy and corroborated with spinal MRI. Cases were divided as partial (non-paralyzing) or complete (paralyzing). We determined long-term functional outcome as well as mortality in those patients with follow-up periods of at least five years. Results We identified 35 patients (partial, n = 15; complete, n = 20) in which complete clinical and imaging data were available (26 with follow-up ≥ 5 years). Patients with complete TM were significantly older than those with partial forms. Positive antiphospholipid antibodies were observed in 80% of patients, suggesting a possible mechanistical role. Surprisingly, functional recovery at one year was in general good; however, we observed a five-year mortality of 31% because of sepsis (in 10 cases) or pulmonary embolism (in one case). Conclusions Short-term outcome of SLE-related TM is generally good, and recurrence rate is low. However, we observed a long-term fatality rate of 31% for reasons unrelated to TM, suggesting that TM is a manifestation of severe immune dysregulation and a predictor of severity and mortality in patients with SLE.

Long-term Outcome of the Cases Classified as Successes Based on Short-term Follow-up in Endodontic Microsurgery

2012 ◽  
Vol 38 (9) ◽  
pp. 1192-1196 ◽  
Author(s):  
Minju Song ◽  
Woncho Chung ◽  
Seung-Jong Lee ◽  
Euiseong Kim
Keyword(s):  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Endodontic Microsurgery

scholarly journals Evaluation of functional outcomes of vertebrobasilar infarction depending on the aff ected intracranial vascular territory of the posterior circulation

2019 ◽  
Vol 27 (3) ◽  
pp. 26-33
Author(s):  
Mariia Prokopiv
Keyword(s):  
Statistical Analysis ◽  
Functional Outcome ◽  
Functional Outcomes ◽  
Posterior Circulation ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Thalamic Infarction ◽  
Vertebrobasilar Infarction

The aim of the work is to examine the features of recovery of lost neurological functions and the quali ty of life of patients with acute vertebrobasilar infarction, to evaluate and compare the short-term and long-term outcome of a stroke depending on the aff ected intracranial anatomical areas of the posterior circulation basin. 120 patients with acute vertebrobasilar infarction were examined, among them 22 (18.3 %) patients had a cerebral infarction, 38 (31.7 %) — pontine infarction, 13 (10.8 %) — midbrain infarction, 22 (18.3 %) — thalamic infarction and 25 (20.8 %) patients — cerebellar infarction. Strokes were distributed into three intracranial anatomical territories of the posterior circular basin: proximal, medial, distal. The diagnosis was established on the basis of data from the neurological clinic and magnetic resonance imaging in standard and DV modes. Clinical and neurological comparisons and a comparative statistical analysis of the functional outcomes of infarctions on the 21st and 90th day of a prospective observation. Despite the fact that there is no clear functional boundary between the proximal, medial and distal intracranial anatomical territories of the posterior circulation basin, which once again confi rms their functional unity, the potential for resuming lost neurological functions, a short-term and long-term outcome after infarction of diff erent anatomical and topographic areas of posterior circulation basin do not always match. Statistical analysis pointed that the short-term and long-term functional outcome after a infarction in diff erent intracranial vascular territories of the posterior circulation basin had certain features of the evolution of functional and neurological recovery. In particular, cerebellar infarctions had a signifi cantly better functional outcome compared to infarctions of the medulla oblongata in the short and long term perspective and midbrain infarctions — on the 90th day of the prospective observation (p <0.05). Paired comparisons of functional consequences between cere bellar, pontine and thalamic infarction did not reveal a statistically signifi cant (p > 0.05) correlation between factorial and eff ective signs during short-term and longterm follow-up.

Influences of Treatment on Long-term Outcome

2016 ◽  
Author(s):  
Lily Hechtman
Keyword(s):  
Psychosocial Treatment ◽  
Adult Outcomes ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Psychosocial Treatments ◽  
Marked Decline ◽  
New Challenges

Medication and/or psychosocial treatment in childhood do not appear to have an impact on adult outcomes of individuals with ADHD. There is, however, a marked decline in medication adherence in adolescence, which continues into adulthood, with less than 10% of adults with ADHD continuing to use medication. Moreover, psychosocial treatments too often do not continue to be used or adapted to new challenges. Thus, it is difficult to conclude what impact medication and/or psychosocial treatments would have on adult outcomes should these treatments be adhered to and applied continuously. As it stands, the lack of impact from treatments in childhood suggests that ADHD is a chronic condition, and that ongoing regular follow-up may be needed to offer patients interventions (medication and psychosocial treatment) that they require both to improve their symptoms in the short-term and promote more positive long-term outcome.

scholarly journals Review and Long-Term Outcomes of Cruciate Ligament Reconstruction versus Conservative Treatment in Siblings with Congenital Anterior Cruciate Ligament Aplasia

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Diego Davanzo ◽  
Paolo Fornaciari ◽  
Geoffroy Barbier ◽  
Mauro Maniglio ◽  
Daniel Petek
Keyword(s):  
Anterior Cruciate Ligament ◽  
Conservative Treatment ◽  
Cruciate Ligament ◽  
Patient Counseling ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Anterior Cruciate

There is no consensus on the best treatment for anterior cruciate ligament hypoplasia or aplasia. To our knowledge, no comparative study between operative and conservative treatment of this condition has ever been performed. Conservative treatment is a viable alternative to surgery for ACL aplasia. Two siblings were examined at our outpatient clinic. The male patient underwent bilateral ACL reconstruction, while his sister was treated conservatively. Our results show a worse long-term outcome for the operative patient. At her last follow-up, the female patient treated conservatively showed subjective improvement in stability and gait. A review of the literature shows inconsistent outcomes after reconstruction in contrast to reports with cruciate ligament agenesis that did not undergo reconstruction with acceptable to good outcomes. Cruciate reconstruction should be reserved for cases of impaired articular instability, objectively manifest in the frequency of giving-way episodes. Treatment depends on the patient’s condition and expectations. Surgery should therefore only be suggested after proper patient counseling.

scholarly journals Long-term outcome following lateral foraminotomy as treatment for canine degenerative lumbosacral stenosis

2018 ◽  
Vol 183 (11) ◽  
pp. 352-352 ◽  
Author(s):  
Sergio Andrade Gomes ◽  
Mark Lowrie ◽  
Mike Targett
Keyword(s):  
Clinical Signs ◽  
Effective Procedure ◽  
Foraminal Stenosis ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Dorsal Laminectomy ◽  
Clinical Records

Lateral foraminotomy has been described as an effective surgical treatment for foraminal stenosis in the treatment of degenerative lumbosacral stenosis (DLSS) in dogs. Clinical records were reviewed from 45 dogs which had undergone lateral foraminotomy at the lumbosacral junction either alone or in combination with decompressive midline dorsal laminectomy. Short-term outcome at six weeks was assessed by the surgeon to be good (11.1 per cent) or excellent (88.9 per cent) in all 45 cases. Long-term outcome beyond six months for lumbosacral syndrome was assessed by the owner as excellent in all 34 cases for which follow-up was available despite recurrence in five cases. Recurrence of clinical signs was not related to re-establishment of foraminal compression at the surgical site when assessed on repeat MRI and was managed by either contralateral foraminotomy in one case or conservative management with excellent response. This study confirms lateral foraminotomy as an effective procedure in the management of DLSS-affected dogs suffering from foraminal stenosis and demonstrates that initial good short-term results are maintained long term despite some treatable recurrences. Lateral foraminotomy is an effective procedure when used appropriately in DLSS with foraminal stenosis either alone or in combination with midline dorsal laminectomy.

Evaluation of the neurobehavioral functioning of patients before, during, and after bone marrow transplantation.

1994 ◽  
Vol 12 (4) ◽  
pp. 820-826 ◽  
Author(s):  
C A Meyers ◽  
M Weitzner ◽  
K Byrne ◽  
A Valentine ◽  
R E Champlin ◽  
...  
Keyword(s):  
Social Support ◽  
Bone Marrow ◽  
Cognitive Functioning ◽  
Short Term Memory ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Term Memory

PURPOSE To evaluate the cognitive and emotional functioning of patients undergoing bone marrow transplantation (BMT) in the protected environment (PE). PATIENTS AND METHODS Patients were given tests of cognition and mood before their hospitalization in the PE, after 2 weeks, at discharge, and at 8 months post-BMT. Locus of control, degree of social support, previous biotherapy, and on-treatment psychiatric consultation were also analyzed. RESULTS Before BMT, 20% of patients had mild cognitive dysfunction, and nearly 40% had significant anxiety. Although few patients developed problems with cognition or mood during the study, short-term memory deficits nearly doubled at follow-up compared with baseline. Anxiety decreased significantly during hospitalization and remained low at follow-up. In contrast, depression increased throughout hospitalization, but decreased at follow-up. Pre-BMT emotional status and cognitive functioning were highly related to long-term outcome. Type of BMT, locus of control, and degree of social support were related to psychologic distress and cognitive functioning, both during and after BMT. Patient age was not a predictor of neurobehavioral symptoms during or after BMT. CONCLUSION Pretransplant emotional and cognitive functioning are important determinants of long-term outcome and quality of life (QOL) in BMT patients. In addition, a few patients undergoing BMT develop short-term memory difficulties and mood disturbance that may persist. Pretransplant identification of patients at risk for neurobehavioral difficulties may guide early interventions during hospitalization. Posttransplant assessment may then be used to develop rehabilitation programs and other interventions for individuals with persisting complaints.

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